Complex trauma and intimate relationships: The impact of shame, guilt and dissociation

Background: This study examined dissociation, shame, guilt and intimate relationship difficulties in those with chronic and complex PTSD. Little is known about how these symptom clusters interplay within the complex PTSD constellation. Dissociation was examined as a principle organizing construct
within complex PTSD. In addition, the impact of shame, guilt and dissociation on relationship difficulties was explored.
Methods: Sixty five treatment-receiving adults attending a Northern Irish service for conflict-related trauma were assessed on measures of dissociation, state and trait shame, behavioral responses to shame, state and trait guilt, complex PTSD symptom severity and relationship difficulties.
Results: Ninety five percent (n=62) of participants scored above cut-off for complex PTSD. Those with clinical levels of dissociation (n=27) were significantly higher on complex PTSD symptom severity, state and trait shame, state guilt, withdrawal in response to shame and relationship preoccupation than subclinical dissociators (n=38). Dissociation and state and trait shame predicted complex PTSD. Fear of relationships was predicted by dissociation, complex PTSD and avoidance in response to shame, while complex PTSD predicted relationship anxiety and relationship depression.
Limitations: The study was limited to a relatively homogeneous sample of individuals with chronic and complex PTSD drawn from a single service.
Conclusions: Complex PTSD has significant consequences for intimate relationships, and dissociation makes an independent contribution to these difficulties. Dissociation also has an organizing effect on
complex PTSD symptoms.

Shame, intimacy and self-definition: An assessment of the emotional foundation and intimate relationship consequences of an introjective personality orientation.

The current study sought to elaborate and test a theoretical proposition that introjective personality functioning, which has been implicated in various psychological difficulties (e.g., self-critical depression, obsessive-compulsive disorder), has an emotional foundation in the self-conscious emotion of shame and is supported by dissociation. Moreover, introjective functioning was predicted to be associated with reduced interpersonal intimacy. To test the model, a Web-based survey design using path analysis was used. Three hundred and fifteen university students were assessed with measures of self-conscious emotions (i.e., shame, guilt, and embarrassment), introjective (self-definition) and anaclitic (relational) personality style, pathological dissociation, and interpersonal intimacy. Introjective personality was found to be associated with increased shame and reduced interpersonal intimacy. However, the path between pathological dissociation and introjective functioning was not significant. The results are discussed with reference to the moderating influence of introjective functioning between shame and reduced interpersonal intimacy.

Perceptions of therapist responses to shame disclosures by clients: A quasi-experimental investigation with non-clinical participants

Background
Therapist responses to initial shame disclosure in therapy have received little empirical attention.

Aim
This study explored different therapeutic responses to shame disclosures in terms of their perceived helpfulness. Responses ranged from complete withdrawal from the feeling (withdrawal) to completely tuning into it (non-withdrawal). Given the tendency of shame to evoke avoidance, participants higher on shame-proneness (as measured by The Experience of Shame Scale) were expected to perceive withdrawal responses to shame as more helpful than non-withdrawal responses.

Methodology
Fifty-five non-clinical participants were assessed for shame-proneness before viewing videos of mock therapy sessions showing clients either disclosing shame (two videos) or shock (control condition). Participants then rated the helpfulness of different therapist responses. The responses differed in the degree they allowed the client to withdraw from their emotions.

Results
High shame proneness was associated with rating withdrawal responses to shame as least helpful. Overall, neither the withdrawal response nor the non-withdrawal response were rated as particularly helpful. The therapeutic response which addressed management strategies when shame is initially experienced in therapy was deemed most helpful.

Conclusion
Despite the tendency to withdraw from shame feelings, this response is not deemed helpful in therapy.

Othering, blame and shame when working with people living with HIV

Significant advances in HIV treatment has meant that for the majority of patients with HIV they are able to live a normal lifespan. However, HIV remains a highly stigmatizing disease with the potential to significantly impact on ones social identity and sense of self. This paper draws on data from a qualitative study of interviews with five gay men, to explore the experiences of shame in relation to living with HIV. The paper adopts a psychoanalytic lens to highlight the mechanisms of splitting that may be involved at both a social and individual level, and the experience of shame among the participants. The paper aims to use this research data to supplement our understanding of what may be occurring ‘on the couch’ with patients who are living with HIV.

The Effects of a Social-Evaluative Body Image Threat on Shame, Social Physique Anxiety, Body Dissatisfaction and Cortisol Responses in University Men

Men struggle with body image concerns particularly related to the desire to be muscular. In women, social-evaluative body image threats have been linked to increased shame and cortisol responses, consistent with social self-preservation theory (SSPT), but no research has investigated these responses in men. Men (n = 66) were randomly assigned to either a social-evaluative threat (SET) or non-social-evaluative threat (N-SET) condition. Participants provided saliva samples and completed body shame, body dissatisfaction and social physique anxiety measures prior to and following their condition, during which anthropometric and strength measures were assessed. Results indicated men in the SET condition had higher body shame, social physique anxiety, and body dissatisfaction and had higher levels of cortisol than men in the N-SET condition post-social-evaluative threat. These findings, consistent with SSPT, suggest that social-evaluative body image threats may lead to increased body shame and social physique anxiety, greater body dissatisfaction and higher cortisol levels.

The Secret Aria on Shame : An Analysis of Narrative Structure and Theme in Coetzee's "Diary of a Bad Year"

Coetzee’s last novel Diary of a Bad Year (2007) has an intriguing triple-voiced narrative structure and deals with the grey area of shame. The narrative is divided between a writer, his written contribution to a book called “Strong Opinions”, and his secretary’s thoughts about both the opinions in the manuscript and her employer’s circumstances. This essay explores the relation between form and theme in Diary of a Bad Year; to see in what way these two fundamental elements of the novel intervene and support each other. By doing so the narrative structure is read through Freud’s structural model of personality, whereby each narrator’s voice is related to the notions of the super-ego, the ego and the id. In other words, this essay argues that the specific threefold narrative structure in Diary of a Bad Year, by reflecting the interrelated parts of human identity, helps in creating and developing the theme of shame, which only exists connected to the human psyche. This connection in turn gives special meaning to the entire narratology of the novel.

Greek Life and God Attachment: the Interaction of Sorority Influence and Religiosity on Women's Body Shame

The present study investigated the relationships between sorority women’s internalization of Greek thin ideals and body image, and dimensions of sorority women’s religiosity and body image. A combined relationship among sorority women’s internalization of Greek thin ideals, body image, and religiosity was also examined. Based on previous research it was expected that women’s internalization of Greek thin ideals would be associated with worse body image (in terms of body shame, body esteem, and drive for thinness) and that women’s religiosity (in terms of secure attachment to God) would be associated with better body image. Combinations of Greek thin ideal internalization and God attachment were expected to significantly predict changes in women’s body image. Women completed a series of survey measures assessing their awareness and internalization of Greek sociocultural thin ideals and their sense of community within their particular sorority. Women also completed a series of survey measures assessing their body shame, body esteem, and drive for thinness, in addition to survey measures assessing dimensions of their religiosity. The study’s findings revealed that women’s internalization of Greek thin ideals was associated with worse body image outcomes and that anxious attachment to God was associated with worse body image outcomes, particularly in relation to body shame. Moderation analyses revealed that Greek thin ideal internalization significantly interacted with anxious God attachment to predict body shame.