In the therapy room, shame – which we often hide, almost at any cost – frequently hinders progress. Clients sometimes conceal aspects of their behaviour they fear are shameful, such as viewing pornography, taking class A drugs, or losing their temper.
This is because it is perhaps one of the most intense and complex feelings we experience as human beings. Unlike embarrassment or guilt, shame often goes straight to the core of who we are. It can make us feel exposed, small, or defective – as if we are unworthy of love or belonging.
We hide it, push it away, or defend against it. But as psychotherapist and author Dr Joseph Burgo argues in his mould-breaking 2018 book “Shame: Free Yourself, Find Joy, and Build True Self-Esteem”, shame is not only inevitable; it also serves an essential positive function. Understanding the good and bad faces of shame can help us work with it more consciously, rather than being imprisoned by it.
Modern neuroscience, particularly the work of Allan Schore, adds another layer of understanding. Schore shows us that shame is not just psychological but deeply biological: it emerges in the earliest attachment relationships, shaped by how infants and caregivers connect. To understand shame fully, we need to see it both as a developmental survival mechanism and as a potential source of lifelong suffering.
From an evolutionary perspective, shame is a social emotion. In early human groups, survival depended on belonging and cooperation. To be excluded from the tribe was to face near-certain death. The hot flush of shame evolved as a kind of internal alarm system, warning us when our behaviour risked rejection.
It is no accident how shame is experienced in the body: downcast eyes, flushed cheeks, slumped posture. These physical signals were ways of showing submission and appealing for re-inclusion. Shame helped regulate social life by curbing selfish impulses and motivating cooperation.
In this sense, shame is not inherently destructive. It has kept us alive as a species by binding us to one another.
The distinguished neuropsychologist Allan Schore has shown, over the past 30 years, in a pioneering series of books about the workings of the human mind, how shame arises at a very early stage of life, before language, as part of the developing attachment bond between infant and caregiver.
When a baby seeks connection — through eye contact, smiling, or reaching out — and the caregiver responds warmly, the baby’s nervous system is regulated. The infant learns that it is safe, lovable, and worthy of attention.
But when a caregiver consistently (in Schore’s language) ‘misattunes’ — looking away, showing irritation, or failing to respond — the infant experiences what Schore calls a ‘rupture in attunement’. This leads to an abrupt shift in the child’s state: the body deflates, the gaze drops, energy collapses. In other words, the infant experiences a proto-form of shame.
This early shame response is not yet cognitive. It is a bodily state of withdrawal, rooted in the developing right brain. Schore’s research highlights that:
- Shame is hardwired into the nervous system as a survival response to misattunement.
- Repeated experiences of empathic repair (when the caregiver re-engages after a rupture) teach the child that shame can be survived and soothed.
- But repeated misattunement without repair can embed toxic shame deep in the developing self, leading to lifelong vulnerabilities in self-esteem and affect regulation.
In this way, shame is not only evolutionary but developmental. It is built into the earliest interactions between parent and child, shaping how we later relate to others — and to ourselves.
The positive face of shame
Burgo, for his part, identifies four ‘faces’ of shame that, in their healthier forms, can guide us towards growth and connection. These are:
- Unrequited love – the pain of rejection teaches us about limits, boundaries, and the importance of loving reciprocity in relationships.
- Exclusion – the sting of being left out motivates us to adjust behaviour to stay connected with others.
- Unwanted exposure – the discomfort of being ‘seen’ can trigger the growth of humility and self-awareness.
- Disappointed expectation – failing to meet social goals or standards can motivate us to try harder and achieve mastery.
When shame operates in these ways, it functions almost like an inner compass. It points us towards empathy, accountability, and integrity. It helps us remain bonded to our communities and attentive to the impact we have on others.
Think of the flush of shame when you realise you’ve spoken harshly to someone you care about. That painful signal may prompt you to apologise, repair the relationship, and do better next time. Without shame, we might lose the motivation to reflect on our actions or take responsibility for their consequences.
The dark side of shame
The positive face of shame turns destructive when it becomes overwhelming, chronic, or linked to distorted beliefs about the self. Toxic shame is not about ‘what we’ve done’ but about ‘who we are’. It whispers:
‘I am defective.’
‘I am unlovable.’
‘If people really knew me, they would reject me.’
This toxic shame often originates in early experiences of neglect, rejection, criticism, or abuse. When children are repeatedly shamed without repair, they internalise the belief that their very self is flawed.
Burgo shows how toxic shame underpins many psychological difficulties:
- Depression – the inward collapse of energy and self-worth.
- Addiction – attempts to numb or escape unbearable feelings of defectiveness.
- Perfectionism – striving endlessly to counter a sense of unworthiness.
- Eating disorders – using control over the body to manage feelings of shame
In these cases, shame is no longer adaptive. It doesn’t guide us toward growth but traps us in cycles of avoidance, withdrawal, or self-punishment.
Shame in the body
One of the most striking aspects of shame is its embodied nature. It is felt physically:
- The heat rising in the cheeks.
- The desire to avert the gaze or hide.
- The collapse of posture, as if trying to shrink away.
Schore’s work shows that these reactions are part of the autonomic nervous system. They happen faster than conscious thought, rooted in right-brain processes that regulate emotion and social connection.
Because shame is so deeply embodied, it often resists purely cognitive approaches. This is why therapies that integrate imagery, experiential work, and body awareness — such as schema therapy, EMDR, or somatic approaches — can be particularly powerful in working with shame.
Working with shame in therapy
Therapy offers a unique space to explore shame, often for the first time without judgement. Some of the key tasks include:
- Naming shame – many clients don’t use the word ‘shame’ at all. They may describe feeling ‘not good enough’, ‘invisible’, or ‘like a fraud’. Helping clients put words to shame begins to loosen its grip.
- Tracing its origins – understanding where shame came from — whether in early misattunement (Schore), painful childhood experiences, or later relational traumas — helps clients see that shame is not proof of defectiveness but a learned response.
- Differentiating helpful vs harmful shame – clients learn to recognise when shame is signalling a need for repair or growth, versus when it is simply punishing the self without cause.
- Developing compassion – the antidote to toxic shame is not pride but compassion. Building an inner voice that soothes rather than attacks allows clients to comfort the vulnerable parts of themselves.
- Repairing in relationship – shame is relational in origin and relational in healing. The therapeutic relationship provides a model of attunement and repair, offering experiences of being seen and accepted even in moments of exposure.
Living beyond shame
Working with shame does not mean eliminating it. As Burgo and Schore both suggest, shame is a fundamental part of being human. The goal is to:
- Soften toxic shame, loosening its hold over our sense of self.
- Harness healthy shame, allowing it to guide us toward integrity, humility, and empathy.
- Develop resilience, learning that moments of shame can be survived, reflected upon, and repaired.
When this happens, shame becomes less of a prison and more of a teacher. We stop living in fear of exposure and start living with greater authenticity. Relationships deepen, the inner critic softens, and life feels freer, more connected, and more real.
Conclusion
Shame has two faces. One binds us together, keeps us accountable, and helps us grow. The other isolates, silences, and convinces us we are unworthy.
By understanding its evolutionary roots, its developmental origins in early attachment (as Allan Schore so powerfully describes), and its psychological impact (as Joseph Burgo outlines), we can begin to approach shame differently.
Shame is not evidence of our defectiveness. It is part of being human. And when we bring it into the open — with honesty, compassion, and support — shame can transform from a source of suffering into a guide towards healing and wholeness.
David Keighley is a BACP Accredited counsellor/psychotherapist offering short and long term therapy to individuals and couples using a variety of techniques such as EMDR, CBT and Schema Therapy. He is also a trained clinical supervisor. He is available at our Brighton & Hove Practice.
Further reading by David Keighley –
Rewiring the past: EMDR demystified
Do we need to do homework during psychotherapy?
How therapy can help with anger issues
