Tag Archive for: shame

Reflections On Medicine, Shame And Stigma

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As I was entering medical school, I found out that my mother had made a postpartum suicide attempt. I did not find out from her; it was shared with me in hushed tones by another family member who thought I should know, “now that I was going to be a doctor.” I was quite surprised by this information. And it made me sad to think that this wasn’t a topic she felt she could openly discuss.

Suicide is a challenging issue for all of us. Secrecy surrounds the topic, with shame as a common co-traveler. That’s why it’s an honor for me to be a small part of NAMI’s movement to make seeking help and support more acceptable. I’ve met many resilient people in the NAMI community who have overcome suicidal thoughts or actions. Often because there was a person who stood by them during a crisis or a new treatment approach that made a difference in their life. Some found sobriety for a co-occurring substance use disorder. Others found clozapine or lithium, which have been shown to reduce suicidal thinking. Some learned coping skills through a psychotherapy like cognitive behavioral therapy or dialectical behavioral therapy. Many found relief in the community of NAMI. Regardless of how, their suicidal thoughts or actions were talked about and changed.

My field sorely needs similar conversation and change. Doctors also have high rates of suicide and it’s a major issue that some of the doctors we turn to for care are often not taking care of themselves. We need to teach help-seeking behaviors in the medical and psychiatric fields. Doctors need the same support and encouragement to get help as their patients.

I lost a patient to suicide early in my psychiatric residency. This was a person with many strengths, who was also in tremendous psychological pain. I worried about him during off-hours and felt powerless to help at times. After I learned of his tragic outcome, I was upset, slept poorly and struggled at work for months. I was worried I had said the wrong thing or had failed in some way as an inexperienced psychiatrist. I seriously considered leaving the field and entering another specialty. I was lucky to receive support and empathy from my colleagues and supervisors as they encouraged me to seek therapy. I did my best to carry on, but I never forgot about this patient and his suffering.

Last year, at an American Psychiatric Association (APA) event, I was impressed that even doctors are wondering if they worry, struggle and stress too much. APA president Anita Everett reviewed the stresses that commonly consume doctors and announced that psychiatric wellness would be a core feature of her leadership. Dr. Everett’s thoughtfulness and openness on the stresses doctors face and her emphasis on help-seeking was powerful; her efforts have started many overdue conversations across the entire field of medicine. Unfortunately, the same shame that led to the secrecy around my mother’s postpartum suicide attempt is alive and well in the medical field.

Doctors don’t have all the answers for stress, mental illness and suicide—our most challenging aspects of being human. Medical culture needs to continually evolve and learn from the remarkable and resilient people like those I have met at NAMI. Facing your mental health challenges head-on and working to get help with a supportive community behind you is a key piece of NAMI culture. It’s a culture we can all learn from.

 

Ken Duckworth is medical director at NAMI.

https://www.nami.org/Blogs/NAMI-Blog/September-2018-(1)/Reflections-on-Medicine-Shame-and-Stigma

How I Healed Myself Of Shame

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I can’t remember a time when I didn’t feel shame. But I do have evidence that there was once a time when I was shame free. I have a photograph of me as a little baby, smiling with a twinkle in my eye. I look radiant and filled with joy. I have another photo of me at four years old, in which I am frowning, and I look defiant and lost. The twinkle in my eye has been replaced with a dark, empty look.

What had occurred that had taken away the joyous smile on my face and replaced it with darkness, emptiness and hatred?

The answer: shame. Shame replaced my innocence, my joy, my exuberance for life. Shame caused me to build a wall of protection and defiance. Who was I defending myself against? My mother, a woman who was so full of shame herself that she couldn’t help but project it onto me.

After being neglected and emotionally abused by my mother, sexually abused at nine and raped at twelve, I found myself riddled with shame and the belief that I was unlovable and rotten inside. I began acting out by shoplifting. I was angry at my mother, the men who had abused me and at all authority figures. I wanted to get back at everyone who had taken advantage of me. After I was finally caught and brought home in a cop car, my mother gave up on me.

Fortunately, I didn’t give up on myself. I knew there was goodness in me and I fought to find it. I turned to solitude and introspection and began to find the pieces of myself I discarded when trying to shield myself from further harm.

Here’s how I worked to heal myself and combat my feelings of shame—and how you can, too:

    1. Stop blaming yourself for the abuse. There is absolutely nothing a child can do that warrants a parent emotionally or physically abusing them, and there is absolutely nothing a child can do to cause someone to sexually abuse them. You did not cause your abuser to mistreat you.

 

    1. Give your shame back to your abusers. Parents often project their own shame onto their children, as was the case with my mother, who had me out of wedlock and felt horrible shame because of it. The following exercise will help you give your shame back to your abuser:
      • Imagine “going inside your body” to look for shame. Some see shame as a cloud of blackness. Others, as an ache in their stomach or a pain in their heart. Wherever you sense shame, imagine taking it and throwing it back at your abuser(s).

 

    1. Gain an understanding as to why you behaved as you did. Instead of viewing yourself as “bad” for acting out (if you did), begin to view your negative behaviors as attempts to cope with the abuse. The following behaviors are some of the most common coping mechanisms in former victims of childhood abuse:
      • Eating disorders: bingeing, compulsive overeating and emotional eating.
      • Self-injury: cutting, burning, head banging or any other form of self-harm.
      • Difficulties with sexual adjustment: sexualizing relationships, becoming hypersexual, avoiding sexual contact or alternating between these two extremes.

 

    1. Show self-compassion. Compassion is the antidote to shame. It acts to neutralize the poison of shame, to remove the toxins created by shame. The goal is to treat yourself in a loving, kind and supportive way. Think of a phrase to soothe and encourage yourself, look at yourself in the mirror, make eye contact and say this phrase with certainty.

 

  1. Provide yourself with forgiveness. Self-forgiveness is different from letting yourself off the hook or making excuses for negative behavior. The more shame you heal, the more clearly you’ll be able to see yourself. Instead of hardening your heart and pushing people away, you’ll become more receptive to others. It’s important to work towards forgiving yourself for: the abuse itself, the ways you hurt others because of your own abusive experiences, and the ways you have harmed yourself.

Don’t let shame take over your life. It took me many years to rid myself of the shame that followed me nearly all my life. The important thing is that you just begin to heal your shame, so it doesn’t dictate your life.

 

Beverly Engel has been a practicing psychologist for 35 years and is an internationally recognized psychotherapist and acclaimed advocate for victims of sexual, physical, and emotional abuse. She is the author of twenty-two self-help books and Raising Myself: A Memoir of Neglect, Shame, and Growing Up Too Soon. In addition to her professional work, Engel frequently lends her expertise to national television talk shows.

https://www.nami.org/Blogs/NAMI-Blog/April-2018/How-I-Healed-Myself-of-Shame