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Shame  from Gender Loving Care

By Dr. Randi Ettner

 Guilt over the "damage," or perceived damage, done to others is often expressed in therapeutic situations and thwarts realistic decision-making. In a study of 262 patients, Schaefer and Wheeler (1995) identified guilt as underlying a host of psychological problems facing the gender-variant individual. This guilt about one's condition leads to the formation of defensive maneuvers and compensatory strategies, as a means of "undoing" and atonement.

 In order to understand the profound toxicity of this gender guilt to the development of identity, it is essential to understand the emotion, or more precisely the affect, of shame. Donald Nathanson is a psychiatrist who has written extensively on the affect system, and particularly the affect of shame. Referring to Sullivan as the founder of American psychiatry, Nathanson superimposes affect, biologically wired mechanisms that are triggered in response to conditions that recur throughout life, atop the phenomenological experiences of self-in-relation-to-others, which Sullivan outlined.

 So, return to the gender-confused child, who, after age two, is capable of cognitively reflecting that parts of the self are not valued, e.g., contrary exhibitions of gender. These experiences form the "bad me." On the other hand, behaviors that elicit praise and acceptance comprise the "good me." According to Nathanson, "in the simplest possible terms, 'good me' equals pride, and 'bad me' equals shame" (1992). This linkage is not just a cognitive appraisal that certain behaviors are disapproved of, but evokes a biological assemblage of physiological sequel that is scripted into the human circuitry. The affect shame throws the organism into a painful state of inner tension. It interferes with neocortical cognition, causes the head to drop, eves to turn downward, the face to undergo vasodilatation (blush), and a brief incapacity to speak.

 But more importantly, shame has one characteristic that is unlike any other affect--it has the ability to act as an attenuator system. As the organism becomes able to assemble perceptions into patterns, and compare patterns with other patterns stored in long-term memory, mismatched patterns that appear in the midst of interest or enjoyment, reduce the positive affect that was operational a moment before:

 Shame affect is a highly painful mechanism that operates to pull the organism away from whatever might interest it or make it content. Shame is painful in direct proportion to the degree of positive affect it limits.... The specific "feel" of shame is that of an impediment to something we had wanted or enjoyed or which excited or pleased us. Although the affect is triggered initially by chance occurrence, later we learn new triggers for shame. The more information we can absorb, the more functions that can be handled by the ever-evolving brain of our species, the more these triggers for shame can be found. (Nathanson, 1992, pp. 138, 139)

 Shame can interfere with any activity. It operates to reduce not only interest-excitement, but also enjoyment-joy, the affects that make people fun, charming, and engaging. Nathanson advises psychotherapists who encounter clients who appear lacking m vitality to "look first for nearness to shame."

 Few experiences are as painful as the feeling of being deserving of rejection. Over time, the incorporation of shame affect and other affects of rejection, such as disgust, are solidified. This amalgamation of painful affect and negative self-appraisal acts as an instrument to isolate the self. Shame in such wise molds character by causing the individual to avoid contact test something be exposed and trigger shame. We have seen this system at work in the formation of the identity of the gender-variant child as he or she progresses developmentally toward preadolescence and accumulates shame-based self-perceptions.

 Thus shame ravages the self. It concerns Nathanson that so little is understood about the nature of shame and the development of psychopathology. Few therapists are aware of how deeply shame influences the entire character structure. For example:

 It seems obvious to anybody who has studied shame that the so-called "borderline illness" is little more than all exaggerated result of the interference in development to be expected when a child encounters severe impediments to positive affect while learning to be independent. "Borderlines" are shame-bound people loaded with diss-mell and self-disgust.., a large part of the time spent in therapy is devoted to meticulous reconstruction of life events made painful by shame. The importance of shame in these cases is rivaled by few clinical conditions encountered in the practice of psychotherapy. (p. 183)

 Kristen's journey is an erudite narrative of the insidious and pervasive nature of shame-based depression. Surely, gender-conflicted people do indeed rival, if not surpass, other individuals in terms of the extent of shame-damage that has affixed itself to the self, defying triumphant living.


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Last modified: 02/09/09