Monday, February 18, 2013

Clearing Shame With RRT

By Mark Chidley, LMHC, CAP
Certified Practitioner, Rapid Resolution Therapy    
In this article, I would like to explore the dimensions of shame as it relates to problems we may encounter in practice, particularly with some persons who have suffered deep wounds of victimization, denigration, and humiliation and for whom making contact poses a major hurdle.

The Contours of Shame

Deep shame is not about making mistakes, but being mistake. Therefore, a person comes in with a sense of being defectiveinferior, and needing to hide. The compulsion to hide and get away from shame is crucial and modulates their ability to meet, as the person is on the lookout for further hurt, perhaps determined to not be seen or show up. For the shamed person, relationships are dangerous. If you are unacceptable and that becomes exposed, you could be further shamed, cast out or left. We have to recognize that deep attachment and therefore, survival fears are being activated at this point. What the old mammalian brain knows is that social rejection is tantamount to death. If you don't hide and let the threat pass over, it may cost you your life.

So clearly for some there is a far more debilitating experience underway than we might ordinarily suspect. Shame is a powerful force. It drives intention and behavior, which is to remain hidden and safe. It becomes paramount to prevent too close physical proximity to another and to thwart the discovery of unacceptable parts of or facts about the self.

The Client's Dilemma 

As we think about it, the person is in quite a bind. If they answer our questions, they risk exposure and the realization of their deepest fears. But if they go the other way and dodge or refuse our questions, they risk activating our administrative option to discontinue the meeting. They understand we are in authority, and they are challenging our protocol. They risk disobedience, our displeasure and termination of the relationship right at the outset. 

However, most counselors wouldn't end a relationship simply because of a client not answering. A deeper part of the mind doesn't think on that nuanced a level. It's in survival mode, and the intent is focused on getting the threat to stop. If I don't comply, I'm screwed. But if I do comply and disclose the unacceptable, I'll be screwed and lose the relationship anyway. Checkmate. The urge to withdraw or a paralyzed shutting down usually wins out.

As a side note about counselor questions, one can never know what will trigger shame. Loaded questions like "What did you go to prison for?" or "What led to your divorce?" or "How is your sexual intimacy?" are obviously tricky under the best of circumstances. But I've seen people shut down when asked even relatively benign questions such as: "Are you and your children in contact?" "How much school have your had?" "What is your family like?" "What do you do for work?" We may feel as if we are just doing our job in good faith with non-judgmental acceptance, warmth, and genuineness. But indeed, the very process of being questioned can feel to some folks like dental surgery without anesthesia.

Shame's Effect on Process: Incoherence

Shame is among the most negative and disruptive of feelings. It fragments and de-stabilizes our ongoing experience. Alexis Johnson writes, "At the most severe level of shame, we are afraid of any kind of self-expression because to be seen is to be seen as dirty, disgusting, worthless and unlovable."
The result in counseling is a progressive shutting down and incoherence. Johnson traces the following five steps in a sequence:
  • The first sign is a shift in eye contact. We lower our eyes and break off our gaze. We lower our heads and droop our shoulders.
  • Second, our ability to perceive reality shifts. We become unable to see or hear clearly what is going on around us.
  • Third, shame interferes with thinking, and we automatically defend ourselves in various ways. We try to get away from this noxious feeling to the extent that we cannot think, cannot problem solve, and certainly cannot be creative.
  • Fourth, shame interrupts our emotions and emotional communication, limiting intimacy and empathy. Shame can interfere with anything and everything from the joy of sex to the joy of ideas.
  • Fifth, I would add the explicit element of incoherence. The client may start a sentence two or three times, may show high ambivalence, may repeat out of context phrases or mix historical narrative with painful realizations and self-critical commentary, may shift contexts without a conversational point of reference, or use 'I dunno' excessively. The variants are endless, but the growing incoherence is telling.
Shame is a Powerful Tuning Fork

In the delicate business of forming a container for our work, we are using the self as an instrument of connection. This containing relationship must support both parties for a meeting to take place that may be transformative. Shame hits a note that shakes this delicate formation unlike any other and can quickly reverberate, like two tuning forks in close proximity. Counselors must be aware of the power of shame in the room and of their own shame issues and not be hypnotized by any of it. Often it will register with the therapist as a sense that the session is not going well. We can escalate, in that moment or afterward, our feelings of incompetence, stupidity, or not up being to the task. 

These are variants on the experience of being ashamed. I like Johnson's observation that more often our response is subtler. We do not feel a huge inner jolt, but a vague sense of being confused, uneasy, weird, helpless and so on. It is helpful to know when those words pop into consciousness that we are in the vicinity of shame. If we don't recognize we are carrying shame about the success of the relationship or perhaps other personal matters the client's story or behavior touches on, we are likely to slip into the trance of self-preservation. We may develop unhealthy polarizations like the "healthy-therapist-and-sick-patient" (p.235).  Overt or covert pathologizing is a sure signal that we've lost our way. And if we aren't aware of what's happening, we can surely become poisonous in our need to defend ourselves. I find in such moments the thing that always brings me back on track is my single-minded intention for the participant.


The implications of shame and its workings in the first sessions are many. In Rapid Resolution Therapy we are taught several ways of clearing shame. But here I simply want to hold the spotlight on how disruptive to forming the connection that shame can be. The person may not "get" your question about what they want to accomplish. They may not "get" a lot of things you are saying to them. As cognition and the emotional ability to read another breaks down and shame ramps up, you'll see a rising discomfort or a confusion about steps of the method or your statements. You'll notice the incoherence, both expressively and receptively. They may stumble with the request to form a design or not catch hold of the model because they are cognitively narrowed, overwhelmed, and intensely concerned with how far short of the model they fall, and how they'd appear, particularly if they did it "wrong." They may feel easily offended by some of our metaphors and stories, such as wolf and rabbit or references to the goat part of the brain. They may not be able to trust an induction procedure, for fear of losing control.

All of these are signs to drop back and take care of the connection. It's good to develop a repertoire of ways to get the client present, such as kidding with them, with gentle warmth and humor, to get with you or check out if you are treating each other okay. You can give them the upper hand by casting them in the role of teacher to a hypothetical younger person whose thinking is held hostage to one of the forms of stuckness or other disturbing beliefs.

At its extreme, shame can form a fork in the road. If the Rapid Resolution Therapist plows ahead through the steps of the method, he or she goes down one road and risks dragging a participant along for the ride who remains silently scared or stiffening into their habitual mindset, which ultimately doesn't let the shift occur. You risk tripping on the hoop of disagreement and your client sitting there with an internal IT'S NOT HAPPENING mindset. If the counselor takes the other fork, the session or progression of sessions may take longer, because of the need for safety. We may have to "slice it thinner," i.e., move toward tiny, provisional targets that are within the participant's bandwidth of tolerance. Or spend some time just building up experiences of successful understanding. We may have to drop back at various points and take care of the alliance and provide safety, through our humor, reassurance, uplift, and repeated demonstrations of interest and understanding.

(Alexis Johnson. Healing Shame. THE HUMANISTIC PSYCHOLOGIST, 34(3), 223-242. Copyright © 2006, Lawrence Erlbaum Associates, Inc.)

Mark A. Chidley, LMHC, CAP, a fully licensed mental health counselor and certified addictions professional, offers counseling services at his office Kelly San Carlos Executive Center in Fort Myers, Florida.He has been in private practice since 1997. He holds certifications in Rapid Trauma Resolution (2010), Imago Relationship therapy (2001), and now specializes in the treatment of couples as well as individual trauma recovery and anxiety issues. He brings rich experience from a combined 26 years of hospital work and mental health counseling.   

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