{"id":3399,"date":"2021-09-01T09:00:00","date_gmt":"2021-08-31T23:00:00","guid":{"rendered":"https:\/\/blog.amt.org.au\/?p=3399"},"modified":"2021-08-31T15:29:10","modified_gmt":"2021-08-31T05:29:10","slug":"taking-the-sting-out-of-shame","status":"publish","type":"post","link":"https:\/\/blog.amt.org.au\/index.php\/2021\/09\/01\/taking-the-sting-out-of-shame\/","title":{"rendered":"Taking the Sting Out of Shame"},"content":{"rendered":"\n

By Tim Clark<\/h2>\n\n\n\n

It\u2019s one of those chaotic days in between lockdowns, filled with clients trying to squeeze in a massage before the inevitable next lockdown is announced.<\/p>\n\n\n\n

I\u2019ve started to notice a pattern.<\/p>\n\n\n\n

\u201cYou\u2019ll have to excuse the COVID kilos,\u201d says one client.<\/p>\n\n\n\n

Another one says, \u201cI\u2019ve been trying to get back to the gym but I\u2019m useless. I just can\u2019t find the motivation.\u201d<\/p>\n\n\n\n

And another: \u201cI haven\u2019t been taking many breaks from the desk, so I\u2019ve turned into a hunchback.\u201d<\/p>\n\n\n\n

It seems that, for many, lockdowns are a case of more AND less.<\/p>\n\n\n\n

MORE: weight, booze, sugar, stress and time at work than usual.<\/p>\n\n\n\n

LESS: exercise, nutrition, relaxation and genuine self-care than usual.<\/p>\n\n\n\n

Of course, I can relate. I\u2019ve picked up some less-than-helpful habits during lockdown. (My baking game has improved exponentially, but those cakes don\u2019t eat themselves.)<\/p>\n\n\n\n

I can hear the guilt in some clients\u2019 words \u2013 a little voice in the background saying, \u201cI\u2019ve been naughty. I\u2019ve been lazy. I\u2019ve given in to temptation and I\u2019m going to need to put things right.\u201d<\/p>\n\n\n\n

But beneath other words lies something darker and more burdensome. It\u2019s a voice that says, \u201cI\u2019m bad. I\u2019m broken.\u201d<\/p>\n\n\n\n

Not just, \u201cI\u2019ve done the wrong thing,\u201d but, \u201cI<\/em> am<\/em> the wrong thing.\u201d<\/p>\n\n\n\n

That voice is shame.<\/p>\n\n\n\n

Guilt and shame are closely related but they have some important differences.<\/p>\n\n\n\n

Guilt brings with it some kind of opportunity to make amends. There\u2019s something that can be done to make things at least a bit more right.<\/p>\n\n\n\n

To make shame right, though, it feels like we would need to become a different person, or at least have a significant overhaul of our essence.<\/p>\n\n\n\n

For most of us who are shame-prone, the odds of that dramatic change occurring seem pretty slim, so we adapt to accommodate the shame. We find ways to make it make sense in our lives. We actively look for confirmation of our shameful selves. Every minor criticism, blemish and perceived inadequacy serves to reinforce over and over that we are not good enough and help to solidify our shame until it feels like an integral part of who we are.<\/p>\n\n\n\n

We also look for ways to mask our shame. We surrender our authenticity. We perform. We people-please. We overcompensate. We seek total control, or sometimes total escape. Anything to avoid letting other people see our shamed parts. <\/p>\n\n\n\n

It\u2019s hard to mask some things when we\u2019re on a massage table, our skin exposed, our bodies offered up for interpretation. It\u2019s hard to hide our weight, our muscle tone or our pain.  <\/p>\n\n\n\n

It\u2019s no wonder people often arrive at a massage treatment with a pre-emptive apology.<\/p>\n\n\n\n

\u201cYou\u2019ll have to excuse the COVID-kilos\u201d and \u201cI\u2019ve turned into a hunchback\u201d are exactly this: apologies.<\/p>\n\n\n\n

They might signal guilt or shame or both. They rest on the belief that I have sinned<\/em> and maybe that I am irredeemable<\/em>.<\/p>\n\n\n\n

They are also a warning. They might be the client\u2019s way of pre-empting the therapist\u2019s disgust: You\u2019re not going to like what you see.<\/em><\/p>\n\n\n\n

Or of pre-empting the therapist\u2019s criticism: I know you\u2019re going to tell me off so I\u2019m going to get in first.<\/em><\/p>\n\n\n\n

Or even: Please don\u2019t tell me off. I couldn\u2019t take it.<\/em><\/p>\n\n\n\n

They are the client\u2019s way of letting in as much guilt or shame as feels manageable. Any more and it might destroy them.<\/p>\n\n\n\n

So, what are we as massage therapists to do when our clients say these things?<\/p>\n\n\n\n

Let\u2019s take my first client\u2019s comment \u2013 \u201cYou\u2019ll have to excuse the COVID-kilos\u201d \u2013 as an example. It seems likely that many of us will hear clients say this kind of thing coming out of lockdown, and it\u2019s worth being ready for it.<\/p>\n\n\n\n

Check In With Ourselves<\/strong><\/h4>\n\n\n\n

Our first step is to be self-aware. Hopefully, we have some sense of our automatic thoughts, which could be anything from, I would never have noticed <\/em>to Yes, you\u2019ve really stacked it on.<\/em><\/p>\n\n\n\n

If we notice something like that latter reaction, it\u2019s going to be really important to acknowledge that there\u2019s something in us that attaches guilt or shame to weight gain. We might have experienced body shame ourselves. It might be worth doing some focused reflection on it now, either alone or with a trusted other, so that you know what is your stuff and what is your client\u2019s stuff when the issue comes up.<\/p>\n\n\n\n

Professional Development Reflection Suggestion:<\/strong> Reflect on your attitudes to any of these issues: weight gain, inactivity, self-care. What shaped these attitudes? Where did you learn to see things that way? Tune in to your own inner critic. Whose voice do you hear when you have self-critical thoughts? Is it your own or is it someone from your past?<\/em><\/p><\/blockquote>\n\n\n\n

Ignore?<\/strong><\/h4>\n\n\n\n

Of course, we have the option to ignore the comment altogether. Depending on our training, it might feel out of our scope of practice. Or maybe it feels like it\u2019s too soon in the relationship and we\u2019d rather wait until some more trust has built up.<\/p>\n\n\n\n

But we also need to be aware that our silence might be taken as agreement.<\/p>\n\n\n\n

Shame feeds on silence. It loves being left in the dark where no one can expose it. Shame-prone people will have no trouble interpreting your silence as confirmation that the shame should<\/em> be left where it is.<\/p>\n\n\n\n

It is an ethical dilemma for us. There may be no \u2018perfect\u2019 response.<\/p>\n\n\n\n

But as with any ethical dilemma, it\u2019s helpful to explore our options.<\/p>\n\n\n\n

Empathise?<\/strong><\/h4>\n\n\n\n

There are numerous ways we could be empathic in responding to this comment.<\/p>\n\n\n\n

\u201cAs long as you excuse mine,\u201d (or similar) is a possibility. It shows your client that you don\u2019t consider them any more wicked or shameful that you consider yourself. The catch is: maybe you consider yourself quite shameful. In which case, the shame is shared but remains fundamentally the same.<\/p>\n\n\n\n

Or how about: \u201cWell, now that lockdown is over, hopefully we can get back to our healthier ways.\u201d<\/p>\n\n\n\n

It keeps the focus on health and<\/em> manages to empathise (note: \u2018we\u2019 and \u2018our\u2019). It shows the client that they\u2019re not alone in their struggles and may plant a seed for action.<\/p>\n\n\n\n

But it also contains a barely perceptible slap on the wrist. Underneath is an assumption that we\u2019ve strayed from the path and maybe deserve to be punished for it. It might even come across that \u2018going back to healthier ways\u2019 is<\/em> the punishment.<\/p>\n\n\n\n

Do we want the client to see healthy, nurturing behaviours as a punishment, or somehow less<\/em> desirable than unhealthy ones? What if there\u2019s another lockdown and they go back to the same habits? Or if they just can\u2019t break their lockdown habits when it ends? What then?<\/p>\n\n\n\n

Clearly, empathy can be helpful but it has its limitations.<\/p>\n\n\n\n

Practical?<\/strong><\/h4>\n\n\n\n

Maybe we shift the focus to practical steps to get the client back to where they want to be.<\/p>\n\n\n\n

We could give advice or education on weight loss, but again we face scope-of-practice issues and the harsh reality that it might have little-to-no effect.<\/p>\n\n\n\n

We could try some motivational interviewing like, \u201cWhat do you think your diet\/exercise regimen will look like now that lockdown is over?\u201d which hands responsibility and autonomy back to the client.<\/p>\n\n\n\n

In doing so, we\u2019ve leap-frogged over the shame and put the focus firmly on the future.<\/p>\n\n\n\n

Wherein lies more dilemmas: would it be more important for us to help the client lose the weight or lose the shame? Which one is the more significant health risk? And which one are we better positioned to treat?<\/p>\n\n\n\n

These are particularly curly questions, and we can only really answer them for ourselves. But I will offer one final option and leave you to reach your own conclusion.<\/p>\n\n\n\n

Professional Development Reflection Suggestion:<\/strong> What’s your take on these difficult questions? What are the arguments for and against your position? What evidence would you use to back up your position?\u00a0<\/em><\/p><\/blockquote>\n\n\n\n

Validate and Reframe<\/strong><\/h4>\n\n\n\n

In certain circumstances, it might be possible to acknowledge what the client has said and suggest a new way of looking at things.<\/p>\n\n\n\n

It\u2019s not going to solve the client\u2019s shame problem, nor is it our job to do so. But in just one sentence it might suggest a new way of relating to the shame.<\/p>\n\n\n\n

It could sound something like: \u201cI can see you don\u2019t feel good about putting on the weight, but whatever you did during lockdown has gotten you here.\u201d<\/p>\n\n\n\n

This acknowledges the guilt or shame without shying away from it. It brings the guilt or shame into the light where it can at least be considered and maybe challenged. The client may not have even been aware it was there.<\/p>\n\n\n\n

Also, it acknowledges the remarkable wisdom of the human organism to adapt in adversity. The adjustments of \u2018more or less\u2019 we\u2019ve made during lockdown have felt necessary to manage the threats of a dangerous viral infection, emotional overwhelm, financial distress, isolation and social division.<\/p>\n\n\n\n

Comfort eating and\/or drinking, \u2018slacking off\u2019 and overworking were the body\u2019s way of sustaining us while we were staying home, away from the virus, staying physiologically safe and keeping others safe. They were the body\u2019s way of maintaining a degree of pleasure, connection, normality or purpose in a necessarily restrictive situation. How very clever.<\/p>\n\n\n\n

When lockdown ends and the existential threat of the virus reduces, guilt and shame may kick in adaptively. The mind and body recognise that good health and physiological safety can now be best maintained not by hiding away but by good nutrition, exercise and work-life balance.<\/p>\n\n\n\n

Any shame feelings that endure beyond that adaptive purpose are likely ingrained (or, as shame guru John Bradshaw would say, toxic) and may indicate referral for counselling or psychology.<\/p>\n\n\n\n

Professional Development Reflection Suggestion: <\/strong>Which of these ways of responding suits you best? How might you adapt Tim’s suggestions to suit you and your way of communicating?\u00a0<\/em><\/p><\/blockquote>\n\n\n\n

In Conclusion<\/h4>\n\n\n\n

Helping people with their shame is difficult for even seasoned mental health professionals. In most cases, it\u2019s the rusted-on build-up of a lifetime of beliefs that have been confirmed over and over again.<\/p>\n\n\n\n

We should expect then that it might take a whole lot of corrective experiences to scrub away the shame and reveal self-acceptance. With every massage, every word of validation and every thoughtful reframing of their experience of shame, we have an opportunity to offer our clients one of those experiences.<\/p>\n\n\n\n

About the Author<\/strong><\/h4>\n\n\n\n
\"\"<\/figure><\/div>\n\n\n\n

Tim Clark is a massage therapist and psychotherapist in private practice in Melbourne. His lockdown achievements include two enormous chocolate fudge cakes, a flourless citrus cake, a lemon yoghurt cake, two pear tea cakes, two passionfruit bundt cakes, three Dutch apple breads, one passionfruit coconut crepe cake and two apple cider doughnut cakes. \u201cThat probably sounds like I’m exaggerating but I’m not. I really have achieved that much.\u201d<\/em><\/p>\n\n\n\n

Ed: And it looks like we may have figured out how to cater for the next in-person AMT Conference.<\/p>\n","protected":false},"excerpt":{"rendered":"

A seemingly casual comment by a client hides guilt and shame. 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