Home Book Reviews Understanding and Treating Chronic Shame

Understanding and Treating Chronic Shame


Written by Dr. Patricia A. DeYoung (2015)

Reviewed by Janay Anderson

Understanding and Treating Chronic Shame by Dr. Patricia A. DeYoung offers readers a deep analysis of shame, how it operates, and how the psychotherapist-patient relationship can be the primary relationship that heals shame. DeYoung defines shame as “an experience of one’s felt sense of self disintegrating in relation to a dysregulating other” (xiii). A “dysregulating other” comes from affect regulation theory: a person who doesn’t provide authentic emotional connection to someone who desires connection to them. If our caregivers continued to dysregulate or not provide for our emotional and physical needs, before long this pre-verbal shame could become chronic. DeYoung’s therapeutic technique for treating shame: building authentic relationships. Authentic relationships are “sharing emotion within ‘I-see-you-seeing-me’ intersubjective space: I will tell you what I feel because we each hear and care about how the other feels” (166). If a patient is dealing with chronic shame, he might not have any authentic relationships. That’s where the therapist comes in. The therapist can be a patient’s first authentic connection and can thus learn how to allow himself to be seen.

DeYoung does not promise that shame can be healed—she writes that only shame resilience is possible. It’s not possible to cure chronic shame because “long-term relational trauma leaves our psyches indelibly marked” (162). Shame resilience doesn’t mean shame is eliminated but transformed. Having a “sustained connection with at least one other person who is close enough to become someone who can regulate, rather than dysregulate their right brain-brain affective experience” (87) is what needs to be built into a client’s life to maintain a healthy relationship to shame.

The main critique for this short shame primer is whether or not the right-brain, left-brain language comes off as pseudoscience. The left brain/right brain split is a useful metaphor but it’s not accurate; neural networks connect across the corpus callosum more often than not. Nevertheless, DeYoung uses metaphor in a way that may be quite useful in therapy: “When we intuit that clients are torn between new trust and old expectations . . . [invite] their left-brain thought processes to step in to make the emergency safer. Sometimes our clients’ rational self can help their right brain to stay engaged in spite of fear, and to make space, with conscious awareness, for new relational experiences even while the old feelings are strong” (97).

New York, New York: Routledge
ISBN 978-1-138-83120-9
Available as Hardcover & eBook
Paperback. 190 Pages.
References and Index included.