Adam Blatner

I think shame should be recognized as being as toxic as lead or scaring kids with descriptions of hell. And many medical conditions have a “final common pathway,” a certain rash, headache, fever. I think shame and guilt—they overlap in many ways, although some differences might be discerned—also generate a kind of shrinkage, a somato-psychic shrinkage at a very deep level. Activities such as Sheila Rubin’s “Healing Shame” workshops are in some ways only the figurative “tip of the iceberg.” In other systems, Eric Berne, a best-selling psychiatrist and author of “Games People Play” in the mid-1960s wrote also about strokes. He said that lack of acknowledgments—strokes—figuratively “shrinks the spinal cord.” I might suggest that while not physically “shrinking” anatomical structures, emotional stresses such as shame does have some physical corollaries at a microscopic or biochemical level.

There are dynamics we don’t know about yet. For example, in mid-19th century London, vitamin deficiency diseases were common. In Dickens’ story, A Christmas Carol that little kid with the crutches, Tiny Tim, probably had severe Vitamin D deficiency, also known as rickets—although people didn’t know about vitamin deficiency diseases back then—or for that matter, vitamins.

Here’s another analogy: Many people age 60 a half-century ago had enough gum disease to justify removal of most or all teeth and replace them with false teeth. From the 1940s through the 1970s Dr. Charles C. Bass discovered the major cause of gum disease were plaques of layers of bacteria that secreted inflammatory chemicals. Bass campaigned to introduce flossing, “plaque control” and since the late 1970s that form of preventive dentistry has increasingly caught on. With flossing the problem of pyorrhea, chronic gum infection, is gradually disappearing. However, the point to note is that not knowing there was anything better, relatively “healthy” also had false teeth! How many other people who seem healthy today will be recognized as low-grade “sick” in fifty years?

Sheila Rubin’s workshops are mixtures of drama therapy, other arts therapy, human potential groups for people who are otherwise considered reasonably healthy. These workshops do more than ameliorate shame. They help relatively healthy people to thrive. And indeed, I suspect that most seemingly healthy people harbor inner “infections” of unresolved shame, and when more people join in seeking self-forgiveness and encouragement, this will become recognized as just a good thing for folks to do—like flossing teeth. It isn’t “therapy”—or it can be, but it doesn’t have to be thought of in only that fashion.

I would venture to say that like plaque control, every time we screw up even in a minor way, we experience a wounding of shame, no matter how passing. I’d suggest that that this wounding is generally not acknowledged by others, often not be oneself, and yet the emotional hardening or even counter-phobic dynamic of pathological narcissism is driven by shame.