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Monday, March 14, 2016

Psychotherapy Blog: Clients Struggling With Shame Can Leave Therapy Abruptly

In an earlier article, Healing Shame in Therapy, I addressed how feelings of shame often bring clients into therapy.  Shame is often at the core of many psychological problems, even when clients in therapy don't realize it.  The unconscious roots of shame usually go deep and can make clients feel uncomfortable in therapy.

Clients Struggling With Shame Can Leave Therapy Abruptly

In this article, I'm focusing on a particular dynamic that occurs when clients feel their shame is so unbearable that they leave therapy abruptly.

Being able to communicate about feeling uncomfortable in therapy is an important skill.  Unfortunately, it's a skill that people starting therapy don't have because they weren't encouraged to express their feelings in their families, so they never developed that skill.

Also, for many clients, feeling ashamed can feel so intolerable that they would rather leave therapy than deal with their uncomfortable feelings.  Unfortunately, it's a skill that many people starting therapy don't have because they weren't encouraged to express their feelings in their families when they were growing up, so they never developed that skill.

For many clients in therapy feeling ashamed can feel so intolerable that they would rather leave therapy abruptly  than deal with their uncomfortable feelings.

Their discomfort might be intense but, at the same time, they might not be able to identify their feelings or they might think their feelings are different emotions, so they might not identify these feelings as shame.  Rather than accepting their feelings, they might think that their therapist is causing them to feel this way rather than seeing that the feelings of shame are coming from within them rather than outside.

The following is a fictionalized example of how this can play out in therapy:

Bill came to therapy because he was feeling depressed, anxious and angry about a breakup that occurred several months before.  Even though he was the one who ended the relationship, he felt victimized, once again, by a woman who mistreated him.

Clients Struggling With Shame Can Leave Therapy Abruptly

As he talked about the relationship, he gave many examples of how the woman he was dating, Ina, was inconsiderate and hurtful from the start.  There were many "red flags" that were evident from the beginning, but Bill wanted so much to be in a relationship that he overlooked them--until he couldn't overlook them anymore.

The final straw was when he found out from his best friend, Joe, that Ina called Joe and asked him out on a date.  Bill felt deeply humiliated and told Ina that he didn't want to see her anymore.

As we talked about his history of prior relationships, the pattern was similar:  Bill chose women who mistreated him, but rather than ending these relationships when he first experienced the mistreatment, he held on until he was so hurt that he couldn't stand it anymore.

After each breakup, Bill's sense of self worth was so low that he felt that no woman was ever going to live him.  At that point, he felt hopeless about ever finding anyone that he could be happy with in a long term relationship.  He said he felt like he was unlovable (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

After discussing his family history, which included a fair amount of emotional abuse from both parents, Bill recognized that he was unconsciously repeating this pattern with the women that he was dating--he was choosing women that would be emotionally abusive (see my article: Unhealthy Relationships: Bad Luck or Poor Choices?).

When he came in for his next session, he seemed very uncomfortable.  His therapist asked him how he experienced their last session.  Looking very ill at ease, he said he wasn't happy about the last session.  Then, with increasing agitation, he said that he was offended that the therapist told him that he felt unlovable.

His therapist tried to tell him that she wasn't the one who said this--he was the one who identified feeling unlovable.  But, with increasing agitation, he interrupted her, denied that he ever said this.  At that point, the therapist attempted to help Bill to calm down, but he walked out of the therapy room abruptly.

His therapist contacted him afterwards and asked him to come to another session so that they could talk about what happened.  At first, he rejected this idea, but by the next day, he was calm enough to come in to talk.

As they talked about the last session, Bill remembered that he was the one, not his therapist, who said he felt unlovable.  As his discomfort increased around these feelings, his therapist slowed down the session so that Bill was able to stay calm, even though he was uncomfortable.

Over the course of the next few weeks, Bill realized how deeply ashamed he felt about himself and that his feelings of shame were longstanding, going back to his childhood.  From the time that he was a child, he believed that if his parents didn't care about him, there must be something very wrong with him.  He must be defective in some way.

His therapist pointed out that this is a common response that many children have when they are emotionally and/or physically abused by their parents.  Rather than thinking that their parents are abusive, they believe that there's something wrong with them because it would be too painful to believe that their parents had problems taking care of them.

Feeling unlovable feels shameful for children and this feeling often continues into adulthood, even when adult children recognize that their parents were the ones who had problems.

This is what was happening to Bill, but the emotional pain involved with feeling this shame felt unbearable to him, so his therapist slowed down the work and helped Bill to develop the emotional resources and coping skills to tolerate doing the work.  She also helped Bill to learn to express his feelings about the shame.

As Bill progressed, there were still times when he wanted to leave therapy, but he began to trust his therapist more and their sessions felt like a safe place where he could deal with his emotions.

The work wasn't easy or fast, but Bill felt, for the first time in his life, that he deserved to with a woman who loved him and treated him well.

Overcoming Shame in Therapy

As he began to date again, he no longer felt so desperate to be loved that he would tolerate being mistreated.  And, when he saw the early warning signs that he used to ignore in the past, he wouldn't continue seeing that person.

Gradually, Bill realized that shame is a common response for many people who were abused or neglected as children.  He wasn't alone.

Over time, his confidence grew.  He realized that he was a genuinely lovable person and there were people in his life who also found him to be a lovable person.  They were there all along but, in the past, Bill was focused on the people who were mistreating him.

Eventually, he entered into a healthy romantic relationship where he was able to both give and receive love.

Shame is a powerful emotion.  Shame is at the core of many psychological problems.

For many people, without help in therapy to develop the wherewithal to deal with shame, shame often feels too uncomfortable to tolerate.

Many of people unconsciously project their feelings about themselves onto their therapists and, in a state of anger, they leave therapy abruptly.

For clients who are able to allow themselves to recover emotionally enough to come back and talk to their therapist, there is a good chance that this dynamic will change over time.

Learning to recognize feelings of shame and low self worth can be challenging.  Clients need the time and space to develop an emotional tolerance to recognize that they feel ashamed of themselves and it is their own feelings about themselves.  Then, there is a possibility for healing from the shame.

Getting Help in Therapy
Shame is often poses a barrier to people either starting therapy of staying in therapy.

It's not unusual for people to leave therapy because they feel ashamed of themselves and their problems.

If you feel burdened by shame, you could benefit from seeing a licensed mental health professional who helps clients with this issue (see my article: Overcoming Shame in Therapy).

Once this burden is lifted, you can develop self confidence and live a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

I have helped many clients overcome their feelings of shame.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.

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