Guilt and shame are two of the most common, difficult, emotions to be dealt with in healing a majority of traumatic events. Guilt and shame are often both present in sexual abuse, childhood abuse and events that encompass death of another, eg. survivor guilt. These two emotions have been combined in this page because they are intertwined core feelings that eat away at a person, constantly provoking Posttraumatic Stress Disorder (PTSD) symptoms. They are near paramount within all cases of complex trauma, often referred to as Complex Posttraumatic Stress Disorder (CPTSD), which is not an actual diagnosis. To try and separate these two emotions would be negligent on my behalf, as one more often than not, goes with the other, as you will read.
What is Guilt and Shame?
Guilt and shame are frequently thought of as the same concept, and the terms are often used interchangeably; however, theorists have recently made a distinction between the two concepts. Both emotions involve concepts of “wrong” behavior or having done something “wrong,” either by omission or commission. They also both involve negative emotions and cognitions related to the perceived offensive behavior.
Shame is a painful emotion arising from the knowing (consciousness) of something dishonorable, improper, ridiculous, disgraceful, embarrassing, etc, done by oneself or another.  Shame is directly attributed to feeling guilty about something, hence shame and guilt intertwine. Shame consists of a negative evaluation of one’s own worth, because he or she has acted “wrongly.”  Shame is conceptualized as including feelings of disgrace, disrepute, dishonor, loss of self-esteem, loss of virtue, and loss of personal integrity.
Guilt is the fact of being responsible for the commission of an offense.  Guilt is composed of negative emotions related to wrongdoings or perceived failures to act appropriately.  Guilt includes feelings of sorrow, repentance, and disappointment in one’s actions. Guilt is both a cognitive and an emotional experience, that occurs when a person realizes that he or she has violated a moral standard and is responsible for that violation. A guilty conscience results from thoughts that we have not lived up to our ideal self. 
According to the above definitions of both guilt and shame, it could be summated that, guilt is concentrated on one’s actions, while shame is directed toward one’s moral integrity and self-worth, and/or past actions and how they are perceived. In other words, a person who feels shameful may think that he or she is to blame for the immoral act and is therefore a bad person. Conversely, a person who feels guilty may believe that he or she acted wrongly and therefore feels that his or her actions were wrong, but they can still maintain a positive view of the self as a person. 
Guilt and Shame's Impact Upon PTSD Symptoms
Previous research has found that guilt and shame, although related, have differential relationships to PTSD symptoms, with shame related to higher levels of PTSD. 
Guilt and shame in trauma survivors are important emotional responses to understand for several reasons, being:
- Guilt is found in both depression and PTSD, in fact many studies have commonly found comorbidity between depression and PTSD. [5, 6, 7]
- Guilt has been found to be an important symptom cluster of PTSD among trauma survivors. 
- Guilt and shame appear to be related to overall symptom severity. 
- Shame research suggests that guilt and shame may interfere with PTSD treatment. 
As stated above, guilt intertwines directly with the feeling of shame. Shame is a near impossible emotion to try and resolve, because there is an underlying component of guilt and/or emotional cocktail. The primary resolution to shame is directly through guilt itself.
The theoretical answer to understanding guilt is extremely easy, and comprises four points to ascertain the realistic facts of a situation for use towards changing guilt cognitively, being:
I told you the theoretical answer is easy. This allows you to understand the facts based on the event itself, removing "what ifs" and "but if I only did..." such negative thinking styles, which often cloud understanding an event itself, using the events facts vs. what you have otherwise told yourself.
- Who owns what blame for the actual event?
- Remove any "pre-outcome" knowledge you had convinced yourself of knowing!
- Review the choices made under the events actual situation, not hindsight.
- Moral standards / self expectations must be gauged against the facts at the time, not hindsight.
A further problem with guilt, is that many use self-blame, which invokes guilt, in an attempt to reduce shame. Nasty little problem these two emotions, as they can directly become there own cycle of internal emotional abuse. You begin feeling guilty for being ashamed of something you or another did, which creates self-blame, further shame, more guilt and the cycle continues until you intervene within it or breakdown.
Notice how I said "you" intervene within it? You are the only person who has the capacity to change you. External influences can only assist, guide, provide you knowledge or techniques, you have to actually evoke the change to remove shame.
The above method has been encapsulated in what a member (Eat0429) replied to another, what I deem to be the perfect answer to resolving shame and guilt, being:
"The therapy and the validation of the therapist is what got me over it, as was educating myself about my trauma and being honest with my husband about what happened. I now place the blame where it belongs, and I excuse myself for the way I acted because there is no way that I can be held responsible for it.
I also know that the people who victimized me wanted me to feel ashamed because this is how they could control me. Now I let them take every bit of blame for what happened and let myself off the hook. Why should I continue to suffer for their mistakes and cruelty is how I look at it." 
In reviewing that response, you can clearly ascertain that the member shifted their guilt from them, onto who was responsible for holding it, they were honest with their partner, removing guilt encompassed within secrecy. Guilt is gone!
Guilt Cycle & PTSD
It is theorized that PTSD symptoms are maintained by guilt through a cyclic pattern; guilt-related thoughts often accompany traumatic memories and these guilty thoughts also produce a negative emotional response (e.g. distress, guilt, anger) within the individual. Through this type of conditioning, traumatic memories trigger negative emotions, and the experience of the negative affect reinforces the aversive nature of the traumatic memory. This negative cycle also tends to increase avoidance of the traumatic memory which reduces the likelihood of improvement through extinction and explains why these painful thoughts do not get better with the passage of time. [4, 12]
In other words, deal with the core problem which removes all negative emotions, which stops feeding PTSD to create symptoms, or continually suffer.
What If I Own Legitimate Guilt?
Firstly, owning legitimate guilt actually has a positive side to it. This means that you aren't a sociopath, you do have empathy, remorse and feel the correct feelings for something within your life that has gone terribly wrong.
Legitimate guilt is the most difficult type of guilt to have providing you are actually at fault, however; you cannot just assume you own guilt, you must still go through the process to ascertain what degree of blame you own, if any, and then only own that portion. Otherwise, you must assign guilt to its rightful owner.
When you own legitimate guilt, regardless the percentage, then your options do become far more limited to minimize or remove the guilt, such as:
Part of being a human being is that you will make mistakes. Some small, some large, some gigantic. You don't need forgiveness to forgive yourself, or to acknowledge your wrong doings.
- Forgiving yourself based on the realistic and factual circumstances (age, situation, etc).
- Acceptance and learning from your mistakes to change future choices.
The reason making amends was not included in that list, is that whilst it can be a positive experience, often people entangle guilt directly with making amends, and it can become counter-productive, even self-abusive.
It is theorized that the key emotions that evoke shame are, hurt, failure and helplessness, which create anger, that when encompassed create shame.  The thing with shame and abuse is that it can stem backwards to early childhood, where an abuser reinforced feeling ashamed. As stated earlier, whenever shame is present, there is guilt and/or other emotions. To try and tackle shame by itself it extremely difficult, if not impossible, due to its complexities of being so self inflicted, a part of a person.
If shame is tremendously difficult to shift by itself, then how do we reduce and/or remove shame? Well, you deal with the other emotions present that cause shame. You target guilt, hurt, failure, helplessness, disgust, etc, and by dealing with those emotions, shame lessens and/or removes.
What many traumatized persons confuse regarding shame, and even other key emotions, is mixing past feelings with present feelings. You can heal present, you can understand the past, but if you remember feeling shame in childhood, that is different to feeling shame now based on past memories. Nothing you do now will remove your memory of feeling ashamed at an earlier period in your life. It is important that a person differentiates between the two. One is memory, the other is present tense. Present tense is where focus must be applied.
You may still feel ashamed of the past, you may still carry shame with you because the past has not been dealt with, though you do not have to carry shame from past events into your future for the rest of your life. Thinking about past tense may invoke the feeling of being ashamed, memory, which is different than feeling ashamed, present tense.
Assertiveness and self-esteem behaviour techniques are the key to keeping shame in check within the future, once existing emotions have been dealt with, as most shame is associated to those with a low self-esteem and passive or aggressive personality. It is extremely unlikely you'll ever find a primarily assertive person with healthy self-esteem who carries a life-time of shame within them, because they have learnt how to deal with complex emotions and communicating with people, so they don't carry such negativity within.
Examples Of Shame & Guilt Being Processed
Due to the complexities and significance of shame and guilt within trauma, it would be unrealistic to not provide direct examples of real shame and guilt, and how the process is applied. A few key situations have been covered below:
Family Values - Shame
As adults, we learn our values based on our trusted sources, typically parents, then brothers and sisters, followed by other family / caregivers, during our upbringing. Physical abuse is not required to cause complex shame and guilt later in life, you just need screwed up family values to achieve an abuse cycle. These values are seen from poverty to extremist religious beliefs, to the richest of families through avoidance of contact.
Muzikluvr said, "SEX is Shameful. It's gross, it's bumping uglies, it's inappropriate, it's nasty, men are the only ones who like it, anyone would be ashamed to admit a man was able to put himself inside you, that's disgusting! Being raped by an ugly man, gross! Being raped by an attractive man after you said you thought he was cute... your fault. Blame. Shame. Women get married so they DON'T have to have SEX anymore. I can't even relate to you, I would never come in here talking about having sex no matter how it happened. You must be more like a boy than a girl. There's something wrong with you. Shame. Shame. Shame. I'm not meeting their standards. I'm inadequate. I'm not natural."
Family values can become quite a toxic and complex case of negative emotional core values being instilled, which are the most difficult to change, yet every behaviour can be changed. Lets look at the toxicity of negative core beliefs instilling shame from childhood:
You can quickly see how deep the underlying negative emotions have built a core perception of disgust and guilt around sex and even men outright. What would be said by a parent/guardian if gay? Even more damaging. Negative family values become core beliefs, as you have typically endured them your entire life, then in adulthood, discover that you are different to what the majority feel or think about the same beliefs. You discover your family inflicted their negative toxicity upon yourself, yet changing is easier said than done. Add that you are now a victim, and suddenly these existing core beliefs enhance negativity to the nth degree, substantially increasing such surface emotions as shame.
- Sex is shameful = I am at fault, guilty, if wanting or enjoying sex.
- It's gross = If I have sex, then I am digusting.
- It's bumping uglies = Human organs are disgusting.
- Ashamed to admit a man was able to put himself inside you - sex is disgusting, I am disgusting for being raped, I am guilty for being raped.
- Men are the only one's who like it = I am disgusting and guilty for wanting or enjoying sex.
- Being raped by an ugly man = I am guilty of being victimized.
- The list goes on and on in the above given example.
Perfectionism - Shame
A very common trait within childhood abused persons is, perfectionism. Parents abuse a child for everything and anything, depending on their mood, so the child attempts to please them, to get it right, which in itself is an impossible task to achieve for an abusee to begin with. Yet this behaviour becomes instinctive and the result is:
IntoTheLight said, "The shame comes from never being "good enough". Again, it is one thing to know it intellectually, but another to have it internalized so completely that it governs so many of my behaviors. I set impossible standards, fail to meet them, therefore I am not "good enough", feel guilty, and the cycle repeats."
Notice how "guilty" was used in the statement with shame. If you were to identify key emotions from that statement, you will find:
You can pull a paragraph apart and isolate out key emotions, which above resonates from an example provided, the key areas that require work to reduce shame is to target feelings of failure and guilt. These will no doubt uncover further key emotions which will lead back to the actual relationship itself, which when all combined, can be logically resolved and enhanced with self-esteem and assertiveness behaviour training.
- Never being good enough = I feel like a failure.
- I set impossible standards = I fail to meet them.
- I am not good enough = I feel like a failure.
- Topped off with, I feel guilty for failing to meet expectations.
Reinforced Perfectionism - Shame For Accidents
Continuing from perfectionism, this is an example of how retraumatization occurs within daily relationships, reinforcing negative core beliefs (perfectionism) that are already damaging and often hinder the process of positive change:
MissAntiSunshine said, "A couple of months ago, I bent down to get something. Two very close friends were around along with my fiance. My fiance walked by me, looked down, and yanked my shirt down violently. I felt my lower back and realized that my jeans, which are too big on me, had slipped down a little and revealed the top of my underwear. He gave me this disgusted look, like I'd just grabbed one of my friends and started making out with them or something. I didn't mean to. I didn't mean to. I didn't mean to let myself show like that. I didn't even know. I wasn't paying attention."
From the above quote, one could ascertain the following underlying possible emotions causing the shame:
This is a direct example of how something so innocent, turned into causing the person to feel shamed, based most likely around reinforcing prior feelings associated with abuse, primarily failure to be perfect, even disgust.
- He gave me this disgusted look - I feel failure, disgusted, embarrassment, sadness that I let someone down I love.
- I didn't mean to, I didn't mean to - Reinforcing the feeling of failure again.
- I didn't even know - I feel guilty for not knowing something I couldn't see was showing.
The actual caring and assertive solution, would have been to calmly notify the person that their underwear was showing, and let the person choose whether they cared or not vs. having something imposed upon them, especially in the moment, reinforcing guilt and shame.
Pleasure From Abuse
Many don't understand that the human body reacts at times regardless what you may want it to do, this means, orgasming or feeling pleasured, even though being raped / sexually abused at the time. Your bodily functions are not something you always control.
LionHeart777 said, "Guilt for having enjoyed some of the physical aspects of the abuse....my body responded to the stimulation, therefore I must have liked it and to my thinking that made it my fault. What I didn't know is that the body will respond to stimulation regardless of who is doing the stimulating. I also did nothing to stop the abuse. I suffered extreme shame and guilt over these things."
If I pull the above statement apart to discover the underlying emotions, then we end up with the following possible outcome: (Possible because all emotions must be clarified with the person before they become substantial)
One paragraph that resonates the truer underlying emotion to feeling guilty, being self-blame. This then expands into feeling guilty, thus shameful. Add being a male, with genetics at play that a male should be tough, strong and indestructible to be abused in the first place, merely deepens self-blame that much further.
- I must have liked it = I blame myself
- I did nothing to stop the abuse = I blame myself
As you can determine for yourself by now, guilt and shame go hand in hand, and often with common emotions that create or enhance negative core beliefs. Shame is not an emotion you can directly target, but instead you will always find deeper emotions beneath shame, and that is what you target and deal with. Shame is not something you just remove or lose, due to its complexity, though the aim is to reduce it so it withers away and no longer dominates. Time will normally complete this process of removing shame completely through assertiveness and self esteem building.
Just remember the key component to both guilt and shame, be honest with yourself and look at the deeper emotions and/or the actual facts of a situation, NOT what you have told yourself or have come to believe. Forums are very handy for laying out a situations facts, then asking for honest feedback to help you determine such ownership or deeper feelings. A good trauma therapist can also help you.
- Fossum, Mason, 1986, Facing Shame: Families in Recovery
- The Free Dictionary
- Hoffman, 2011, Encyclopedia of Psychology, Enotes.com
- Bratton, 2010, Shame, Guilt, Anger and Seeking Psychological Treatment Among a Trauma Exposed Population
- Kaltman, Green, Mete, Shara, Miranda, 2010, Trauma, Depression and Comorbid PTSD / Depression in a Community Sample of Latina Immigrants, Subscription
- Scherrer, Xian, Lyons, Goldberg, Eisen, et al., 2008, Posttraumatic Stress Disorder; Combat Exposure; and Nicotine Dependence, Alcohol Dependence, and Major Depression in Male Twins
- Taft, Resick, Watkins, Panuzio, 2009, An Investigation of Posttraumatic Stress Disorder and Depressive Symptomotology Among Female Victims of Interpersonal Trauma.
- Hovens, Falger, Op De Velde, Meijer, De Groen, et al., 1993, A Self-Rating Scale for the Assessment of Posttraumatic Stress Disorder in Dutch Resistance Veterans of World War II, Subscription
- Kubany, Abueg, Owens, Brennan, Kaplan, et al., 1995, Initial Examination of a Multidimensional Model of Trauma-Related Guilt: Applications to Combat Veterans and Battered Women, Subscription
- Ehlers, Clark, Dunmore, Jaycox,Meadows, Foa, 1998, Predicting Response to Exposure Treatment in PTSD: The Role of Mental Defeat and Alienation, Subscription
- Moscarello, 1992, Victims of Violence: Aspects of the “Victim-to-Patient” Process in Women, Subscription
- Kubany, Manke, 1995, Cognitive Therapy for Trauma-Related Guilt: Conceptual Bases and Treatment Outlines, Subscription
- PTSD Forum, 2011, How Do You Deal With Shame / Guilt?
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