Exposure Therapy Less Effective For Shame Based Responses To Trauma?

[Tinyflame]

Dear @Anarchy, I don't understand, isn't it the shame that indicates ('one knows') abandonment is coming? The shame is there before being abandoned. (The other way around. )Though I guess it could create a self-fulfilling prophecy?

I am so confused by this stuff, it seems so circular. :confused:

Dear @stenni , I know it is so difficult, like self-rejection t the innermost DNA level. I wish you much help & discovery at your appointment, & the ability to manage it, & gentle hugs for you. :hug: :hug: :hug:

 

[Tinyflame]

I'm t the point where I don't even or can't identify 'specifics' but rather the shame feels as @stenni said related to the core of my being, the very fact I exist.

 

[Eleanor]

it seems so circular

Exactly. It IS circular. It is a loop. So. How to interrupt the cycle and break the pattern? This seems like an objectively tough nut.

Animal trainers are generally of the opinion that if it can be trained/conditioned in, it can be trained/conditioned out. The retraining may not be 100% but it might be a whole hell of a lot better than it is to start with.

There are a lot of approaches to this both on the cognitive and affective (and both) level, a bunch of which have already been mentioned.

From what I've known and done I'd say the first step is getting as aware as you can of what is going on in a nano second inside you. If it is like: "Compliment - PANIC or FEAR - denial - self criticism - feeling bad - believing bad " (just made this up) then the first step is to slow that process down so you can see it happening. And then start interrupting the cognitive part (denial and criticism) to get it to cohere with the rest of your belief system about the world (If everyone else on the planet deserves to have a place to live, surely I must too!) And then maybe work on the feelings themselves, in any number of ways including re-training oneself to feel other things (practicing feeling attached - dogs, squeeze machines, movies, anything that activates the emotional system in a positive way) and gradually attaching those feelings to one's current life.

And @Junebug, you so deserve to exist I wish there was ten of you. :hug::hug::hug: (hearts.)

For that matter I wish there were more of all my friends here - we seem to me a cut above average on the honesty, compassion and thoughtfulness (in the sense of thinking) fronts.

I find myself shamed by even having any needs

I am a compulsively rational person so this would be the place I could find a way in. It is plainly irrational to my way of thinking. Since "ought implies can" and it is not in anyone's control to have needs or no (everything that acts has needs) then one couldn't logically criticize a person for being a moral agent at all. If no one else should be ashamed of having needs, then I should not be so ashamed either QED. That may not be the "magic bullet" that shifts the pattern, (tho it might) but having feelings that don't conform to what would work better is... just the condition of being human. And feelings are plastic. They can be shaped over time. I don't know what will work for you - do you have any sense of where the weakest point in the loop is for you?

I'm totally interested to know what the T says.

 

[Tinyflame]

For that matter I wish there were more of all my friends here - we seem to me a cut above average on the honesty, compassion and thoughtfulness (in the sense of thinking) fronts.

@Eleanor , isn't that so true. And compassion/ sweetness. You too especially. :) :inlove:

I am a compulsively rational person so this would be the place I could find a way in. It is plainly irrational .. everything that acts has needs

Dear Eleanor, I can't quote all as I wish I could, but I wanted to say (& I hope @stenni has found it just as helpful) but catching it in the 'nanosecond' is so so so very important I think. Even if one has to return later to delve deeper in to it. Similarly your statement above helps me when I think of my sweet dog, that she deserves all that (easy to see in that way). She was terribly abused but I've tried to hope I could do as well as she, but naturally I don't think of her or treat her as I do myself. ( :eek: )

I can't say I'm terribly proficient at coming up with ideas, but I love yours of associating it with positives, counter-conditioning. Really simple but practical, fantastic idea. :hug:

I do think (now) the shame (as @Anarchy said) is fear- fear of doing harm, or further harm, is one big part (like thinking I should tattoo a big WHMIS Hazardous Materials warning sign on my forehead. :rolleyes:). I guess I have fear-based shame over a lot.

I also think maybe I have been hoping/ searching/ dying for a 'magic bullet' solution. (Even after 30 years of not finding one. :rolleyes: ) Oddly though, when I think back, I was a very remarkable very small child (sounds odd to say.) That (none of us) should be ashamed of.

And Link Removed, you so deserve to exist I wish there was ten of you. :hug::hug::hug: (hearts.)

Oh Dear Eleanor, thank you. :) :cry: I was never one for cloning, but you're one of the exceptions. :) :inlove: Xox. :hug: :hug: :hug:

 

[fellowsufferer]

For me only exposure therapy isn't enough. I need to feel my repressed feelings of the trauma also. It doesn't work on a rational level alone. For me it's about processing my suppressed feelings also, i need them both

 

[Alien Goodness]

My T would go on and on about exposure as the way to reduce the level of fear I felt. It worked in some ways (for example, I was able to return to the location where I experienced trauma), but in other areas I felt it made things worse for me as it just reinforced my fear responses. I had to stop my therapy in the end as I was becoming more and more neurotic.

Speaking personally, I find it hard to separate fear and shame as different things. I see fear as a general wide-ranging term, and shame as a specific form of fear.

Though on reflection, there is a difference but it's hard to define. I find many things in life makes me fearful and I have learned to manage those fears. But shame freaks me out and I get overwhelmed. Often I experience shame when I compare myself to another person, or to a social norm. But I also experience intense shame for no apparent reason. My belief is that this stems from my childhood as I have blanked out all memories before starting school.

As a parallel thought: Isn't a characteristic of psychopaths is that they don't feel shame?

 

[Tinyflame]

Yes @Alien Goodness ,can't describe it well but to me it almost feels like a new bridge to life has to be built with positive stuff, not just trying to patch the old rickety bridge to the trauma stuff. Because that one always feels like it's going to break at anytime (re-exposure). I think (I fear) one day I'll venture over yet again & never get back. :rolleyes:

PS, interesting on the childhood stuff, can't remember most of mine. Thought that was 'normal' til I came here.

 

[Friday]

Doesn't this depend on whether there is actually anything wrong in the first place? It's possible that my allotment is actually completely acceptable (because my husband keeps it up), but my sense of shame and failure mean that only perfection, or at least the best allotment in town, would be non-shameful. Sadly, I know that if it was the best, I would them feel enormous guilt for distressing other allotment holders. It comes back to the underlying knowledge that I am unacceptable in almost every way.

It would seem to me, and I could be wrong, that this is a second issue entirely. Exposure therapy for the first... But perfectionism & cognitive distortions wouldn't be helped repetition. ET, in my experience, is about becoming acceptable to yourself. Not acceptable to everyone else. When your opinion of yourself is based on your perception of how other people think/feel about you? That's a different creature altogether.

First off, because it's impossible. There is no way on planet earth than anyone can make everyone happy all of the time. Secondly, none of us are mind readers. An impossible task, with an impossible premise. Even doing it once would be a damn miracle, much less time and again!

* * *

There's a few related quotes surrounding the impossible idea of controlling how other people see things:

- "You can fool all the people some of the time, and some of the people all the time, but you cannot fool all the people all the time." - Abraham Lincoln

- "Do what you feel in your heart to be right- for you'll be criticized anyway. You'll be damned if you do, and damned if you don't." & "No one can make you feel inferior without your consent." -Eleanor Roosevelt

- "If you always do what interests you, at least one person is pleased." - Katharine Hepburn

- "What other people think of me is none of my business."

- "Never judge your insides by other people's outsides."

- "If you compare yourself with others, you may become vain or bitter, for always there will be greater and lesser persons than yourself." - Max Erhman, Desiderata

- "Those who mind don't matter, and those who matter don't mind." -Dr. Seuss

 

[Eleanor]

And now for some comic and loosely related relief...about the failure of exposure and the success of cognitive change.

 

[scout86]

Good ol' Dr Seuss!

This reminds me of something my T talked about once, quite awhile ago. That day, for reasons I don't know, he got off on the subject of "shame based people". He likes to talk. He really got going on this. I was busy looking for a way either out of the room or out of the topic, and I really don't think he noticed. He was THAT busy expounding on the topic. Finally, in a rather lame attempt to end to topic, I said, "So, what do you do with them?" (Meaning shame based people.) He responded by leaning forward and loudly saying "You LOVE them!" Scared me half to death! LOL Seriously. I didn't tell him until later, maybe even in an email. There was a few seconds there where all I could do was watch him closely, looking for indications he was going to attack, measure the distance to the door in my head, and try to convince myself I could make it to the door before he did, if I had to. At that moment, he seemed to be the most dangerous person on the face of the earth.

Weird, huh? He told me later that he could tell he'd hit a nerve, but he had no idea he'd hit THAT kind of nerve. We haven't talked about it since. Possibly because he doesn't enjoy terrorizing people. I really can't explain my reaction. (And I DON'T want to talk about it! :stop:) But, I suspect there's a connection between what you all have been talking about and what he was talking about. I'm not quite sure how "You LOVE them!" is an actual therapeutic approach...

 

[Tinyflame]

I was going to say I loved @Eleanor's above, yes! Empathy & care for others is one of the few things overcomes my fears.

Then I read @scout 's. :wideeyed: Not sure what to say. :wideeyed: :confused: :sorry: :nailbiting: :bag: :eek: :wideeyed: :notworthy:

 

[The Albatross]

... "So, what do you do with them?" (Meaning shame based people.) He responded by leaning forward and loudly saying "You LOVE them!" Scared me half to death! LOL Seriously. I didn't tell him until later,
[snip]
We haven't talked about it since. Possibly because he doesn't enjoy terrorizing people. I really can't explain my reaction. (And I DON'T want to talk about it! :stop:) But, I suspect there's a connection between what you all have been talking about and what he was talking about. I'm not quite sure how "You LOVE them!" is an actual therapeutic approach...

Relate, relate, relate... tough one. Best as I can say... I try, I try, I try then... ka-BOOM. But it's getting better and a whole lot less scary. I vote you pursue the topic when you've got some levity and see what else he says about it... I'm all EARS!!!