The role of shame and self‐critical thinking in the development and maintenance of current threat in post‐traumatic stress disorder

Abstract

There is increasing recognition of emotions other than fear in post‐traumatic stress disorder (PTSD), and recent research has looked at the role of shame. Cognitive theory suggests that PTSD is caused by traumatic experiences being processed in a way that causes ongoing current threat. In this paper we suggest that shame might contribute to the creation/maintenance of ongoing current threat as it attacks an individual's psychological integrity. A correlational design was used to investigate some of the factors that might contribute to a shame response within a PTSD sample. It was hypothesized that individuals with PTSD who report higher levels of shame would be more prone to engage in self‐critical thinking and less prone to engage in self‐reassuring thinking than individuals with PTSD who report lower levels of shame. Data were gathered using self‐report questionnaires, and results supported the hypotheses. It is suggested therapy for shame‐based PTSD needs to incorporate strategies to help individuals develop inner caring, compassion and self‐reassurance. Copyright © 2009 John Wiley & Sons, Ltd.Key Practitioner Message:• Some individuals with PTSD report high levels of shame.• High levels of shame are associated with high levels of self‐critical thinking and low levels of self‐reassuring thinking.• Therapy for shame‐based PTSD needs to incorporate strategies that help individuals develop inner caring, compassion and self‐reassurance.

Above and beyond emotional valence: The unique contribution of central and traumatic shame memories to psychopathology vulnerability

“…By becoming highly available and linked to other autobiographical knowledge, they influence subsequent processing and may elicit intrusions, hyper arousal and avoidance symptoms. These traumatic features constantly place the shamed individual in face of an ongoing threat to the (social) self and his psychological integrity (Budden, 2009;Ehlers & Clark, 2000;Harman & Lee, 2010). Thus, these shame memories seem to have a long lasting effect by elevating current feelings of externally and internally focused shame and increasing vulnerability to enter defeat and threat states, translated into depressive, anxiety and 25 stress symptoms.…”

“…A possible explanation for these findings may be found in recent 7 conceptualizations of PTSD (Ehlers & Clark, 2000) and shame-based PTSD (Budden, 2009;Harman & Lee, 2010;Lee, Scragg, & Turner, 2001) in that shame might cause an ongoing threat to one's psychological integrity, leaving one to feel inferior, powerless or socially unattractive.…”

“…Few studies primed participants with specific instructions on the type of emotional event to be recalled (e.g., shame; PintoGouveia, & Matos, 2011), shame or guilt (Robinaugh & McNally, 2010), sexual abuse (Robinaugh & McNally, 2011), pain (Perri & Keefe, 2008), or loss (Boelen, 2009 Grey et al, 2001;Harman & Lee, 2010;Holmes et al, 2005). To date, no study has compared different types of emotional memories that become central and traumatic memories regarding their impact on psychopathology.…”

Post-traumatic Stress Disorder and Social Isolation among North Korean Refugee Women in South Korea: The Moderating Role of Formal and Informal Support

“…Although North Korean refugee women can lead better lives in South Korea due to stable jobs and improved economic status, these women may suffer from psychological conditions such as PTSD. The most common responses to PTSD symptoms are interpersonal avoidance, self-critical thinking [52], and emotional adjustment problems [53,54]. These symptoms affect North Korean refugees' relational and emotional ability to settle into South Korean society, resulting in social isolation.…”

The efficacy of psychotherapy in reducing post-psychotic trauma

“…The role of shame following trauma has attracted recent attention from PTSD researchers (Harman & Lee, 2009;Matos & Pinto-Gouveia, 2009). There is now growing evidence to suggest that conditional risk of PTSD following specific traumas is strongly mediated by the degree to which the traumatic event induces shame (Breslau et al 1998).…”