Outline

Shame, Attachment and Social-Emotional Development

• The difference between guilt, shame and core shame
• Shame and attachment
• Ruptured interpersonal bridges
• The evolution of social-emotional development
• Why self-compassion is so hard to access

The Neurophysiology of Shame:
Polyvagal Theory, Shame and the Shutdown Response

• Shame and the Vagus Nerve
• Neuroception, shame and felt safety
• Core shame and implicit memory
• Three common responses to shame
• How addressing shame expedites treatment

Recognizing Shame: Assessment Tools

• Why shame goes undetected by clinicians
• Multicultural perspectives
• Perfectionism, rage, blame and other defenses against shame
• Reading the body – non-verbal signs of shame
• Interview questions for assessing shame in relationships and current patterns
• Self-assessment: identify your own shame

How to Create a Safe and Empathetic Therapeutic Environment

• Mirror neurons and relational presence
• Attunement as the key to therapeutic change
• Large Empathy and being vulnerable
• Avoid stigmatizing language in therapy
• Co-regulating safety and equal power in the therapeutic relationship

Re-Write the Story of Shame into “I Am Enough”:
Clinical Strategies to Cultivate Secure Attachment and Self-Compassion

• Somatic approaches to cultivate secure attachment
• Self-compassion and gratitude exercises
• The four therapeutic “R”s: Recognize, Respect, Regulate and Re-Story
• Four “C” shovels to calm nervous system and self-regulate shame response
• Exercises to strengthen connections
• Creative arts, music and poetry – increase neuroplasticity
• Playfulness, humor and being in nature can rewire the brain
• Mindfulness and meditations for non-judgmental awareness of shame
• Narratives and visualizations to re-write clients stories to safety and being enough
• Research, limitations and potential risks

Connect Shame-Informed Clinical Strategies to the Treatment of:
Anger and Rage

• Shame of fear: Shame as a cover for anger
• Self-acceptance techniques for internal damage control
• Compassion and forgiveness exercises to let go of anger

Trauma

• Somatic interventions
• Strategies to survive without guilt
• Exercises to rediscover self-worth

Stress and Anxiety

• Mediate the paralysis of perfection with self-acceptance
• Social anxiety as shame & self-doubt
• Mindfulness-based, non-anxious self-consciousness

Eating Disorders

• How shame pushes clients into binge eating
• Choice Awareness Training for moderation & presence
• Self-acceptance strategies for emotional eating

Substance Abuse and Addiction

• Addressing the shame of relapse
• Self-assertive trigger avoidance
• Choice awareness techniques for habit modification
• Build craving/impulse control skill power

Depression, Self-Harm & Suicidality

• Recognize how internalized shame can deepen depression
• Developing healthy coping strategies for uncomfortable feelings
• Demystifying shame responses and returning them to their origin