As well as enduring the symptoms of their illness, people with a mental disorder often feel self-blame or agonize over the feeling of failure because they have a mental illness. Psychologists call this “internalized” shame. It often ensures that those affected withdraw from friends and family, seek professional help less often and therapy does not work as well for them. An Australian research team has therefore dealt with the question of whether internalized shame can be tackled with special exercises.
The working group led by Susanne Norder from Macquarie University in Sydney summarized the results of 16 previously published studies. The interventions examined therein were all aimed at the sense of shame of the mentally ill subjects. This was measured using a questionnaire containing statements such as “Compared to other people, I feel like I’m not good enough” or “I think people look down on me”.
As there is still no established treatment for internalized shame, the therapeutic approaches used have varied widely, ranging from 2 to 16 sessions, both individual and group therapy, and relying on a variety of techniques. Acceptance and commitment therapy, which is based, among other things, on the concept of mindfulness, was used most frequently. In addition, there were exercises to increase self-compassion, information about the emergence of feelings of shame in mental illnesses or art therapy approaches.
In 12 of the 16 studies, people had fewer self-shaming thoughts and feelings after treatment. In 7 out of 10 studies, it was also shown that people in a treatment group fared better than subjects under control conditions (there was no such group comparison in the other studies).