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"Big Boys Don't Cry"Diagnosis & Treatment of Male Shame and Depression
6 CEUs Big Boys Don't Cry Diagnosis & Treatment of Male Shame and Depression

Section 5
Recognizing the Role of Defensive Processes in
Empirical Assessment of Shame

CEU Question 5 | CE Test | Table of Contents | Depression CEU Courses
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs

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In the last track, we discussed the techniques of Redefining Relationships and Reparenting as ways to reduce shame that can be the basis of depression.

In this track, we'll look at the ways of "Recognizing Shame."

Facing the shame, as you know, is one of the most important components of overcoming it. Everingham presents many techniques, or tools, to use in defeating shame. You've probably heard some of these before, but I find it helpful to go into depth with them and really explore how they can help depressed males faced with shame. In this track, we'll look at the ways of "Recognizing Shame."

When Bill, a 40-year-old construction manager, came to see me, he was deeply in denial of his feelings. He had, in fact, in the past a major depressive episode. However, upon recognizing signs of a relapse, Bill sought treatment. During our first session, he stated he knew he was a perfectionist, but that it didn't seem to be a problem.

As we talked more, though, Bill admitted that at times he would be in a bad mood all day long if he didn't get something right the first time or if he didn't do some task better than everyone else at work. I asked Bill, "When you slip into these bad moods, do you think it might be because of some kind of shame you feel but perhaps don't recognize?"

Recognizing Shame
As you know, often, mental and physical effects go hand-in-hand. Luckily, shame, with its emotional, cognitive, and physical manifestations, is no exception. With a little bit of practice, depressed men can begin to recognize when they feel shame. And recognizing shame can help break the "Shame Rules" of Denial, Disqualification, Control, and Perfectionism. You already know the basics of how your male client looks and thinks when he is in the state of shame, but let's go over them in detail now.

Emotional, Cognitive, and Physical Keys for Shame
Emotional keys for shame include feeling like shrinking or crawling into a hole, feeling frozen, having a sinking feeling, wishing desperately to hide, experiencing intense emotional discomfort with no ready explanation as to why, feeling like being on the hot seat, imagining that all eyes are on him, and fearful self-scrutiny and self-consciousness. Of course, there are other emotional cues for shame, but these are the main beginning symptoms.

Cognitive keys for shame include being inarticulate, feeling helpless in trying to explain himself, experiencing the panicky awareness of having his mind "go blank," noticing when somebody else is using shaming rules on him, and noticing when he is using the shaming rules on either himself or somebody else.

Finally, physical keys for shame include averting his eyes, keeping his head down, feeling his face flush or his cheeks turn red, feeling his ears burn, shuddering involuntarily, feeling tight in the throat or chest, feeling his speech stick in his throat or halt without resonance and power, and feeling his gut go rigid or begin to churn.

To your client, it seems natural that when even one of these emotional, cognitive, or physical manifestations of shame is triggered in your client's body, he begins to look for reasons why. But for your depressed male client who has dissociated from his feelings and who often denies emotions he doesn't want to feel, he has become numb to them. That's why I like to review this list of the three keys of emotional keys, cognitive keys, and physical keys to men who have trouble recognizing when they are ashamed.

What Situations Bring out Feelings of Shame?
I felt Bill's next step was to figure out what situations brought out his feelings of shame. I showed him the list we just discussed of emotional, cognitive, and physical keys for shame. I told him that the next time he felt unhappy in the workplace, he might write down specific feelings and physical changes he experienced. Then, I ask him to try to trace those changes back to a particular event. For instance, an event that came to mind for Bill was when his boss asked him to redo a report or project.

Bill agreed to the exercise, and in the next session, he stated, "I finally started to figure out when I am feeling ashamed." Next, I told him to name the shame when he felt it. This involved in his self-talk saying "I feel ashamed" when he picked up on the emotional, cognitive, and physical cues of shame.

Do you have a client who could better recognize his shame by going through this list of emotional, cognitive, and physical manifestations of shame? Consider sharing it with him in your next session.

In the next track, we will discuss forgiveness and healing masculine depression.

Peer-Reviewed Journal Article References:
Eterović, M. (2020). Recognizing the role of defensive processes in empirical assessment of shame. Psychoanalytic Psychology. Advance online publication.

Gebhard, K. T., Cattaneo, L. B., Tangney, J. P., Hargrove, S., & Shor, R. (2019). Threatened-masculinity shame-related responses among straight men: Measurement and relationship to aggression. Psychology of Men & Masculinities, 20(3), 429–444.

Legate, N., Weinstein, N., Ryan, W. S., DeHaan, C. R., & Ryan, R. M. (2019). Parental autonomy support predicts lower internalized homophobia and better psychological health indirectly through lower shame in lesbian, gay and bisexual adults. Stigma and Health, 4(4), 367–376.

Mereish, E. H., & Poteat, V. P. (2015). A relational model of sexual minority mental and physical health: The negative effects of shame on relationships, loneliness, and health. Journal of Counseling Psychology, 62(3), 425–437. 

Sullivan, R., Green-Demers, I., & Lauzon, A. (2020). When do self-conscious emotions distress teenagers? Interrelations between dispositional shame and guilt, depressive and anxious symptoms, and life satisfaction. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, 52(3), 210–219.

Online Continuing Education QUESTION 5
What are three ways shame is manifested? To select and enter your answer go to CE Test.

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