Untangling Guilt, Shame and the Vocabulary of Therapy

Of all the words we use for emotions, ‘guilt’ and ‘shame’ may be the most troublesome to pin down.

The Quagmire of Words

Spoken language is a cornerstone of client / therapist interaction. Surely voice tone also matters, as does body language, yet mere words do much of the heavy lifting during a session. And more often than not they’re imprecise, and occasionally it seems words just aren’t up to the task at all.

Lack of clarity comes from several directions. The first is that some words used in therapy have rigorous meanings. Disorders like depression do manifest differently from client to client, but they include a compact list of recurring symptoms that are generally recognizable. Other words, like ‘trauma,’ can have more than one pinned-down definition, e.g., physical trauma versus psychological trauma. Finally, there are words that you might expect to have crisp definitions, but in practice, do not. ‘Codependency’ is one that always comes to mind when I think of a seemingly-technical term that I find exceedingly difficult to pin down.

So perhaps I shouldn’t have been as surprised as I was to hear television pop-guru Iyanla Vanzant describe guilt as a ‘useless emotion.’ “That’s not right!” I thought to myself. I had my definition of that word in my own head: guilt as regret for past bad acts; if you mess up, and you don’t feel bad about it, you’re probably not going to learn much. From where I am sitting, feeling and responding appropriately to guilt is useful, if not essential, in recovering from mistakes. In the moment, I forgot that ‘guilt’ is one of those words that people use in radically different ways. A few moments later, Vanzant revealed her own personal definition for guilt: persistently beating oneself up in the present for past bad acts.

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If ‘guilt’ is tough to pin down, then so is ‘shame.’ Often, these two words are used interchangeably. Here’s how Bioethicist Carl Elliott tries to pry them apart:

These two different reactions — shame versus guilt — differ in important ways. Shame is linked with honor; it is about losing the respect of others, and by virtue of that, losing your self-respect. And honor often involves collective identity. While we don’t usually feel guilty about the actions of other people, we often do feel ashamed if those actions reflect on our own identities.

Shame, unlike guilt, involves the imagined gaze of other people.

So Elliott is defining shame as a social construct: shame as a loss of face before the community. There’s nothing inherently wrong with this definition, as long as everyone is on-board with using the word in that way. What’s interesting is the larger context of the article. Elliott is discussing a situation where a research project at the University of Minnesota led to the death of one of the subjects. Seeking to explain why faculty members of the university won’t speak out against the alleged misconduct, Elliott posits that faculty might feel guilt about individual wrongdoing, but not shame for how this researcher had stained the reputation of the university.

Elliott’s take on guilt and shame is an inversion of how I, and I believe most clinicians, would distinguish between the two words. While guilt is negative sentiment in response to our own past bad acts, shame is the feeling or belief that we are unworthy because of our past wrongdoing. I find myself not at all eager to endorse the idea of collective shame, although I can see why Elliott values it in this context. While Elliott wants to show that shame and guilt both have their uses, therapeutically, guilt is usually seen as the ‘good guy,’ while (contrary to Vanzant) shame, not guilt, is the ‘useless emotion,’ because shame references identity and identity is often not amenable to change. With such seemingly simple words defined in such starkly different ways, and different value assignments given to each, it’s no wonder we’re confused.

When Words Can’t be Trusted

I’ve had clients say “I’m depressed,” but before I launch into dialog about dealing with depression (the clinical condition), I’ve learned to ask “what’s it like to feel ‘depressed’? If I were a Martian, explain ‘being depressed’ to me.” I ask this not to be obtuse, but because people use words like ‘depression’ in radically different senses. Asking people to define their terms may seem pedantic, but it clears up a great amount of unclarity in short order, and is almost always worth the time invested. This goes double for words like ‘guilt’ and ‘shame.’

Other times, there’s no need to be so direct. As my discussion of Iyanla Vanzant showed, people will often define their own terms, either explicitly or through usage and context, when given the opportunity. Patience and and rapt attention are two of the best antidotes to misunderstanding. In fact, I’d go so far as to suggest that most arguments could be headed off if just one party could wait, listen a little more, and see if there isn’t some sense in what the other person is saying.

When you know someone for a while, either as a client or personally, they often have their own vocabulary for what goes on in their lives. Although I love words and feel the impulse to teach clients the technical terms for what they’re experiencing, I also find value in learning the client’s personal vocabulary and language. In the end, the client is the ‘local expert’ in their own lives, so if a word has gravity for them, I’d do well to understand their words and why they’re important.

• communication
• society
• therapy