The Shame Deception 

Fighting guilt & confronting shame in mental health              

Chapter One

Ethan’s anxiety

To keep a secret, you must hide it from yourself

George Orwell

I think I may have forgotten this before

Stephen Wright

Emotions are our closest companions and our very earliest experience of ourselves, yet we quickly lose touch with each other. We become distant and suspicious. Emotion comes pre-installed at birth, but as we pick up language, our left brains are put on a fast-learning schedule and they get impatient with their more emotional twin: the right brain hemisphere. Emotions are our secret interior life, but we get separated as we start to turn our attention to more pressing matters in the outside world. We encounter emotion in other people’s faces – but we train our own faces to conceal it. And when we do speak about emotions, it’s the left hemisphere (the wrong bit) that does the talking. Our left brain majors in language, our most prized technology. Imagine someone asking: Would you prefer power or feelings? Feelings are great but risky: control is safer. So left brain gets the language-package and many of us become stuck in a left-brain version of our personal history, which leaves occasional gaps in our ‘official’ biographies. These gaps can lead to confusion about who we really are, which was precisely the problem for 26-year-old Ethan.

A short history of Ethan’s face

Ethan suffered with a rather severe form of anxiety, for which he tried various interventions and had visited a number of psychologists, cognitive therapists and clinics. On each occasion, he emerged with excellent skills to allow him to continue in his job as joint head of sustainability at a wind turbine energy start-up, but after a while, deflatingly, anxiety seemed to return. The shaking would start on a Sunday night and by Monday morning his face felt like a furnace. He would struggle with words for the first few hours at work, and if he had to present something in a meeting – even to colleagues he had great relationships with, it brought him to the verge of panic. 

People like Ethan are termed ‘functional’ since they operate through crippling anxiety, but even Ethan hit his limits, and after a medical review, he was referred for NHS intervention. Ethan was approachable and didn’t seem at all nervous when I met him. He had a ‘sunny disposition’ – a trait that clearly made him popular at work but behind which he hid his anxiety. During his assessment, he mentioned his family life and childhood were ‘all good’. Just for conversation’s sake, what in particular was good, I asked him. He was smiling in family photographs – in every single one, and there were a lot of them. His family confirmed he was a carefree, happy child, so he was certain his anxiety was a disorder without cause, merit or justification. Regarding his ‘happy childhood’, we now had face-proof confirmed by memory backed by photographs – an unbreakable evidence chain. Only his childhood was more like a jigsaw puzzle with more than one way of putting it back together. A hidden design was buried inside; eventually, it would rearrange itself.

Emotions made no sense to Ethan: he often disagreed with them. He found he got sad when he ought to have been happy, and anxious when he wasn’t under threat. He was told when he was growing up he was in charge of his emotions – but his emotions seemed to have little interest in what he was taught. Ethan’s attempts to swerve his feelings was an understandable if unrealistic objective. We have this interesting feature of slight distance in brain structure, where left brain is slightly separated from right brain – just enough to give it opportunities for ‘blocking’ its twin. The right brain is unable, naturally, to move to a more distant location, even though that might suit left brain much better. Emotions are things we often try and avoid but which we sometimes need to engage – a theme for all the individuals in this book, despite the fact all had good reasons for doing the avoiding part. 

Ethan’s charming exterior masked a story (of course it did), one that slowly pieced itself together. Ethan’s elder brother, Jacob, was not an especially happy child. Jake was diagnosed with autism when Ethan was around four, and when Ethan was ten and Jake 20, he was diagnosed with a form of schizophrenia. For years Jake was in and out of institutions, and was held occasionally in hospitals under Section 3 of the Mental Health Act. Ethan’s family were often swamped in Jake’s crises, and these overshadowed Ethan’s early life. Because Jake’s predicament was a source of real worry for his parents, and for Ethan too, he became the opposite of Jake: a ‘problem-free’ child whose emotional needs never intruded. Ethan protected his family from further worry, and his smile was a form of misdirection, except Ethan himself was miscued by the misdirection – he started to believe his own face-messages. Eventually, Ethan’s inside experiences completely vanished from view – and he, alongside everyone else, lost sight of how he felt. Only disowned feelings cannot simply disappear.

Ethan became a self-contained child. He could even be described as an isolated one. Young children are designed to attach and seek comfort and reassurance, but Ethan had learned to ignore these needs, and then forgot he had forgotten them. Remembering would only cause suffering to his overwhelmed parents (and misery for him, since what he needed was out of reach). Conflict between Ethan’s isolation misery and his ‘official history’ fuelled anxiety, because misery was trapped inside a false story, and nothing that exists likes to be trapped. It fought to get out, and the escape bid formed a big part of Ethan’s dread: the truth released would be accompanied by a torrent of unexpressed emotion and a great dam-burst of needs would follow – needs he must ignore to maintain his identity, integrity – his dignity. Shame rose sharply at any prospect of release – deepening fear and anxiety.

Ethan’s official biography was designed to keep the shaming truth of his needs as far away as possible, because somewhere inside he believed that needs in an overburdened family must be proof of an inadequate, frail or self-interested nature. He was very invested in his ‘persona’ – someone for whom others’ needs were more important than his own; someone solid and dependable in a crisis, and this was reflected in his professional identity: an admired and non-replaceable member of the start-up team. Only a slightly ‘unfortunate’ anxiety flaw spoiled this perfect front.

Ethan didn’t really say very much about himself during our assessment, except he wanted the problem ‘gone’ so he could get back to work. He wanted the very best techniques for dealing with anxiety (he in fact already had them from a number of specialists), and since talking about his life only made him more anxious, he became increasingly frustrated with me during our follow-up sessions. After around two months of working together he left a voice message saying thank-you, but he wasn’t coming back. He added the observation his anxiety had become ‘worse’ since starting therapy.

Ethan certainly was not alone in struggling with emotions – or disagreeing with anyone who might want to put him in touch with them; we all struggle at times. Even science struggles. Scientists cannot agree on what emotions are, how they are produced or why they exist3. We measure things in science mode, but we experience them in feeling mode – and they work in different codes and operate on distinct pathways. Science (like our left brain) values detachment – it needs distance. Emotions are almost as much an inconvenience to science – the discipline of investigation, experiment and observation, as they are to the rest of us. They can only be experienced up close, and studied from farther away; and as they recede, so does understanding. Emotions are not easy to observe, and generally refuse to come out of their hiding places to order (even though they seem to have little difficulty coming out of their hiding places at the most inconvenient of moments). Up until the 20th Century, psychology was not fully a branch of science – it was more a cottage industry of underground ideas, art and folk-wisdom. Emotions would struggle with the transition to a more rigid, science-based regime.

Almost a year passed before I heard anything further regarding Ethan, when out of the blue I received an email from him to say he had been thinking he wanted to give it ‘one more go’ – a courageous message, and a brave step. We did give it another go – and this time, while working back through his history (which he still found deeply unpleasant), Ethan was inclined to withdraw the facts of his official biography. He had discovered it was a false story – that he and his face had somehow acquired separate biographies. But updating Ethan’s history meant confronting personal dread. All his discarded emotions and needs had leaked out of their holding centre during the therapy and were now on display – the very last place he wanted them. This became Ethan’s biggest crisis yet.

A painful but honest reckoning with his family followed, with every phobic instinct fighting against his involvement in this acutely ‘embarrassing’, expanded family-therapy process. Yet he pushed hard against his most allergic instincts, and found himself swamped, as a result, by feelings of hurt, bewilderment and anger. Eventually, feelings of grief bubbled up from somewhere he didn’t even know existed, a great void of loss for a vanished childhood.

When our work eventually finished, Ethan continued to struggle to express his feelings and it still felt to him like a betrayal every time he managed to do so; but he came to accept that others (me included) thought his feelings perfectly understandable, normal and acceptable. His family now also understood them better, and expressed their sadness and remorse. He still broke into a sweat before going into work, but anxiety attacks no longer felt so desperate, and panic receded into milder episodes. While I don’t think Ethan ever found it easy to talk about emotions, he learned at least to spot when he needed to do so. His close friends and family learned to read the code: when Ethan got anxious, he was usually experiencing emotions he still found too painful to express. The feeling of anxiety remained the only exception: a fairly ‘generic’ state that even Ethan could admit to. But why was anxiety more acceptable, and why is it so commonplace?  

To achieve any task, we need to narrow attention and block out other tasks. If I want to read my book, I might have to ask Alexa to silence the music. To switch something on, we need to switch something else off. Our brains work a bit like that; our minds too. If there’s a crisis and I need to escape my car and reach safety while stuck in a snow blizzard, my mind has to switch attention from my hypothermia, my frostbite and my hopelessness and focus on my family instead. But some of us learn early in life the danger that needs blocked is ourselves. A child in crisis has limited options other than escape (difficult) or rescue (not always forthcoming). The only way to survive is to become unseen, and to do that, emotions must be powered down. Little or no knowledge of this will remain, but what does remain is the shame that made us want to vanish, and the vague anxiety some invisible part might wish one day to return from its vanishing point. 

The 200 million-year-old human attachment system carries our powerful need for acceptance and belonging – a desire counterbalanced by our fear of rejection. Abandonment shames, and many of us are shame-phobic. Charles Darwin identified this dual drive as: our love of approbation and our dread of infamy – only the latter (dread) holds more power than the former, since we are motivated more by fear than reward. Negative events (eg disapproval) have a greater impact upon us than positive ones, and figure more heavily in our decision-making. The ability of feared or unwanted outcomes to influence our thinking is called negativity bias. It was certainly an influence on Ethan, since his was installed early.

Ethan escaped himself as a child by blocking his own care-needs, and the inner banishing of need led to his family’s approval and acceptance, while outright displays of emotion did not bring about either of these desired outcomes. His emotions posed a survival-threat. Ethan might have picked up on his parents’ helpless disappointment – their exhaustion whenever his emotions or needs were on display, but you cannot repress emotion without some residue of anxiety. Anxiety was his needs pushing back against oblivion.

Our social brain is engaged in a constant risk assessment of others’ behaviours relative to our own. Most of us scan for negative consequences that displease others and assimilate the ‘danger’ into our: ‘‘no – avoid – reverse’’ relapse-prevention patterns next time. Kindness and care are vital commodities for humans – but disappointment and rejection (multiply your shame-phobia by your negativity bias!) are accorded priority status. We will forego our desperate need for reassurance and compassion if it will only prevent the shame of exclusion. Shame traps our emotional needs, wraps security tape around them, and cuts them off from the rest of the world. Anxiety, which we just think of as a nervous system ‘glitch’, is preferable to exposing deeper vulnerability. Anxiety sits further down our shame hierarchy, and carries a lesser ‘inner critic’ penalty.

Disclosing anxiety caused Ethan only minor anxiety! It aroused surprisingly little curiosity or even suspicion. Anxiety was something Ethan found you could seek help for without upsetting anyone so long as you trained your face not to reveal too much. In fact, Ethan saw a school counsellor for anxiety when he was nine – but Ethan and his parents had ‘forgotten’ this fact within the ‘Ethan has no needs’ version of his official biography.

Ethan’s eventual recovery from the worst of his anxiety attacks didn’t come down to learning new ways of managing anxiety – more in discovering the reasons underlying it. Once Ethan was able to acknowledge how much he feared rejection, and was prepared to admit his real need for reassurance (alongside his disgust at having this need), his anxiety, grown monstrous in a petri-dish of fear lost some of its power. His family didn’t reject him when his official biography unravelled, but Ethan had to wrestle with the rejection inside his head before he could tackle it out in the world – and every allergic sinew strained against the risk. Ethan would almost rather have put up with panic and anxiety for the rest of his life than face the horror of his needs released from their prison.    

Fear of rejection will trump just about everything else. Whenever a social consensus turns its back on us, whether in the classroom, the playground, the gym or the office, our self will reject its own emotions to fit in with other selves. Shame is part of our ‘survival pack’ – only perhaps one that is working overtime. Evolutionary psychologists argue shame and guilt are protective emotions, getting us to modify our behaviours to conform with others’ expectations, preventing hurt, or worse: abandonment by family, community and tribe – so ensuring our survival.

They may be right – up to a point. Breaking point.

Chapter Two

Lissa’s War

I fear I am not worthy of my suffering

Fyodor Dostoyevsky

Even happiness, doesn’t completely escape the spell of negativity bias. Happiness, that positive sunny upland state we all want (or at least we seem to want other people to believe we have it) doesn’t necessarily arouse joy in others when we actually acquire more than our allotted share. It can elicit envy, resentment, indifference or aggression, and people can soon discover it may be safest to keep it to themselves. And anyway, when we are happy, we generally don’t much think about our feelings, it’s only when we’re unhappy we give them much attention.  

Feelings – oblivious when they’re good, wishing to eliminate them when they’re not. There is something lopsided about emotions – they seem inclined towards fear, loss or sadness in our attention and focus. Could it really be happiness, joy and pleasure are just moments we catch ourselves when we’re not suffering?

Emotions create an unwelcome bridge between remembering and forgetting our past, because they carry remnants of the vanished data. Emotions smack us in the face ‘for no apparent reason’ – they don’t work on a simple cause-and-effect basis since they are able to jump across time, and since we spend a fair bit of our time trying to outdistance them, we are outraged by this ability. Emotions have acquired a bit of an unfair reputation for unreliability and confusion – and since they are also linked with pain, we have developed a mistrustful relationship.

Which brings us to Lissa. I was thinking of Lissa recently, after I received a letter from her where she described her therapy as the best and worst experience of her life. Lissa had been highly reluctant to disclose her history when she made her way into mental health services, long before I met her. She had been sexually abused as a child – and when the truth finally came out (completely against her wishes) nobody in her family believed her. This left behind serious confusion. It set up an argument inside Lissa herself. She had been hurt: her experience, physical memory and all her instincts confirmed this was so. But what happens to that knowledge when the rest of the world (the social consensus) says it didn’t happen? It is beaten back with force – and the individual soon gets the message they urgently need to unlearn what they know to be true. How are you supposed to not know something that you know? We might be able to achieve this with a mere fact – but try to unlearn an emotional reality and you get into difficulties. Emotions don’t deal in facts, but with something far more important.

Fear, surprise, happiness, anger, sadness, hatred and disgust are examples of ‘primary’ emotions – and secondary emotions are what happens in response to primary ones. If I was publicly ridiculed for no apparent reason, surprise and rage (primary emotions) surface, and my hot cognition primes a response. I might insult my abuser right back, shout at them, go bright red in the face, get in their face – or I might be shocked, frozen and open mouthed, before quietly slinking away. While rage and shock are my primary emotions, shame is my secondary one when I reflect on the helplessness and inadequacy of my response, or remember the fact there were witnesses – or guilt should I judge that I completely over-responded.

Why does any of this matter? Because emotions have their own rules which have little to do with us or our rules: they can be a response to other people, to events, or they can be a response to their own response. And it’s worth noting that while our first ‘hot’ emotional response is instantaneous, our secondary response is slower, cooler – grimly hanging round long after the primary emotion has evaporated. Some psychologists go so far as to suggest primary emotions protect us from secondary emotions: that we prefer anger to grief, rage to hurt, wrath to shame. Many of us seem more comfortable in high arousal states than low-arousal ones, and sometimes secondary emotions, as we’re just about to witness, are followed up with a whole new unwanted set of primary ones. It’s as if we’ve entered a whole new ecology when we drop down into the world of emotion.

Whatever their underlying purpose, emotions can create the sort of headwind that throws us off our daily flight path; and perhaps off our flight path altogether. Emotions are a lifetime condition from which few of us are immune. In the absence of an owner’s manual, all of us can find ourselves hopelessly adrift, clinging to the same life raft.

Lissa grew up in a large family in a rural corner of continental Europe with a busy GP father, a nutrition scientist mother and competitive siblings who rubbed along noisily but well. The wider family didn’t really accept ruptures in its fabric – and it was only in retrospect Lissa could see how skilfully she had been groomed, by someone very close to the family. She didn’t disclose any details to her own family (she eventually told a friend) because she feared she wouldn’t be believed. She wasn’t.

The most up to date, evidence-based clinical thinking contends while we may not be able to control negative feelings themselves, we can modify the thoughts that trigger them (cognitive approach) – or we can control the urges and behaviours that result (behavioural approach). Education around pain tolerance and emotional control is extremely reassuring for some people – and disasterous news for others. When Lissa sought help from mental health services, this is what she was told, and at that moment she believed she was lost. It seemed she’d been informed she didn’t feel what she felt most of her life – she thought she had just been told it again.

Lissa didn’t actually need to subdue or survive her feelings, she just needed someone to help her listen to them. Somewhere underneath all Lissa’s anger, hurt and confusion lay the reality of her grief and suffering, but she never got to grieve because no one acknowledged she lost anything, and certainly not anything that mattered. Inside her survived a belief surrounded by powerful sensations she had suffered real harm, but hurt and rage were trapped because others insisted she had nothing at all to be angry about.

Eventually powerful new emotions well beyond Lissa’s control were unleashed – these ones literally bigger than she was. She didn’t choose this response. She in fact tried very hard to unchoose it. They chose her. No matter how hard she pushed, these emotions wouldn’t, couldn’t go in the direction they were sent. This conflict caused a new category of harm – one even more overwhelming than her original injury. Emotions were contested and emotions fought back. She became the battleground. 

Emotions are a force in the world as real as oceans and earthquakes. When we ignore or disown them, a gathering storm lies in wait. It might be hours or it might take years, but one day the storm strikes. Concerned we go to the GP insistent something terrible just happened and our mental health has collapsed, but at this point emotions are simply the weather vane of the self, the leveler, the corrector, the ready-reckoner; our most essential and personal information technology. The problem is human beings have no proprietary ownership of this technology: we have no idea who does, and our mind doesn’t like things it can’t control.

Outrage and pain, having nowhere else to go were unleashed inside Lissa. With responsiveness and understanding, Lissa would have survived the sexual abuse: what she struggled to deal with was denial and rejection of her injury. But due to Darwin’s insight that we fear rejection even more than we crave acceptance, Lissa had little choice but to note the human consensus, view her emotions as a threat to her own survival, and respond by trying to contain the inner cyclone. Only, as we know, that doesn’t mean her emotions obeyed or disappeared.

While our right brain is connected with our internal experience (Lissa’s secret hurt for example), our left brain is much more concerned with what the rest of the world thinks, shaped perhaps to protect us from coming into harmful conflict with others. These are incompatible objectives, for while we operate in a left-brain dominated world, we live inside a right-brain sensitive body.

Our need for the acceptance of our fellow human beings results in unbearable confusion when we are the object of an injustice at their hands. Lissa evaded family disapproval only when she avoided her own pain, but her pain followed her around in the same way her synapses did, her central nervous system or her lower spine. Rejection and shame turned her pain into guilt – which she had to bury. Lissa complied with the outside world at the expense of her inside world, but ultimately Lissa could not control those feelings, no matter what the outside world thought. 

(C) M Appleton 2023

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