Seeing and being seen: Shame in the clinical situation

Translations of summary

Shame may prevent the patient from emerging from a psychic retreat. As begins to do so he confronts two fears, first of seeing the object more clearly and second of being seen become prominent. Seeing leads to deeper and more distressing feelings connected with guilt and depression as the damage done to good objects is recognized. However it cannot be faced if shame leads to a demand for immediate relief.

Shame is a prominent feature of the analytic situation and recognizing this may help the analyst to support his patients to tolerate the discomfort of being seen so that the conflicts about seeing can be worked through.

Two clinical examples are briefly discussed. In the first feelings of inferiority lessened as they were analysed and allowed appreciative and depressive feelings to emerge. In the second embarrassment was associated with progress that the patient felt he had made but was embarrassed to admit.

It is argued that the analysis of shame in the analytic situation is necessary so that being seen can be tolerated and allow the conflicts over seeing to be worked through.

Key words:

• embarrassment
• shame
• humiliation
• persecution
• depression
• Education Section, Shame

Notes

1. It is interesting that early in infancy the child is unaware of embarrassment and shame, for example in relation to nudity and toilet functions. Then at some stage, usually in subtle ways from the beginning of the second year embarrassment begins to emerge and a touching loss of freedom develops as if the child too has emerged from paradise. If the embarrassment fails to develop the child may lack an important restraining factor and grow up to be shameless. If the inhibition is overly severe he may develop an oversensitivity to shame.

2. These observations arose from comments made by Ignes Sodre (2012, personal communication).

3. The clinical material is reported more fully in Steiner (2006, and 2011, Chapter 1).

4. This clinical material is reported more fully in Steiner (2011, Chapter 3).