“You know, men who have sex with men get HIV.” This was the simplistic and bigoted response I received from a university nurse practitioner when I disclosed my sexual orientation during a screening questionnaire during the first weeks of college. As it happened, I had foolishly decided to sleep in sheets directly out of the packaging and developed a rash, which happened to coincide with a cold I developed upon moving to Boston. Despite telling the NP about my bedding and the likely cold, I was disregarded and then ordered a full STI screening. I was stunned. I had just moved from a very rural, conservative part of the country, and I had worked hard to overcome shame and stigma when I came out. I had feared people in my town would reject me (some did), and I constantly felt as though I ought to apologize or compensate for who I was. Coming to a city as notoriously liberal as Boston, I thought I would be free of that shame and stigma, yet there I was, two weeks in, sitting with a healthcare provider and feeling those same feelings of shame and disgust with myself. I felt wrong, as though my very existence was dirty to others.
With December 1st honored as World AIDS Day, we spread awareness of HIV/AIDS and remember those, disproportionately LGBTQIA+, people who lost their lives during the AIDS epidemic. During that time, shame and stigma hid the impact of AIDS upon the community from public discourse and slowed research and access into effective treatments. Even today, there still exists political efforts in this country to defund AIDS relief programs and to remove the queer community from public sight, shaming people for the simple act of existing. Within the queer community, the intersections of identity and power have generated internalized messages of shame and stigma around body image, race and gender, which alienates those within the community from each other. This isn’t an emotion reserved for one group either. Most people would probably be able to tell you of a time they felt truly ashamed.
The negative impacts of shame are clear. Research into shame has found that increased feelings of shame correlate with negative mental health outcomes, such as increased symptoms of addiction, depression, compulsive behavior, anxiety, codependency and more. Moreover, social stigma around mental health challenges can often reinforce the shame fueling them. Guilt, a similar but distinct emotion to shame, focuses on the moral congruence of one’s behavior with one’s social environment and thereby motivates corrective action. Some addiction research even suggests that experiencing guilt correlates with better treatment outcomes. However, shame was not observed to do the same. Unlike guilt, shame focuses on who a person is, not what a person does. Because one can not simply change the nature of their existence, shame can quickly de-motivate and can send a person into a self-critical, depressive and isolating spiral.
So why do we feel shame in the first place? Psychologists recognize the function of many emotions. Anger motivates action towards justice and self-preservation. Sadness slows life down and encourages reflection. Love drives connection and pro-social behavior. Guilt guides corrective action and relationship repair. The function of shame is less clear. Some researchers posit that shame is a tool by which we measure where we stand in comparison to those around us, motivating behavior that promotes social cohesion. Evolutionarily, it makes sense. Separation from the group in the wilderness would have been a death sentence for most humans, and we are therefore intrinsically wired to equate isolation with death. However, we no longer live in that early environment, and the interconnectedness of modern society means we are constantly surrounded by a diversity of values, experiences, beliefs and personalities. It seems shame results in more harm than benefit these days.
So what do we do about shame? If shame insidiously whispers that we don’t belong with those around us, we can take action to reality check it. One potential option would be to meditate or journal reflecting upon times, people or even artists who have made you feel seen or understood. We tend to gravitate towards people who reflect our values and strengths, so how are you reflected in the people important to you? Another option, if it’s hard to recall a time when you felt connected to others, is to try attending an interest group, such as a book club, hiking group or volunteer group, where you can find and connect others who share your interests, values and beliefs. Community is a powerful way to have one’s strengths and values mirrored back to oneself, which can increase one’s sense of confidence, belonging and support. The best way to form it is through repeated presence. It could be as simple as becoming “a regular” at your favorite coffee shop. Finally, it can be helpful to recognize and separate the voice of shame when it speaks to you. Remember that you are accountable for what you do, not who you are. Shame may speak to you (persuasively), but you can choose whether or not to listen.
Mike Shirek is a third-year graduate student completing his master’s degree from Lesley University in clinical mental health counseling with a specialization in expressive arts therapies. He received his Bachelor of Arts in psychology from Harvard University. He is a member of the International Expressive Arts Therapy Association and is working towards becoming a licensed mental health counselor and registered expressive arts therapist. Mike has 2 years of clinical mental health experience working in both partial-residential hospital and non-profit community settings. He has experience in exposure and response prevention (ERP) therapy, CBT and DBT skills, expressive arts interventions, trauma-informed care and narrative therapy techniques. He is committed to honoring individuals’ personal stories and experiences and seeks to empower individuals to pursue meaningful changes in their lives.
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