Chronic shame: Origins, impacts, and interventions

Chronic shame is a deep-seated and pervasive emotional state that can profoundly affect both psychological and physical well-being. Unlike fleeting feelings of shame, chronic shame is a persistent condition, often tied to early childhood experiences. 


Origins of chronic shame

Chronic shame often originates from childhood trauma, such as abuse, neglect, or continuous exposure to invalidating environments. According to DeYoung (2015), chronic shame develops when children internalise negative messages from caregivers, resulting in a deep-seated sense of unworthiness. These early experiences can disrupt the formation of a stable self-concept, making individuals susceptible to shame throughout their lives.

Attachment theory and chronic shame

John Bowlby's attachment theory provides a useful framework for understanding how early relational trauma can lead to chronic shame. Children who experience insecure attachments are more likely to develop feelings of inadequacy and self-doubt (Bowlby, 1969). Inconsistent or emotionally unavailable caregiving can cause children to internalise a belief that they are unlovable or fundamentally flawed. In contrast, secure attachments foster a sense of safety and self-worth. Without this, children may carry unresolved feelings of shame into adulthood.

Developmental trauma and shame

Developmental trauma, as described by van der Kolk (2014), involves chronic exposure to traumatic events during critical developmental periods. This trauma can hinder normal emotional and neurological development, leading to difficulties in emotional regulation and self-perception.

Constant criticism, neglect, or abuse can make children internalise these negative experiences, resulting in a persistent sense of shame. This internalised shame can affect their ability to trust others and form healthy relationships, perpetuating a cycle of negative self-perception and relational difficulties.

Psychodynamic perspectives

Kohut’s self-psychology emphasises the importance of empathic attunement from caregivers in developing a cohesive self (Kohut, 1971). When caregivers fail to provide this attunement, children may develop a fragmented self, characterised by chronic feelings of shame and unworthiness. Winnicott’s concept of the ‘good enough’ mother highlights the necessity of responsive and supportive parenting in fostering a healthy self-concept (Winnicott, 1965).

Neurobiology of shame

The neurobiology of shame involves complex interactions between various brain regions and neurotransmitters. The amygdala, associated with processing emotions, plays a crucial role in the experience of shame (Siegel, 2012). When individuals encounter shame-triggering situations, the amygdala activates, leading to heightened emotional responses.

Chronic shame also affects the prefrontal cortex, which is responsible for executive functions such as decision-making and self-regulation. Prolonged exposure to shame can impair the functioning of the prefrontal cortex, making it difficult to manage emotions effectively. Neurochemical imbalances, particularly in cortisol and serotonin levels, can exacerbate feelings of shame and contribute to depression and anxiety (Gilbert, 2010).

Impact of chronic shame in adulthood

Chronic shame continues to affect individuals well into adulthood, often resulting in low self-esteem, perfectionism, and a pervasive sense of inadequacy. These feelings can lead to difficulties in forming and maintaining healthy relationships, as individuals may fear rejection and criticism. DeYoung (2015) notes that chronic shame can manifest in behaviours such as avoidance, withdrawal, and aggression. For example, individuals may avoid social situations to protect themselves from potential shame triggers, or they may exhibit aggressive behaviours to mask their underlying shame.

Chronic shame is also linked to numerous mental health issues, including depression, anxiety, and substance abuse. The persistent sense of worthlessness and self-criticism can lead to depressive symptoms, while fear of judgment and rejection can contribute to anxiety disorders. Some individuals may turn to substance abuse to numb their emotional pain and escape from feelings of shame.

Working with chronic shame

Treating chronic shame requires a multifaceted approach addressing both the psychological and neurobiological aspects of the condition. According to DeYoung (2015), effective treatment involves creating a therapeutic environment that fosters safety, trust, and empathy. Therapists must help clients develop a more compassionate and accepting view of themselves, challenging the negative self-beliefs that contribute to their chronic shame.

The role of therapy

  • Person-centred therapy: Chronic shame often stems from early relational trauma and a lack of validation during childhood. Person-centred therapy addresses these core issues by providing a corrective emotional experience through the therapeutic relationship.
  • Compassion-focused therapy: Compassion-focused therapy (CFT), developed by Paul Gilbert, aims to help individuals develop self-compassion and reduce self-criticism (Gilbert, 2010). Through cultivating a compassionate mindset, clients can heal from past wounds and develop a healthier self-concept. CFT combines techniques from cognitive-behavioural therapy with practices that enhance self-compassion, helping clients reframe their negative self-perceptions and foster emotional resilience.
  • Mindfulness and acceptance-based therapies: Mindfulness-based approaches, such as Mindfulness-Based Stress Reduction (MBSR) and Acceptance and Commitment Therapy (ACT), offer valuable tools for addressing chronic shame. These therapies encourage individuals to develop a non-judgmental awareness of their thoughts and emotions, helping them disengage from the negative self-talk that perpetuates shame (Kabat-Zinn, 1990; Hayes, Strosahl, & Wilson, 1999). Fostering an attitude of acceptance and self-compassion, these approaches can help individuals break the cycle of chronic shame and develop a more positive self-view.

Final thoughts

Chronic shame is a deeply ingrained emotional state that originates from early childhood experiences and has lasting effects on mental health and well-being. Understanding the origins, neurobiology, and impact of chronic shame is crucial for developing effective treatment strategies. Creating a nurturing and supportive therapeutic environment enables individuals to start healing from chronic shame and develop a more positive self-concept.


Bowlby, J. (1969). Attachment and Loss: Vol. 1. Attachment. New York: Basic Books.

DeYoung, P. A. (2015). Understanding and Treating Chronic Shame: A Relational/Neurobiological Approach. Routledge.

Gilbert, P. (2010). Compassion Focused Therapy: Distinctive Features. Routledge.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. Guilford Press.

Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Delta.

Kohut, H. (1971). The Analysis of the Self: A Systematic Approach to the Psychoanalytic Treatment of Narcissistic Personality Disorders. University of Chicago Press.

Siegel, D. J. (2012). The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are (2nd ed.). Guilford Press.

Van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.

Winnicott, D. W. (1965). The Maturational Processes and the Facilitating Environment: Studies in the Theory of Emotional Development. International Universities Press.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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London NW1 & Chesham HP5
Written by Melinda Mozes, Psychotherapist | Clinical Supervisor MBACP
London NW1 & Chesham HP5

I am an experienced psychotherapist and counsellor working online with adults of all ages.  I work with a wide range of clients; specialisms include bereavement & loss, relationship issues, workplace stress, anxiety and depression.  I offer a confidential and safe space where I help cl...

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