Trauma, Guilt and Shame From an ACT Perspective

Sonja-Batten

Booz Allen
Department of Veterans Affairs
Yale University
University of Nevada, Reno

Key Points

  1. The experience of shame is common among trauma survivors.
  2. It can be experienced as visceral sensations, emotions, or negative evaluations.
  3. These suggest there’s something wrong with the person.
  4. Addressing avoidance behaviors is key.
  5. Direct guilt and survivor guilt are common responses.
  6. Work on defusion and acceptance.
  7. Approach guilt as an important source of values information.
  8. Work with the client to commit to actions that are in line with the values that underlie their guilt.
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Transcript

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One of the consequences that can arise from the experience of trauma is a feeling of shame or the sense that deep down there is something wrong or defective with the person who has survived either a single traumatic event or a series of repeated traumas, perhaps in childhood. Shame can arise through a combination of simply feeling that the horrifying event defines a person or because of things that were directly communicated to the individual in conjunction with the trauma. For example, a child sexual abuse survivor may have been told repeatedly that they were responsible for the abuse or may have fused with other negative evaluations of themselves that were conveyed by the perpetrator.

Batten, S. V., Orsillo, S. M., & Walser, R. D. (2005). Acceptance and mindfulness-based approaches to the treatment of posttraumatic stress disorder. In S. M. Orsillo & L. Roemer (Eds.), Acceptance and mindfulness-based approaches to anxiety: Conceptualization and treatment (p. 241–269). Springer Science + Business Media.,McKay, M., Greenberg, M. J., & Fanning, P. (2020). The ACT workbook for depression and shame: Overcome thoughts of defectiveness and increase well-being using acceptance and commitment therapy. New Harbinger Publications.

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This experience of shame can be very aversive and has both a cognitive and an emotional component. There may be specific negative evaluations around being bad, dirty, or broken that may need to be identified and then addressed through defusion.

Batten, S. V., Orsillo, S. M., & Walser, R. D. (2005). Acceptance and mindfulness-based approaches to the treatment of posttraumatic stress disorder. In S. M. Orsillo & L. Roemer (Eds.), Acceptance and mindfulness-based approaches to anxiety: Conceptualization and treatment (p. 241–269). Springer Science + Business Media.,McKay, M., Greenberg, M. J., & Fanning, P. (2020). The ACT workbook for depression and shame: Overcome thoughts of defectiveness and increase well-being using acceptance and commitment therapy. New Harbinger Publications.

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