Denver Psychotherapy Counseling, Therapy, & Psychologist Resources for Denver, Lakewood, Broomfield, Aurora, Littleton - Clinical Worksheets & Self-Help

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Treating Shame

Jeff Peterson conducts research and presents on Addressing Shame with Clients Who Identify as Lesbian, Gay, Bisexual, and Transgender.  Download a PDF of his Presentation:  Jeff Peterson Presentation - The Developmental Impact and Long-Term Effects of Shame on Sexual and Gender Minorities.pdf










Additional Objectives of this Presentation:

- Differentiate between shame and guilt

- Explore the ways shame manifests through cultural messaging and microaggressions

- Examine how LGBT individuals attempt to reduce or avoid shame

- Introduce the Compass of Shame Model for understanding the developmental trajectory of shame

- Investigate how LGBT individuals turn against themselves as an attempt to regain efficacy

- Identify those who are most at-risk

- Discuss what providers can do to help clients process and overcome the long-term effects of shame



Key Points Regarding Shame & LGBT Identities


•Homophobia is internalized before we have a sense of who we are.


•Hiding parts of ourselves produces shames and affects our relationships with other.


•Depression, anxiety, relationship issues, overachievement may all be signs of internalized homophobia.


•So much of shame is dealing with the expectations of others.


•As children, we may not hear anything derogatory about LGBT people, but do we hear anything at all? It's as if LGBT people do not exist.


•For some, identifying as LGBT is too much to bear so treatment may be avoided. If that's the case, consider working on other areas of the client's life, like trauma, before discussing the LGBT issue.


•The power to identify with the tribe (or group) is strong. This may inhibit someone from coming out or cause an individual who does not fit the definition of "LGBT" to be shut out from the community.


•Strategies include identifying and naming internalized homophobia: some clients may not be aware of the dynamic.


  1. Remember to move at your loved one’s pace: they may not be ready to identify as LGBT.



Resources Addressing Shame


Books Addressing Shame


Byron Brown – Soul without Shame: A Guide to Liberating Yourself from the Judge Within


Ronda Dearing & June Price Tangney – Shame in the Therapy Hour


Christopher Germer – The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions


Alan Downs - The velvet rage: Overcoming the pain of growing up gay in a straight mans world, Second edition


Brene Brown - Daring greatly: How the courage to be vulnerable transforms the way we live, love, parent and lead.


Dossie Easton & Janet W. Hardy - The ethical slut



Videos Addressing Shame


The Whittington Family – Ryland’s Story

https://www.youtube.com/watch?v=yAHCqnux2fk


TED Talk: Brene Brown on vulnerability

http://www.ted.com/talks/brene_brown_on_vulnerability


TED Talk: Brene Brown on shame

http://www.ted.com/talks/brene_brown_listening_to_shame?language=en



News articles Addressing Shame


New York Times – “Living the good lie”

http://www.nytimes.com/2011/06/19/magazine/therapists-who-help-people-stay-in-the-closet.html?pagewanted=1&_r=0&emc=eta1



Clinical References From Jeff’s Presentation


Bybee, J., Sullivan, E., Zielonka, E., Moes, E.  (2009).  Are gay men in worse mental health than heterosexual men? the role of age, shame and guilt, and coming-out.  Journal of Adult Development, 16:(1), 144–154


Centers for Disease Control and Prevention (CDC). (2011).  Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9–12 — Youth Risk Behavior Surveillance, Selected Sites, United States, 2001–2009. MMWR Early Release, 60, 1-135.


Dearing, Ronda L. (Ed.); Tangney, June Price (Ed.).  (2011).  Shame in the Therapy Hour.  Washington, DC: American Psychological Association.


Dwairy, M.  (2010).  Parental Acceptance–Rejection: a Fourth Cross-Cultural Research on Parenting and Psychological Adjustment of Children.  Journal of Child & Family Studies, 19(1), 30-35.


Gausel, N., Leach, C.  (2011). Concern for self‐image and social image in the management of moral failure: Rethinking shame, European Journal of Social Psychology, 41, 468– 478.


Goldsmith, S., Pellmar, T., Kleinman, A., Bunney, W.  (2002).  Medicine’s Reducing Suicide: A National Imperative.  Washington, DC: The National Academies Press.


Greene, D., Britton, P.  (2013).  The influence of forgiveness on Lesbian, Gay, Bisexual, Transgender, and Questioning individuals’ shame and self-esteem.  Journal of Counseling & Development, 91(1), 195-205.


Hatzenbuehler, M.  (2011).  The social environment and suicide attempts in Lesbian, Gay, and Bisexual Youth.  Pediatrics, 127, 896–903.


Jimenez, X., McAfee, S.  (2010).  Crystal Methamphetamine, Body Dysmorphia, and Shame: A Psychodynamic Case Report from the Trainee Perspective.  Journal of Gay & Lesbian Mental Health, 14:355–366.


London, B., Downey, G., Bonica, C., Paltin, I.  (2007).  Social causes and consequences of rejection sensitivity.  Journal of Research on Adolescence, 17(3), 481-506.


Marshal, M., Dietz, L., Friedman, M., Stall, R., Smith, H., McGinley, J., Thoma, B., Murray, P., D’Augelli, A., Brent, D.  (Aug 2011).  Suicidality and Depression Disparities Between Sexual Minority and Heterosexual Youth: A Meta-Analytic Review. Journal of Adolescent Health, 49(2), 115-123.


McDermott, E., Roen, K., Scourfield, J.  (2008).  Avoiding shame: young LGBT people, homophobia and self-destructive behaviours.  Journal of Culture, Health and Sexuality, 10(8): 815–829.


Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697.


Peden, M., McGe, K, Krug, E.  (2002).  Injury: A leading cause of the global burden of disease.  Geneva: World Health Organization.


Ploderl, M., Faistauer, G., Fartacek, R.  (2010).  The Contribution of School to the Feeling of Acceptance and the Risk of Suicide Attempts among Austrian Gay and Bisexual Males.  Journal of Homosexuality, 57(7), 819-841.


Ryan, C., Huebner, D.,  Diaz, R., Sanchez, J.  (2009).  Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults. Pediatrics 2009;123:346–352.


Sherry, A.  (2007).  Internalized homophobia and adult attachment: Implications for clinical practice.  Psychotherapy: Theory, Research, Practice, Training, 44(2), 219-225.


Suicide Prevention Resource Center. (2008). Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth. Newton, MA: Education Development Center, Inc.


Tan, P.  (2005).  The Importance of Spirituality Among Gay and Lesbian Individuals.  Journal of Homosexuality, 49(2), 135-144.