Coping With Borderline Disorder Embarrassment and Shame

Coping With Borderline Disorder Embarrassment and Shame BPD Print Coping With Borderline Disorder Embarrassment and Shame By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial policy Kristalyn Salters-Pedneault, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 24, 2020 Ryuichi Sato / Getty Images More in BPD Diagnosis Treatment Living With BPD Related Conditions Many people with borderline personality disorder (BPD) experience intense and chronic shame, a self-conscious emotion associated with a sense of worthlessness, self-contempt, or self-loathing. Shame may in part explain the high rates of self-harm and suicidal behavior in people with BPD.?? What Is Shame? We use the word all the time, but what exactly is shame? Shame is considered one of the self-conscious emotions; it is an emotion that relates to our behavior or self, often in relation to other peoples opinions. Other self-conscious emotions include embarrassment and guilt. Although the lines between these emotions have been conceptualized in different ways, one way to think about this is that shame is different than embarrassment or guilt because we experience these two emotions in relation to our behavior, whereas shame is an emotion that relates directly to our sense of self. To understand this distinction, lets use the example of an impulsive act that some people with BPD struggle with shoplifting. Imagine that, on impulse, you shoplifted something from a store. Even if no one found out about the shoplifting, you may experience guilt, a feeling that you have done something that is wrong. If someone did find out about your behavior, you might experience embarrassment, the feeling you get when other people find out you have done something that violates social norms. Shame, on the other hand, is a feeling that you are bad or worthy of contempt. It is not necessarily about a specific behavior or event  but is a feeling of being inadequate as a person. You may feel shame after shoplifting, but shame carries with it an additional judgment. BPD and Shame Many people with BPD experience pervasive and chronic shame, regardless of their behavior.?? This has lead researchers to believe that shame may distinguish BPD from other mental health disorders. For example, a study from 2007 found that women with BPD and post-traumatic stress disorder (PTSD) were not more shame-prone than women who only had BPD.?? These findings suggest that shame-proneness could be specifically related to BPD rather than co-occurring trauma-related symptoms. Other studies seem to support this suggestion.?? Research on the role of shame in BPD has shown that women with BPD report more shame-proneness compared to women who did not have BPD, as well as compared to women with other mental health disorders such as depression and social anxiety, and to women who did not have a mental illness (healthy controls).?? The Relationship Between Shame, Self-Harm, and Suicide In addition to growing research that shows a connection between BPD and shame, a number of experts have suggested a connection between shame and deliberate self-harm and suicide attempts.?? Shame may also precede episodes of deliberate self-harm. Self-reported feelings of shame and self-disgust have been associated with suicide threats and thoughts in people with several mental health conditions, including BPD.?? Research has also demonstrated that women with BPD who expressed more shame when talking about their self-harm behaviors were more likely to self-harm in the future.?? Reducing Shame While it is well-known that intense emotional pain is generated by feelings of shame associated with BPD, there are not yet effective treatments directly aimed at reducing shameful feelings. Researchers concede that more studies are needed to prove that reducing shame can reduce self-harm urges in people with BPD.?? Some preliminary research indicates that the Dialectical Behavior Therapy  skill of Opposite Action may help reduce shame about specific events for some people with BPD.?? Unfortunately, people who experience high levels of shame may also feel motivated to hide their feelings because they are afraid of judgment. In turn, that secrecy can prevent them from receiving the treatment they need. If you or a loved one has BPD and is dealing with feelings of shame or having suicidal thoughts, its imperative to share these feelings with a therapist or another qualified mental health professional that you can trust.