It’s publication day! I’m very pleased to announce that a psychology book was published today that includes a chapter I wrote on my concepts regarding shame. The title of the book is;

Practical Alternatives to the Psychiatric Model of Mental Illness: Beyond DSM and ICD Diagnosing

It is from a series called The Ethics International Press Critical Psychology and Critical Psychiatry Series., ed. Arnold Cantu’, Eric Maisel, Chuck Ruby

Chapter Title: “Clinical Case Formulation and Interventions Using a Shame-Informed Model.”


Because of the power of the emotion of shame to influence intrapersonal emotional wellbeing and interpersonal behavior, the mental health profession should consider adopting a shame-informed model to assess emotional and behavioral problems, rather than the disease model of the Diagnostic and Statistical Manual (DSM) and International Classification of Diseases (ICD). While shame is often ignored by clinicians and clients, it is generally considered a trans-diagnostic influence on conditions labeled as mood disorders, personality disorders and even childhood behavioral disorders. Specifically, shame intolerance leads to fear-based shame management strategies of avoidance, externalized anger, or self-directed anger and criticism. These strategies may help individuals cope with the distress of embarrassment, but often lead to blame-shifting behaviors that damage relationships.  Clinicians can easily learn to identify indicators of client negative self-image and beliefs of unworthiness by assessing for trauma history, attachment patterns, view of self and other, affect/presentation, and blame-shifting patterns in interpersonal relationships. Because compassion is the antidote to shame, compassion-focused therapy models provide evidence-based interventions that directly address both cognitions of self-criticism and the neurobiology of shame/fear states. A shame-informed case formulation model would lead to simplified, but meaningful, case conceptualization and treatment planning for clinicians and — most importantly — improved outcomes for clients.

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