Shame, trauma, and dissociation
Forkus, Contractor, Raudales & Weiss (2022) published “The Influence of Trauma-Related Shame on the Associations Between Posttraumatic Symptoms and Impulsivity Facets” in Psychological Trauma: Theory, Research, Practice, and Policy. I like this study for several reasons. It has a large number of participants with clearly documented trauma and approaches the study with the possibility that trauma-related shame (TRS) may either increase or decrease the likelihood of impulsive behavior. Here’s the abstract:
Introduction: The co-occurrence of posttraumatic symptoms (PTS) and impulsivity is associated with higher levels of risky and self-destructive behaviors and consequent safety and health risks. Trauma-related shame (TRS) may influence the association between PTS and impulsivity such that engaging in impulsive behaviors may serve to cope with emotional distress. Alternatively, TRS may motivate a deliberate consideration of behaviors (i.e., less impulsivity) to prevent further cognitive and emotional distress. Objective: The goal of the current study was to examine the influence of TRS on the associations between PTS and impulsivity facets (lack of premeditation, lack of perseverance, negative urgency, positive urgency, sensation seeking). Method: Data were collected from 506 community individuals who endorsed lifetime sexual trauma (Mage = 34.56, 54.3% women, 78.7% White). Results: Findings indicated that TRS moderated associations between PTS and impulsivity facets of lack of perseverance, b = −.001, SE = .0003; t = −2.68, p = .008, 95% confidence interval [−.001, −.0002], and premeditation, b = −.001, SE = .0003; t = −3.70, p < .001, [−.002, −.001]; these associations were significant at low, but not high, levels of TRS. Conclusions: Findings suggest that in the context of PTS, TRS may reduce certain forms of impulsivity, potentially as a means to self-protect against further cognitive and emotional distress. Findings have important implications for understanding how individuals regulate and respond to shame in the context of PTS.
In the end, their data suggest differences depending on the level of TRS. More research is obviously needed but this research may motivate therapists to ask more questions when discussing trauma, shame, and impulsivity.
In the second study, Kouri, D'Andrea, Brown, & Siegle (2023) published “Shame-Induced Dissociation: An experimental study of experiential avoidance” in Psychological Trauma: Theory, Research, Practice, and Policy. I’m going to begin with the impact statement, then the edited abstract:
Shame is a well-known emotion associated with symptoms of posttraumatic stress, including dissociation, or alterations and disruptions to consciousness, memory, self-identity, and perceptions of the body and environment. Using the experimental “script-driven imagery” paradigm, this study demonstrated how female-bodied or identified adults dissociate when recalling shameful memories. The phenomenon of shame-induced dissociation occurred regardless of the severity of the participant's exposure to childhood maltreatment. Although shame and dissociation are related to posttraumatic stress, the results suggest a unique relationship that should be a clinical target in therapeutic interventions.
The study experimentally investigated shame-induced dissociation, and to what extent that process was associated with exposure to childhood maltreatment. Using a shame-related script-driven imagery paradigm and mirror-viewing task, 50 female participants from the community recalled two shame-related and two neutral autobiographical memories, after which they listened to recordings of themselves retelling the narratives looking in a mirror or at a black curtain (i.e., mirror-viewing task). Shame-related memories compared to neutral memories resulted in higher rates of dissociation. The relationship between shame and dissociation was significantly moderated by experiential avoidance or avoidance of unwanted cognitive and affective reactions. In contrast to previous research, looking in the mirror and childhood maltreatment severity did not predict dissociative responses. The strong relationship between shame and dissociation suggests the importance of monitoring patients’ affect and behavior when revisiting shame-related memories, to not reinforce dissociative reactions and inadvertently foster treatment resistance.
This study provides helpful information about the relationship between shame and dissociation. It is a small sample, all female-identified, but is potentially helpful to both therapists and testing psychologists.