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The Mechanism of Shame

LEON WALLACE, M.D.
Arch Gen Psychiatry. 1963;8(1):80-85. doi:10.1001/archpsyc.1963.01720070082010.
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I  It is a commonly observed phenomenon of clinical experience that shame appears to be absorbed by guilt, or at least that the 2 affects are confused. Patients often use the terms interchangeably and when challenged are sometimes unable to differentiate between the 2 feelings. The statement "I am ashamed" may carry the implication of shame, guilt, or both. In contrast to this most patients can recall some situations in which they felt clearly ashamed or guilty, without any confusion regarding the nature of the affect. The affects appears to function as if they served a common purpose in the psychic economy; yet, they have marked differences in their physiological counterparts and are considered to have distinct origins.In face-to-face psychotherapy, resistances to free expression of thoughts and feelings are enforced by shame or its threat with particularly great frequency. The frequency of this observation in a multitude

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