Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for January 20th, 2012

Shame: The Hallmark of Early Adolescence

Posted by Dr. Vollmer on January 20, 2012

Douglas and Barbara Schave proposed that early adolescence, ages eleven to fourteen is a distinct developmental stage, marked by shame as the main disruptive affect, which can be further differentiated into affects of dishonor, ridicule, humiliation, mortification, chagrin, embarrassment or disgust. Reading their paper made me think of Lela, fifty-two, who did not follow-up with her primary care physician in getting her mammogram and her colonoscopy, such that she felt such shame that although she had a relationship with this physician for fifteen years, she felt she could no longer go back. She was convinced that because she did not do what he recommended that he would think so poorly of her that their relationship could not continue. “What if you explained to him that you were nervous to get these screening tests done and so you procrastinated?” I asked, knowing that the issue is not one subject to logic, but to deep-seated feelings of shame and humiliation, leading Lela to need to hide and withdraw. Lela said “well, I just could not face him.” “That reminds me of how twelve-year-old girls feel when they get a pimple. They feel that everyone is looking at their face, so they just cannot go out in public,” I say, trying to tie Lela’s feelings to a developmental phase without further humiliating her. “Yes, it may be like that,” she says without getting defensive, “but I am trying to explain to you how I feel.” “Yes, I appreciate that. I think I understand the deep feelings of shame because I can relate it to that phase in life in which shame is felt so much of the time.” Lela looks at me a little calmer now. “Compared to my mom, I have a lot less shame,” she says, with a touch of defensiveness. “Well, I am sure that your mom’s sense of shame has a lot to do with yours as well,” trying to tie the two together, rather than making it a competition. “Yea, of course, but I am glad I am not as bad as she is,” Lela says to comfort herself. “Maybe you can go back to your physician. Maybe it is important to maintain the relationship, since he has known you for so long,” I say, encouraging her to re-examine her resistance. “I will think about it,” she says, convincing me that our session meant something to her.

Posted in Adolescence, Psychoanalysis, Psychotherapy, Shame | 2 Comments »

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