Paula Branch Holt, LCSW, PhD is in private practice in San Francisco. She has a BA from Mary Baldwin College in Staunton VA, worked on her MSW at the University of Texas and completed her MSW at San Francisco State before earning her PhD from The Sanville Institute. She has also worked on a Masters degree in English Literature. She has been exploring the subject of shame for many years, continuing an open-ended pursuit to understand its impact on the emotional health of client and therapist, and its pervasive existence in the environment, the culture, the individual, and the unconscious. She is currently working on a book on shame for the general, but informed, reader.
My dissertation (2012) was on the subject of shame. The problem of shame has always puzzled me and often baffled even before I sat down with my first client. It became absolutely necessary that, as a therapist, I explore shame. I had to find out more about it. Shame frightened me as it captivated me. Shame is elusive and subtle. It seems to be a magnet that attracts all our human troubles to it.
The complex emotions collected around shame come in the door with every client. We see self consciousness, fear, anxiety, lack of self worth, difficulty talking, difficulty thinking, difficulty focusing—a miserable knot of pain and emotion. Even those who present a more “together” aspect can show the disabling presence of shame. Important pieces of the presenting problem will elude the client. The client will become confused. Defenses will erupt suddenly, only to suddenly disappear taking all thought away with them. The client will be unable to hold an insight or understanding.
Even so, shame is a gift because shame holds the key to working with and understanding a client’s core problems. Holding a space where we can begin to access and look at shame issues is central to doing essential work. All of our skills in setting up the therapeutic alliance, and a safe holding environment are crucial. But, finally, it is out own ability to access our own shame and hold to the presence of that vulnerability inside of our own selves, that ultimately may open the client to healing. We connect with the client by extending the wounded hand of our own shame.
While working for my PhD, at Sanville I had an opportunity to learn further how to access my difficult feelings, how to sort them out, as well as how to research my subject. It was a gift to work with senior psychotherapists who shared their experience and their techniques. Because of the subtlety of the subject of shame and its history of neglect as a focus, I had the advantage of an open field to explore. My personal investment in understanding shame led to building a personal repertoire of technique, and some unique discoveries. I completed my dissertation having found a professional confidence that now serves all my work.