The Impact of Shame on the Therapeutic Alliance and Intimate Relationships

Black, Rebecca; Curran, David; Dyer, Kevin

doi:10.1002/jclp.21959

Cited by 55 publications

(46 citation statements)

References 20 publications

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“…Currently, new models of treatment for childhood sexual abuse and complex trauma (e.g., STAIR Narrative Therapy; Cloitre et al, 2014) incorporate emotional regulation strategies and coping skills in the initial phases of therapy to provide a stable base for clients to then engage in later trauma processing. Bearing in mind the unhelpful role of some shame coping styles observed in the current study and recent findings that shame responding can be a barrier to the therapeutic alliance (Black et al, 2013), the integration of shame interventions at these early therapeutic stages would be beneficial.…”

Section: Discussionmentioning

confidence: 74%

“…Ironically, "withdrawal" was initially asserted as a psychologically healthy shame coping style (see Nathanson, 1992). Gathering empirical evidence has provided a different picture of this coping style and found that it is both a problematic coping strategy for DID and a risk factor for difficulties in both forming effective therapeutic relationships and overall relationship functioning (Black et al, 2013;Dorahy et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Therapists of participants used assessment information, DSM-IV (American Psychiatric Association [APA], 1994), and clinical judgement to informally diagnose the main presenting problems of participants. This sample has been described previously in Black et al (2013); however, nine participants who reported trauma and/or clinical PTSD symptoms were excluded from the present study to prevent overlap with the Complex Trauma Group. Of the 41 participants, 19 had mood problems (e.g., Major Depression); 10 had anxiety disorders (e.g., Generalised Anxiety Disorder); and 12 had personality problems (e.g., Borderline Personality disorder).…”

Section: Methods Participantsmentioning

confidence: 99%

See 2 more Smart Citations

Comparing shame in clinical and nonclinical populations: Preliminary findings.

Dyer¹,

Dorahy²,

Corry³

et al. 2017

Psychological Trauma: Theory, Research, Practice, and Policy

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Objectives: To conduct a preliminary study comparing different trauma and clinical populations on types of shame coping style and levels of state shame and guilt. Methods: A mixed independent groups/correlational design was employed. Participants were recruited by convenience sampling of 3 clinical populations—complex trauma (n = 65), dissociative identity disorder (DID; n = 20), and general mental health (n = 41)—and a control group of healthy volunteers (n = 125). All participants were given (a) the Compass of Shame Scale, which measures the four common shame coping behaviors/styles of “withdrawal,” “attack self,” “attack other,” and “avoidance,” and (b) the State Shame and Guilt Scale, which assesses state shame, guilt, and pride. Results: The DID group exhibited significantly higher levels of “attack self,” “withdrawal,” and “avoidance” relative to the other groups. The complex trauma and general mental health groups did not differ on any shame variable. All three clinical groups had significantly greater levels of the “withdrawal” coping style and significantly impaired shame/guilt/pride relative to the healthy volunteers. “Attack self” emerged as a significant predictor of increased state shame in the complex trauma, general mental health, and healthy volunteer groups, whereas “withdrawal” was the sole predictor of state shame in the DID group. Conclusions: DID emerged as having a different profile of shame processes compared to the other clinical groups, whereas the complex trauma and general mental health groups had comparable shame levels and variable relationships. These differential profiles of shame coping and state shame are discussed with reference to assessment and treatment.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Methods Participantsmentioning

confidence: 99%

See 1 more Smart Citation

Comparing shame in clinical and nonclinical populations: Preliminary findings.

Dyer¹,

Dorahy²,

Corry³

et al. 2017

Psychological Trauma: Theory, Research, Practice, and Policy

Self Cite

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“…They did not find any significant relationship between self-shame and coping mechanisms; however, they found a significant correlation between shame coping style and PTSD, and said, "In PTSD samples, a specific, definable trauma, or multiple traumas (e.g., childhood abuse, rape), can clearly be linked to the emergence of shame-related coping; however, the nature and origins of shame coping styles in non-trauma groups is less clear" (p. 646). In short, the definition of shame is very subjective, and it might differ based on a client's self-concept (Black et al, 2013;Harder & Lewis, 1987;Tangney & Dearing, 2002). Thus, researchers would more carefully define shame because it might be different in diverse social and cultural contexts.…”

Section: Shame Guilt and Hopementioning

confidence: 99%

The Role of Religious Leaders in the Restoration of Hope Following Natural Disasters

Hirono

Blake

2017

SAGE Open

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“…From this rationale, attachment pattern, cognitive-emotional factors (e.g., alexithymia), and the dominant behavioural coping strategies of clients could be highly salient factors in the therapeutic alliance of clients with PTSD (Ackerman & Hilsenroth, 2003;Black, Curran, & Dyer, 2013).…”

Section: Ptsd/trauma Have Been Experienced Over the Past 35 Years In mentioning

confidence: 99%

Client factors that predict the therapeutic alliance in a chronic, complex trauma sample.

Reynolds¹,

Simms²,

Webb³

et al. 2017

Traumatology

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This project was completed as a PhD dissertation by the first name author. We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. AbstractThis investigation aimed to examine how specific client characteristics of individuals with chronic, complex trauma are associated with the type coping strategies they employ and the quality of the therapeutic alliance. Fifty-nine adult participants with diagnostic levels of posttraumatic stress disorder (PTSD) and who attended therapy for complex trauma in Northern Ireland were obtained via opportunity sampling. Participants completed self-report measures of client attachment style, alexithymia, coping strategies, and the therapeutic alliance. Preoccupied attachment factors such as "Need for Approval" and "Preoccupation with Relationships" were related to use of maladaptive coping strategies. In contrast, the adaptive coping strategies of "Acceptance" and "Instrumental Support" were significant predictors of a positive therapeutic alliance, whereas established psychological and traumatogenic factors (e.g., attachment, number of traumatic events) did not significantly predict the therapeutic alliance. The findings have implications for understanding the relationship between client characteristics and the therapeutic alliance within complex trauma populations, as well as developing protocols to assist this process.Keywords: Therapeutic Alliance, complex trauma, client factors, coping CLIENT FACTORS, THERAPEUTIC ALLIANCE, AND TRAUMA 3 Client characteristics, coping strategies, and the therapeutic alliance in a chronic, complex trauma sample Defined broadly as the collaborative and affective bond between therapist and client, the therapeutic alliance has long been considered an essential element of the therapeutic process. Research has consistently found a substantive relationship between the alliance and therapeutic effectiveness, regardless of therapeutic orientation, presenting problem, or problem severity (Goldsmith, Lewis, Dunn, & Bentall, 2015;Martin, Garske, & Davis, 2000). The capacity to engage in an effective therapeutic alliance, however, is thought to require concomitant implementation of certain coping strategies by clients (e.g., reflection, active coping, openness), which can prove challenging (Stiles, Agnew-Davies, Hardy, Barkham, & Shapiro, 1998).One clinical group in which this area of study is particularly relevant is individuals who have experienced chronic, complex or childhood trauma. Herman (1992) proposed the concept of 'Complex PTSD', or 'Complex Trauma' as it is also known, to describe the multifaceted clinical presentation of individuals experiencing protracted, recurring trauma, particularly of an interpersonal nature (e.g., childhood sexual abuse, sectarian violence).Compared to clients with a discrete or 'simple' PTSD presentation, individuals with complex PTSD have a more severe and comprehensive sympt...

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The Impact of Shame on the Therapeutic Alliance and Intimate Relationships

Cited by 55 publications

References 20 publications

Comparing shame in clinical and nonclinical populations: Preliminary findings.

Comparing shame in clinical and nonclinical populations: Preliminary findings.

The Role of Religious Leaders in the Restoration of Hope Following Natural Disasters

Client factors that predict the therapeutic alliance in a chronic, complex trauma sample.

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