Do you feel there are things best kept to yourself, things that aren’t fit for the public eye – things you’re deeply ashamed of? For example, I have a patient who struggles to trust her partner. She knows she should, but she just can’t and she sees this inability to trust as an ugly and shameful part of herself. Another patient has such an exaggerated view of body flaws that she starves herself – and feels such self-loathing because of it. These patients bring to therapy not only these symptoms, but a deep and painful shame about what they see as hidden ugliness. What “dysfunctional” behaviors do you engage in that you feel helpless to stop even though you promise yourself you will?

The thing is, and it’s profoundly important: everything you do – no matter how dysfunctional it is! – was at least sometime in your life meant to be self-preserving. Sometime in your past, consciously or unconsciously, you needed to find a way to feel better, and so you created a coping strategy to help you postpone the emotional or even physical discomfort and pain. However, these coping strategies are now outdated – they’re old and now that the situations that evoked these responses are in the past, the coping strategies are now dysfunctional behaviors. These coping strategies that got you through dark times now leave you feeling frustrated and ashamed.

For example, my distrustful patient grew up with a profoundly unstable mother. Her mother was so volatile that my patient never knew if she’d come home to find all her belongings strewn across front lawn, or when her mother would fly into a rage. As a result, my patient developed her own set of rules to navigate these situations, remaining on guard at all times. She developed distrust to help her survive – she had to.

My second patient grew up with an emotionally distant mother, but remembers her mother once bragging to a friend that the daughter’s thinness made her proud. Because her mother was distant, my patient was left to develop her own world-view, eventually coming to consider the world a judgmental place that had the power to determine her self-worth. One slip – one dessert! – she feared would send her spiraling out of control, careening toward the obesity, thus creating a cycle of starving, losing control, and self-loathing.

But let’s be patient with my patients: both coping strategies were once necessary; both strategies helped before they hurt. Both women created the opportunity to feel better in the face of unbearable pain and shame, at the expense of later feeling worse.

There are hundreds of conscious and unconscious coping strategies. For example, much research shows that POWs and combat veterans might unconsciously use humor to cope with memories of their experiences. On the conscious side of the spectrum, other research (e.g., this from the journal Health Psychology), shows the coping strategy of self-monitoring can help moderate weight gain during the holidays. And some coping strategies can be both conscious and unconscious, for example, this study shows that trauma nurses use days off to cope with the physical and emotional demands of their jobs. Even drug and sex addiction may once have been coping mechanisms, meant to make the addict immediately feel better.

Your therapy goal may be to stop this dysfunctional behavior or attitude. But the key is to allow yourself to accept that these behaviors initially came from a self-preserving place, thereby chipping away at the shame these behaviors now create.

The first step is to recognize the trauma – large or small – that compelled you to create your coping strategy. The next step is to learn to feel compassion instead of blame for yourself – the person you are now and also the person you were at the time. Try to understand the necessity of the coping strategy from the perspective of the child who created it. Only by understanding and forgiving your younger self for deploying this coping strategy can you replace shame and self-loathing with empathy and self-acceptance.

The piece of your personality you see as ugly once served you well. It’s not easy and it won’t happen overnight, but by working to forgive yourself, you will be closer to leaving this piece behind.


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