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Shame and Nondisclosure: a Study of the Emotional Isolation of People

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Shame and Nondisclosure: a Study of the Emotional Isolation of People BritishJournal of MedicalPsychology (2001), 74, 1–21 Printedin GreatBritain 1 q 2001The British Psychological Society Shameandnon-d isclosure:Astudyofthe emotionalisolationof peopler eferredfor psychotherapy James Macdonald* SalomonsCentre for Applied Socialand PsychologicalDe velopment, Kent, UK Ian Morley Departmentof Psychology, University of Warwick, UK Thirty-fourpeople referred to an NHS psychotherapydepartment were given a modied formof Oatley and Duncan’ s (1992)emotion diary which included questions about whethereach recorded emotion had been subsequently disclosed to anyone (for example apartner,friend or professional). One week later the diaries were collected and participantsinterviewed. Interviews focused, among other things, on reasons for non- disclosureof recorded emotional experiences and the relationship between shame and non-disclosure.The results indicated that a majorityof the emotional incidents recordedin the diaries were not disclosed (68%). This result contrasts with studies onnon-clinical samples in which only approximately 10% of everyday emotions are keptsecret. Qualitative analysis of the interview data revealed that participants appearedto behabitual non-disclosers of emotional and personal experiences and that non-disclosurewas related to the anticipation of negative interpersonal responses to disclosure(in particular labelling and judging responses) in addition to more self- criticalfactors including shame. It issuggested that these results add to the existing literatureon shame by illustrating the interpersonal effects of shame in a clinical sample. There are many unresolved issues regardingthe denition of shame. Ina recent review of theories Gilbert (1998)argues that adenition which captures shame most closely is that it is ‘an inner experience ofself as an unattractive social agent,under pressure to limit possible damage to self via escape orappeasement’(p. 22). Shame can bedifferentiated from guilt where the action tendency promotes reparation andthe focus ofattention is outside the self (Lewis, 1971;T angney,Miller,Flicker, &Barlow,1996).Shame can be associated either with aconsciousness ofhowone is seen byothers (Sartre, 1943)or with a negative self-evaluation, andthese two different facets ofshame have been termed external shame and internalizedshame respectively (cf. Gilbert, 1998).While in practice these two cognitive domains are likely to behighlycorrelated (Lewis, 1971)this is notnecessarily the case (Gilbert, 1998).Perhaps the least controversial characteristic of shame is that it is *Requestsfor reprintsshould be addressedto James Macdonald,Salomons Centrefor AppliedSocial andPsychological Development, David Salomons Estate,Broomhill Road, Southborough, T unbridgeWells, Kent, TN3 0TG, UK. 2 JamesMacdonald andIan Morley associated with adesire to hide or conceal the self oraspects of the self (Barrett, 1995; Lindsay-Hartz, 1984;Mollon, 1984). Inrecent years studies have linked atendency toexperience shame with the incidence ofpsychopathology(Andrews, 1995, 1997; Gilbert, Pehl, &Allan, 1994;Harder, 1995; Sanftner, Barlow,Marschall, &Tangney,1995;T angney,Burggraf,& Wagner,1995; Tangney,Wagner,&Gramzow,1992);however Alexander, Brewin,V earnals, Wolff, and Leff (1999)found to the contrary that pronenessto guilt rather thanshame was associated with depression.Most of this research has been cross-sectional andquestionnaire-based andto date there appears tohave been noattempt to examine the role shame plays in the interpersonal lives of psychologically distressed people. Anaspect of psychologically distressed people’s interpersonal lives that seems especially likely tobeaffected bythe experience of shame, andthe accompanying impulse of hidingor concealment, is that of emotional disclosure. Bothcommon sense andempirical evidence suggestthat emotional disclosure is an important componentof clinical practice. Stiles (1995)has reviewed anumberof studies which suggestthat all types of psychotherapyare characterized byhigh levels of personal disclosure byclients andthat personal disclosure bythe client is in turncorrelated with measures of goodpsychotherapy process. Aconsumer studyby the Mental Health Foundation(1997) indicated that aprimary need of mental-health patients whenin distress is to have ‘someone to talk to’. Thisis consistent with the protective effect of havinga close conding relationship in the presence of other factors conferring vulnerability to psychopathology(Brown & Harris, 1978).Pennebaker andcolleagues (e.g. Pennebaker,1993) have demonstrated that the disclosure of traumatic experiences appears to have physical-health benets (including decreases in visits tophysicians andan enhancement ofimmune function) whendisclosure includes the emotional response to the experience. There is already some evidence that shame may beassociated with emotional secrecy in non-clinical populations.Research byRime ´,Finkenauerand colleagues has revealed that disclosure of everyday emotional experiences occurs approximately 90%of the time (Rime´,Mesquita,Philippot, & Boca, 1991;Rime ´ et al.,1994). Follow-up research designedto identify characteristics of the 10%of emotions that were notdisclosed suggestedthat ‘secret’emotions are associated with the desire to avoid shame andother unpleasant social emotions suchas guilt andembarrassment (Finkenauer &Rime´, 1996; Finkenauer,Rime ´,&Lerot,1996). Finkenauer and her colleagues have notfocused onthe role ofshame per se in the non-disclosure of emotional experiences. Nor didthey examine the disclosure decisions of‘normally occurring’emotions. Finally,as notedabove, their workwas conductedin anon-clinical sample. Thecurrent studyaims to extend the literature onshame andpsychopathology and shame anddisclosure byexamining the impact of shame onan aspect of the daily interpersonal lives of psychologically distressed adults—namely their non-disclosure of specic negative emotional experiences. Given the lack of research in this area, it was decided that aspecic focus onthe role of shame shouldbe accompanied bya more open-endedinquiry into factors associated with non-disclosure.This, it was hoped, wouldresult in aholistic andcontext-sensitive view of the role ofshame in emotional non-disclosure. Thedesire to develop an inclusive andcontext-sensitive understandingof participants’ Shameand non-disclosure 3 decisions notto disclose emotions led to the adoptionof aqualitative research method based onthe ‘grounded’techniques described byPidgeon and Henwood (1996). This procedure enables the researcher to develop atheoretical understandingwhich is based closely onparticipants’ own accounts andwhich can encompass unforeseen factors which mightotherwise beobscuredby the researchers’ a priori constructs. Method Materials Amodied form of Oatleyand Duncan’ s (1992)emotion diary was used to obtain accounts of shame,guilt, hatredand disgust. This method is based on the assumption that, while not all affective experiences are accessibleto introspection, people are able to identify accurately many of their more salient everyday emotionalexperiences (see Oatley and Duncan (1992) for further discussion of thisissue) including shame. A reviewby Macdonald (1998) suggests that, in spite of the fact that few instruments intended to measure shameactually ask participants directly about their experiences of shame (Andrews, 1998), the available evidencesuggests that both clinical and non-clinical samples will voluntarily report experiences of shamein a condential research setting. Oatley and Duncan’ s (1992)development of emotion diaries represented an attemptto obtain more reliable accounts of subjectiveemotional experiences by minimizing retrospective biases,which would seem more likely in studies where people are simply asked to recall an instance of the emotionof interest,as forexamplein Wicker,Payne, and Morgan (1983). Oatley and Duncan (1992) provide someevidence for the validity of thismethod in a studycomparing participants’ diary record of theirown emotionswith an independent record of their emotions provided by their partners. This demonstrated an 84%agreement as totheoccurrence of incidents. Thediary was structured and asked participants to recordspeci c detailsabout each emotion as soonas possibleafter the emotion had been experienced. Participants were asked to llin the diary questions for the rstinstance of anyof thefour emotions of shame,guilt, hatred and disgust that they experienced in the7 daysafter they had been given the diary. The diary included a numberof questionsabout the disclosure or non-disclosureof each emotion that had been recorded. Of relevanceto the current report was the question ‘Didyou tell anyone about this?’ and two follow-up questions asked if thereply was negative ‘ Wereyou afraid abouthow others might see you if you told them?’ and ‘ Didthe thought of tellinganybody make you feelany shame?’Full details and ndingsfrom the diary are reported in Macdonald (1999). Afollow-upsemi-structured interview was carried out in which participants were asked to provide informationabout (1) the reasons for the non-disclosure or disclosureof eachemotion they recorded in the diary,(2) shame and related feelings associated with anticipated disclosure of eachemotion, and (3) theeffects ofdisclosure or non-disclosure of each emotion on their relationships with other people. The interview protocolfor non-disclosed emotions is included in Appendix1. Thesequestions were designed as afollow-up tothe ‘ yes/no’questions about non-disclosure included in the diary.
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