Feelings of guilt, shame, and unworthiness: From the viewpoint of a psychotherapy group of psychiatrists, psychologists, and psychotherapists

Abstract

This article is an account of the work I did with a psychotherapy group which lasted over 20 years. The participants were psychiatrists, psychologists, social workers, psychotherapists, and educational staff who were working in various sectors of the Italian National Health Services. The group was ‘slow open’ therefore, when someone was ready to leave, others were able to join. The group's life came to include five generations of participants. Over and over again, we found ourselves engaged in mainly two kinds of problems: feelings of guilt and, shame and unworthiness. Both of these were partially related to choices of profession and the difficulties of working in the public service. We were able to deal quite successfully with the feelings of guilt and the related moods of depression. On the other hand, alleviating the sense of shame and unworthiness was more difficult. I succeeded with all but three participants. In these three cases – which are presented in this article – the childhood feelings of shame and unworthiness had produced extreme socio-syntonic defenses (defenses which are very well attuned to the current social values). These defenses had helped and kept on helping the three patients a great deal in forcing their way through life and their work places; they felt they had the right to behave this way. However successful these defenses were, they prevented these patients from having a complete and satisfactory affective life, rooted in the belief that they have a right to be loved simply because they exist.