Thursday, November 29, 2012

Dissertation on shame. Chapter 27.5 Respect and recognition

27.5 Respect and recognition

The struggle for respect and recognition was spoken of by several of the participants in the interviews. Gunhild, Knut and Ivar discuss the importance of feeling respect; both self-respect and the respect of others.

Gunhild:         To be respected for whom I am. To be seen as I am. Be accepted as I am. I don’t mean that people have to accept all of my reactions. ((Laughs)) When I scream and shout. Yeah. That’s important for me.

Knut:              What is really important for me? You have all of these material objects, but do they have any value in themselves? What does my house, boat, car mean for my self-image? The most important thing is my self respect. I noticed in my healing process, that it was very important what others thought of me. That’s important. There’s something I feel that I keep to myself, the feeling that I have to live up  to others’ expectations. That’s something I dislike. (.)

Ivar:                I expect others to respect me (.) for whom I am.

All three speak of the respect from others for whom they really are. In my opinion this can be difficult to achieve in institutions which do not respect others as they are because they are occupied with the control of those who are asking for help. Zola (1972) argues that therapy has become an institution of social control in the name of health. This has occurred because we define many of the problems of daily life as sickness, and because labelling things as either healthy or sick has become an ever increasing aspect of human existence. He writes that if we search for ways to explain this, we will find that it is rooted in our increasingly complex technological and bureaucratic system. This is a system which has led us down the path leading to the reluctant reliance on the expert. Lazare (1987) argues that patients have a high risk of experiencing shame and humiliation in any form of therapeutic encounter. This is because we commonly perceive illness as rooted in defects, inadequacies, or shortcomings. Visiting therapy institutions often means physical and psychological exposure. Patients respond to the shame and humiliation that is evoked by avoiding therapy experts, withholding information or complaining. It would in my opinion be interesting to conduct a similar exploration of the concept and phenomenon of shame within the settings of a psychiatric institution.

Dagny, who is one of the users of the Incest Centre, explains that helping others with shame is a way of healing her own shame.

Dagny:            ((Nods her head)) The first thing I think of is I’ve done something that I can use to help others. It’s not about me. I’m always last in line. What’s important is helping others. By helping others, I myself am healed.

Finding the other as a helper implies showing oneself to the other. When Dagny opens up for others in my opinion, her own shame is recognized and this contributes to the diminishing of her own shame. Thomas and Parker (2004) argue that in the healing process the focus should be on facilitating the emergence of the self. By strengthening the emergent self, one is able to move it developmentally toward the point where the self becomes secure enough to take responsibility for its actions. Until the self becomes stable enough to distinguish itself from its actions, the person will continue to confuse the two. In working to weaken the grip of shame, emotional work is important and involves nurturing the self so that it is able to move away from the massive self-condemnation that prevents the self from making a realistic assessment of its actions and choosing appropriate responses. Educating new social workers in emotional work seems in my opinion to be an important task.

The healing process which is illustrated in figure 4 is in my opinion both a complicated and a frightening experience of for many, both for those asking for help and the social worker. The social worker should start off carefully, giving the individual the time that is necessary. Linda explains that a lot of people do not dare to come to the Centre for a conversation or even to speak on the telephone. She says that using text messages on her cellular phone is often a good way to make contact with someone who has problems sharing problems with others. Reading and writing messages to each other can be of great help in creating enough security and enable people to come out of their hiding places.

Linda_1:         Using text messages is also a big help. I use them a lot, all the time. ((Places her hand in front of her mouth))…It’s a real good way of helping people. Yeah. I remember one girl here who changed her whole behavior because of text messages. She used to just sit here on the floor. I had her for two and a half years. She just sat on the floor and played with her car keys. She didn’t dare look me in the eyes. So I tried sending her a sms. It worked and she opened up and wrote a whole lot. Talking to me face to face was unpleasant, but reading and writing on the cellular phone worked fine.

Meeting others does not have to be face to face meetings in order to be genuine. Linda illustrates that meeting the other where one is might sometimes require not being able to see the other person. Having conversations over the telephone is a similar form of meeting. Many users of the Incest Centre start their contact and healing process through telephone conversations or even as Linda tells by written text messages over the cellular phone. I agree with Kaufman (1980, 1989) when he argues that the first step in the healing process is to construct a relational bridge. Since nurturing the emerging self is the focus in healing shame, the method must be relational and not behavioral. One has to find the hiding self and restore the relational breach by first asking where the individual is. Shame involves moving away from relationships, hiding. Trying to address guilt instead of shame may be a way of allowing the self to continue hiding. The social worker who moves to affirm and value the shamed self takes the first steps towards strengthening that self. Then the self can is able to reflect upon its deeds with a less punitive evaluation, whether this involves negation of the self or blaming others. Helping others overcome unbearable shame involves building strong relational bonds between the caregiver and the shamed and suffering self.   

Emotional work and acceptance towards people suffering from shame seems in my opinion to be important in the healing process of shame. Larsson and Starrin (1990) argue that skilful helpers use communication of an everyday character as a means of reaching the personal and emotional level in a natural everyday manner and communication dealing with personal and emotional qualities, and they use less communication dealing with facts and practical issues. Margaret explains that abused women and men are often withdrawn when they come for the first time seeking help and security. Helping others with shame involves having experienced the same kind of pain with one’s own body. She argues that personal experience makes a good fellow human being.

Margaret_1:    They are very withdrawn ((Places her hands in front of her)) humiliated, and it’s important that they take one small step at a time and try to zoom in what kind of place this is. They are very afraid of getting in someone’s way here. They are afraid to ask and afraid of doing something wrong. Usually they speak very little. Some of them just sit on the sofa and search for some security. We never start a conversation about abuse or other problems. We always let the users start the conversation…I tell them that they can use me if they want and that I’m here for them…I want to make a difference for them…The most important qualification for working here isn’t whether one has experienced sexual abuse or not, but if you’ve really lived your life. (.) Yeah. That’s what makes a human being a good fellow human being…They find out that they are not alone. They meet others and that means a lot. They meet others who have the same emotions, same thoughts and they start believing in a future. There are many things that fall in place when one dares to share oneself with others.

Margaret stresses that meeting others who have similar emotions and thoughts is important. It takes time to build new relations and Linda says that people may use the Incest Centre as long as they need to.

Linda:                         There are some people who have been users here for ten years. They can use the centre as long as they want.

Several of the participants speak of not being able to trust others and that it takes often a long time to be able to trust others again. This is especially towards significant others. Some speak of mothers who where not there for them in their childhood and miss having a loving and caring mother. Nina tells about a woman she met at the Incest Centre who felt that she had never had a mother, and who now feels as if she has thirteen mothers: all of whom were employed at the centre.

Nina:                           I had one who told me once that she really never felt that she had had a mother, but now she has 13. ((Everyone laughs)) That was cool.

Being a mother for users of the Centre is not a role that is given the employees by the institution but by some of the users, and they see this as something positive. In my opinion the employees seem to be careful not to encourage this role but give the users the opportunity to view the Incest Centre as a home and the employees as caregivers and significant others. Pia feels grateful each time people trust her enough to express their shame and suffering to her.

Pia:                  You get a real good feeling because you’ve helped others with your own costly experience. I tell them so, too, that they give me so much by showing me trust and letting me help them. I’m very grateful to them for that. I never take anything like that lightly. If someone shows me trust umm that’s something I store in my heart. There must be a reason for showing me trust.

Pia sees the trust developing in genuine meetings, she even feels grateful for the trust users show her. Trust is not something the social worker has as an employee at the Centre, but something one receives from the users if one is found worthy of receiving this trust. Building this trusting relationship is important for helping the user to be able to let go of their self-focus and be able to relay on others. Being less self-focused (I-with-me) and more occupied with oneself in the world (I-with-me-in-the-world) will in my opinion lead to a better self-evaluation and make the creation of a new identity possible.  Covert, Tangney, Maddux and Heleno (2003) argue that since shame involves an intense self-focus a person experiencing shame is likely to have difficulty thinking of effective solutions to an interpersonal problem. More importantly, however, the person experiencing shame may have a set of beliefs about himself or herself in the interpersonal domain that makes it difficult for them to use the skills that they actually have. People who frequently experience shame are likely to experience frequent failure in their attempts to solve interpersonal problems, and these experiences are likely to lead to low self-confidence for solving even the common problems and conflicts that occur in interactions with other people. Trude and Ruth discuss how children protect their mothers and how this had been a source of shame for them.

Kaare:             Did you try to protect her?
Trude:                         Yes. ((Nods her head)). Yes. I did then and I still do, even though I tell myself ((Points a finger at her head)) up here, that that’s the way it was and I’ve worked a lot with it, but it’s still lying there under my shoulder blade. I still protect her ((Bites her lips and nods her head)).
Ruth:               It’s weird how we protect our mothers.
Trude:             Yeah. It’s like the last old tie that keeps us together.
Ruth:               And makes you feel shame in a way.
Trude:                         Yeah. That’s something I have to work with. It was (  ) fine that this came up now so I could think about it ((Bites her lips and nods her head))

Linda has a similar experience as Trude and Ruth and protected her mother and it seems that Linda felt sorry for her mother being married to her father. Her father was unfaithful and drank a lot.

Linda_1:         I’ve protected her a lot because umm my father was so rotten to her. He drank a lot and messed around with other women and I really felt sorry for Mom.

Trude, Ruth and Linda were very aware of their parents, especially their mothers. Children’s awareness of their parents needs has been investigated by Jensen, Gulbransen, Mossige, Reichelt and Tjersland (2005) who have carried out a qualitative study of families reporting possible sexual abuse using a sample of 20 families with 22 children in therapeutic sessions. Their results indicate that disclosure is a fundamentally dialogical process that becomes less difficult if the children perceive that there is an opportunity to talk, and a purpose in speaking, and a connection has been established to what they are talking about. It is difficult for children to initiate a conversation about something so secret, confusing and distressing, and where there are few conversational routines in a family for talking about such themes. Children are also sensitive to the needs of their caregivers and fear the consequences of talking about their families and the offenders. Children need a supportive structure or scaffold in order to expose their experiences of child sexual abuse.

Rafferty and Hartley (2006) argue that even though  a lot still remains to be learned about shame it is clear that shame is a painful self-conscious emotion that operates, albeit quietly and hidden, in the development of a wide variety of personal and social problems. It is also clear that, for an individual to be freed of shame, he or she needs to be approached with sensitivity and tact. Perhaps listening to children and adults, with an ear open for the voice of shame may help professionals connect with their shame and release them from their distress. Not to do so would be, in a very real sense, shameful.

In Figure 5 below, figures 1, 2, 3, and 4 are combined to illustrate the struggle for recognition within the context of sexual abuse and the settings of the Incest Centre in Vestfold. This struggle for recognition is influenced by Honneth’s theory of recognition (1996) and is in my opinion a valuable perspective for social work practice (Høilund and Juul 2005; Møller 2008). The figure illustrates that the social-self can be evaluated by self and others in a way that leads to lack of respect and a negative self-evaluation. It is this process, characterized by the destruction of relational bonds, exclusion, hiding, and so forth, that leads in my opinion and based on the interviews in this exploration, to shame. If the person shame is not met with respect and recognition in a dialogical I-Thou meeting with others, then emotions may become repressed and the healing process is obstructed. This means that others are kept at a distance, intimacy is difficult, and the individual objectifies oneself and others. This will often lead in my opinion to a negative spiral, causing more suffering.

Meeting people with problems may be conceived as turning the world upside down; it means moving from being within an I-It relationship to an I-Thou relationship. This can only be accomplished in my opinion through a setting where one is allowed to express one’s emotions, where one is accepted and can carry out emotional work with others when exposing these emotions, and where one gains new experiences that enable the social self to develop in a positive direction.

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