Application: Family Life-Cycle Stages

Sexuality and Shame

Carole Shadbolt

Abstract This article discusses the development of

childhood and adult sexuality from a rela- tional and cultural perspective. The roots of shame are identified and the affect of shame is described. The strong links between sexu- ality and shame are explored. The author suggests that sexual shame is a Type III im- passe, and its resolution within the context of therapeutic relatedness is addressed. The article's central point is the unique, indi- vidual, and shifting character of each per- son's sexuality.

There is nothing tame about shame, which wounds in direct proportion to the good feeling and sense of relational safety it at- tacks, impedes, stifles.

Nathanson(1999, p. vii)

There is a curious and abiding relationship be- tween sexuality and shame. Both are multiface- ted, fundamental aspects of our personal and public lives. Sexuality, excitement, and shame meet at the boundary of our private and public selves. As such, they appear as central issues to be thought about and addressed in psychothera- py. Equally as curious is the relatively small amount of writing and discussion within the field of psychotherapy, especially humanistic circles, about sexuality and shame.

Despite Freud's writings on the centrality of sexuality as the key to human disturbance, cli- nicians seem to hedge around the topic of sexu- ality. As Pajaczkowska and Ward (2008) put it, "Ironically, psychoanalysts today do not talk about sex very much—preferring instead to focus on issues of attachment, dependence, fears of abandonment, aggression and envy" (p. 24). They also quote Freud:

I can only repeat over and over again—for I never find it otherwise—that sexuality is the key to the problem of the psychoneu- roses and of the neuroses in general. No

one who disdains the key will ever be able to unlock the door. (p. 24) Bollas (2000) comments on sexuality as be-

ing enigmatic and not easy to understand much less to write about: "Questions that surround sexuality—not the least being 'What is it?'— are simply parts of the original complex im- posed upon the child: What is happening to the self? How is one to understand this develop- ment?" (p. 15). Within the transactional analy- sis community, of late, discussions and articles on the importance of sexuality have been in- creasing. Articles have appeared with sexuality as their theme and a conference on sexuality was held in Brighton in the United Kingdom in 2007.

The difficulty of dealing with sexuality in clinical work was brought to mind when I heard Irving Yalom lecture to a huge audience of some 900 psychotherapists in London in 2004. Ninety-nine years after Freud's words, Yalom offered this: "If you are' not talking about death with your patients at some point during their psychotherapy, you are not doing psychotherapy." His words had an immediate impact on me, and I have remembered them often as I work, maybe catching myself not speaking to a client's fear of death, which by implication raises thoughts and existential fears of my own. I have come to think of sexuality in the same manner: If I am not speaking at some point about sexuality with my client, 1 am not doing depth psychotherapy.

The avoidance or difficulty of speaking about both sexuality and death is not deliberate or intentional; it merely illuminates the traumatic nature of both. In a child's developing and ar- riving sexuality, there is a death of sorts: the death, as Bollas (2000) puts it, of "mama and baba" (p. 14) and of childhood. And with death comes loss. Perhaps speaking to sexuality in session or writing about it raises for us the same anxieties and fears that are present when talking of death.

It has been said before that most theoretical writing turns out to be autobiographical and

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evolves from our efforts to make sense of per- sonal experience. So it is with my fascination and curiosity about sexuality and shame and how to think about its resolution in psychotherapy.

Childhood Sexuality and Relational Shame, or "Don't Do that Some More, You Naughty Little Boy"

Attachment, relatedness, and the develop- ment of our sexual ities seem to me to be in- extricably linked. To the late Stephen Mitchell (as cited in White & Schwartz, 2007, p. 1), "Sexuality is the arena in which fundamental relational issues and struggles are played out." He continued, "It is the establishment and main- tenance of relatedness that is fundamental and the mutual exchange of intense pleasure and emo- tional responsiveness is perhaps the most pow- erful medium in which emotional connection is sought, established, lost and gained" (p. 3).

Relatedness is central in understanding the dynamics of an emerging sexuality and the po- tential for shame in both mother and child. In Sensuality and Sexuality Across the Divide of Shame, Lichtenberg (2007) stresses the nature of the massive transition children undergo when their infantile sexuality develops from the sensual experience of being touched to becom- ing the one who desires to do the touching, from the one who is desired, touched, loved, and being impacted on to the one who desires and wants to love back—and what is at stake as a consequence. Elsewhere, Lichtenberg (2007) has suggested that there is less risk in sensual desires than in sexual desires, arguing that "the interplay between desire and prohibition cre- ates an experience of tension in sexuality that is not present in sensuality" (p. 2).

The determination of which aspects of a child's behavior, thoughts, or feelings become sexual as distinct from sensual is a relational decision or process, one that, to Lichtenberg (2007), depends to a large extent on the cultur- al and personal values ofthe child's caregivers. And their approval or disapproval is mediated through shaming ofthe unsanctioned expres- sion ofthe child's body/mind.

An anecdote from my past comes to mind. When I was a child growing up in working- class London ofthe 1950s, a poor but neverthe-

less deeply conservative environment, I remem- ber my beloved grandmother, a woman of few words, announcing herself "disgusted" by the sight of a mother breast-feeding her baby in public. That was a truly shocking, radical sight for those days and caused my grandmother much disturbance. It brought to her| mind the story often told in our house at an appropriate moment—and this was such a moment—of a woman, rather isolated, something of an out- sider in our community, who was still breast- feeding her 5-year-old child. He—for it was a boy—would run back from school to his moth- er's breast, which she willingly, apparently, provided over the front gate! For what I now wonder? Milk? I rather doubt it, but perhaps.

What is pertinent in this dialectical story is the apparent absence of shame, in both;the moth- er my grandmother saw and the long-ago moth- er ofthe story. Perhaps the latter was "shame- less," perhaps that was her "brazen"i defense/ protection against a disapproving society, in this instance personified by my grandmother. What is clear when one understands; the rela- tional context of sexual development is that the 5-year-old boy in question could not! progress from the experience of sensuality to that of sexuality. i

For Lichtenberg (2007), as the toddler's emerg- ing sexuality develops, as he or she begins wanting to touch, caress, suck, and impact an- other relationally (usually mother), the child explores and touches as he or she always has, as in breast-feeding (which is also breast fond- ling and touching), except that now, what was once a source of pleasure, life, and sensuality has suddenly—inexplicably to the child, no doubt—become sexual, and therefore forbid- den, and his or her desires a source of shame.

The relational manner in which the child's innocent, natural intentions are received and responded to by the other (usually mother) are, in part, determined by the mother's own morals and value system. This relational manner, in tum, determines the toddler's self-image in re- lation to excitement, desire, and the sensuality- sexuality dynamic. In addition, corresponding joyous, erotic responses in the mother, who perhaps cannot win here, lead to culturally "un- acceptable, dangerously arousing, lustful sex-

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uality" (Lichtenberg, 2007, p. 3). If this rela- tional dynamic, when curbed (as it eventually must be), is communicated to the toddler as something to be ashamed of, the child may in- terpret that to mean that he or she is the source of shame, that his or her body is shameñil. The child may then conclude, in a body sense rather than cognitively, that he or she is "a naughty little boy or girl." A child's response to being "a naughty little boy" might well be one of pro- test in the form of embodied fury, temper, and demand as well as shamelessness and entitle- ment. A stronger response from his mother to his now "bad boyness," added to her previous mild removal of his hand from her breast, would create tension between desire and prohi- bition. Lichtenberg (2007) describes this as "a bodily itch" (p. 4), a dynamic far removed trom the safe comfort of sensuality. • It is not difficult to understand the embodied choice point between sensuality and an emerg- ing sexual expression and what is at stake. In this scenario there is more than the selfishness ofthe toddler, entirely pleasure seeking in his or her emerging sexual desire and sexual iden- tity. What is at stake is the fear of loss in the dawning awareness of difference. Bowlby ( 1986, chap. 1) described this kind of loss as the child's response to an unwilling separation, a traumatic experience of difference and possible rejection, of being thwarted, perhaps following feelings of shame and humiliation. This separa- tion process ñ"om both mother and an intra- psychic infant self is perhaps experienced as a mini-death, and it returns me to my preoccu- pation with Yalom's statement, cited earlier, about the centrality of death and the sexual metaphors it brought to my mind. The child who discovers that he or she now differs from

,the m/other as he or she develops sexual self- consciousness is in, as Pajaczkowska and Ward (2008, p. 3) describe it, a place of "abjection," where shame is very close. It is about differ- ence and perceived difference. Abjection, first described by Julia Kristeva (as cited in Pajacz- kowska & Ward, 2008, p. 3), is a place of dis- gust and marginal ization, a place without d igni- ty, a place that is traumatic as a developmental experience. "Shame is implicated in the first self- conscious experience and the first experience of

self-consciousness since it is through the mir- roring look of the mother, and the necessary aversión of her gaze, that the nascent self is brought into being" (Pajaczkowska & Ward, 2008, p. 3).

Adult Sexuality and Shame Not every adulthood is solely determined by

childhood experiences, but adolescence and sibling relationships undoubtedly make an in- delible impact for some. The psychological, physical, and sexual roller coaster of adoles- cence and its potential for shame cannot be underestimated or overstated. In the teen years, through shame and shaming, the private and public is again revealed, but during this time of life it appears exaggerated. Differences be- tween oneself and parents, now viewed as im- perfections, become all too painfully obvious. Shame appears in that we are often ashamed of our parents as well as ourselves. The out-of- control experience of unstoppable bodily chan- ges brings excruciating shame if attention is drawn in public to such changes. The certainty and omnipotence of childhood is lost in identity confusion, which can sometimes feel of epic proportions until some order or wholeness and clarity of identity is acquired.

Similarly, the influence of siblings and peers has a dramatic impact on the development of our sexuality. This factor is often overlooked, no doubt because, as J. Mitchell (2003) puts it, "of our preoccupation with vertical relation- ships" (p. xv). In our developing sexualities with siblings, there is the opportunity for mir- roring, safe experimentation, role modeling, observation and information gathering, and the vital rough-and-tumble of childhood play. How- ever, with even a moment's thought about sexu- ality through the lens of sibling relationships, the shame potential is obvious. Memories of rivalry, murderous rages, shaming and shame- ful comparisons about sexual attractiveness, tauntings, and bullying all come to mind when momentarily revisiting the lateral world of sib- lings and sexuality. Unintentional shaming at the very moment of a child's emerging sexu- ality can be seen in the ubiquitous bath sce- nario. Brothers and sisters may well share a bath (as children may with their parents) until

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the gender difference revealed in genital dif- ferences becomes obvious. The message given at that point is often that there is now some- thing to be avoided, or perhaps to be ashamed of

While in many cases an adult life follows a predictable path, in others, despite all the odds, outcomes are different and autonomous, both positive and negative. So, although the past is also in the present, and our adult sexuality is built, in part, on child and adolescent experi- ences, adult'and childhood sexuality are differ- ent in a myriad of ways. Adult sexuality and shame are also culturally, socially, and politi- cally shaped—directly experienced and con- structed—through education, history, and religion.

In Westem culture, moral edicts about what is sinful, the chastity of women, the sanctity of marriage, the moral degeneracy and immaturity of homosexuality, the superiority of male hetero- sexuality, the deleterious effects of masturba- tion, gender roles, sexist imagery, biological determinism, and so forth are part of adult con- sciousness and life experiences that directly im- pact adult sexuality. And while the mother's own unconscious, as it is transmitted to and in- trojected by the infant, is an important factor in this process, it is not the only one. The way in which we hold prohibitions from both the past and the present—embodied injunctions, impas- ses, and interruptions—creates the difference between sexual aliveness and sexual deadness as described by Wilhelm Reich and others (Smith, 1987, p. 6). Reich connected touch, bodywork, sexuality, and politics to psycho- therapy, describing in the process the embodi- ment of emotional pattems and the rhythmic energy flowlOf the body, which brings with it vitality, emotional richness, and sexual alive- ness. He understood the effects of oppression and political scripting on individuals, including their emotional, physical, and sexual lives. He saw and named what was damaging to a per- son's sexuaijty at the hands of another (e.g., a teacher) whose own stified sexuality could deaden a child's natural curiosity about his or her body.

Whereas Freud believed in the existence of a fundamental death instinct, which is some- times referred to as "Thanatos," Reich believed in the opposite: that human beings have a basic

capacity and instinct to love life freely, fully, and without repression. He hoped foi" a society that would refiect his views, even though they were strikingly different from those of his con- temporaries. He expressed hope for a time "when you will only shake your heads at the time when one punished little children for touching their love organs; when human faces on the street will express freedom, animation and joy and no longer sadness and misery" (Reich as cited in Emst & Goodison, 1981, p. !l 13).

Reich's ideas are close to those of although the latter might place more

emmism, emphasis

on the subjective experience of women's sexu- ality, that is, women's relative lack oi"power, a rejection ofthe centrality and necessity of vagi- nal penetration, and the recognition! of wom- en's pleasure in the clitoris. ;

My own experience reflects the views ex- pressed by Reich (as cited in Emst & Goodi- son, 1981) in that I leamed "the real facts of life" as an adult, in my twenties, fromimy lesbi- an feminist sisters. Like many young |women, I learned from the women's movement that the personal is political and that our sexual selves and our experience of our bodies inl relation- ship to other bodies (as well as our own) are as diverse as the human face—not one in all the world is exactly the same. Like our faces, our sexuality is fiuid and has a myriad of expres- sions and reactions. And it is seen differently depending on who is doing the looking and why. Our sexuaiities, like our faces, are unique, multifaceted, shifting, deeply relational two- way mirrors. !

That being so, I saw that my sexual identity is not necessarily fixed or proscribed, ^h i l e for historical reasons 1 may choose to identify my- self as lesbian, to borrow from a deeply ques- tioning Professor Joad of BBC radió "Brains. Trust" fame in the 1940s and 1950s, pends on what you mean by it. My

it all de- eventual

enlightenment came years after my only visit, in my teens, to a psychiatrist because of my confusion and misery about my sexuality. Dur- ing an exhaustive assessment, among other humiliations (related to an absent mother and lack of "proper" fathering), 1 passionately pro- tested that ho, I most certainly did not mastur- bate. The leamed professor of psychiatry and

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his ubiquitous trainee psychiatrist, barely able to conceal their scepticism, conspiratorial ly concluded that I had a lot to say for myself Whether or not their hypotheses and my read- ing of their judgments were correct, their man- ner confirmed my worst fears about my "per- version." I left red-faced, wronged, and "sick" —in other words, deeply shamed—never to re- tum. Later, in what felt like another life, as a psychiatric social worker I worked with that same psychiatrist. I f he remembered me, which I doubt, he never let on, and I, who would nev- er in all my life forget him, did not either. In the intervening 20 years, the world had turned.

These days I might view autoeroticism, psy- chiatry, and patriarchy differently, but femi- nism has taught me that no one way of expres- sing gender or sexuality has precedence over another. Such expression is deeply rooted in culture and social conditioning, and a woman's sexuality can and should be in her own hands as she becomes the subject instead ofthe object in her own "herstory."

What is right, wrong, or fixed in the con- struction of our sexualities and genders—that is, moral, scientific, and biological absolutes —is challenged and reshaped these days by a number of factors, including a constructivist view of identity, queer theory, and feminism. There is a continuum between essentialist views of sexuality, which assume that sexuality is fixed and exists independent of culture and so- ciety, and a constructivist, postmodern view that assumes that "sexuality has no inherent quality and merely represents a system of cul- tural meanings which are themselves created within matrices of social power relations" (Drescher, Ercole, & Schoenberg, 2003, p. 1).

When reflecting on these vital matters with regard to sexuality, it is easy to see that when the uniqueness of our sexual identity collides with the views of others or even our own views and expectations of what is "normal" and of how we should be in both our private and pub- lic selves, shame will not be far behind. In the area ofsexuality, all too often shame is the re- sult when the inner meets the outer.

Shame and Affect I f distress is the affect of suffering, shame

is the affect of indignity, transgression and of alienation. Though terror speaks to life and death and distress makes the world a vale of tears, yet shame strikes deepest into the heart of man. Shame is felt as an inner torment, a sickness of the soul, the humiliated one feels himself naked, de- feated, alienated, lacking in dignity and worth. (Tomkins as cited in Adamson & Clark, 1999, p. 23) • Although much more has been written of late

about shame, including its etiology and treat- ment(e.g.,followinga 1993 Minneapolis trans- actional analysis conference on "Shame," the April 1994 Transactional Analysis Journal guest edited by MaryeO'Reilly-Knapp focused on the same theme), until comparatively recent- ly the importance of shame has been over- looked not only within transactional analysis but also in the wider psychotherapy commu- nity. As I consulted my books and papers for this article, not surprisingly, I found few refer- ences to shame.

Shame is a universal human experience. As Morrison (1989) noted, hardly a therapy ses- sion goes by without the appearance of some expression of shame, humiliation, embarrass- ment, disgrace, or mortification. In my own ex- perience, the memory of the burning shame I experienced as a teenager when I visited that psychiatrist has never left me. It was as i f the two psychiatrists could see right through me with their judgmental gaze and know me to be lying. What's more, I knew that they knew that I knew that they knew.

The sheer all-encompassing physicality of my experience fits well with Tomkins's ideas of shame as an affect. His work is referred to in the Transactional Analysis Journal by Nathan- son (1994), an authority on the study of shame and its effects. Tomkins's major contribution to the psychological cannon was the theory of af- fect and its etiology and complex nature, known today as "affect theory." Nathanson's careful article charts Tomkins's modem understand- ings of affect, emotion, and shame. Nathanson is somewhat critical of transactional analysis, which he sees as seeking to alter emotional ex- perience without having an adequate descrip- tion of emotion itself.

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An understanding of affect as distinct from feelings seems vitally relevant to understanding sexuality and shame. Affect is experienced as an all-encompassing body experience of pro- found disturbance in which nervous energy is released in a random manner. It has little to do with cognitive processes and is not readily open to behavioral social control (e.g., blushing).

Tomkins's view is reminiscent of the way that psychoanalysis eventually recognized that countertransference, far from detracting from therapeutic work, was not only an intrinsic part of such work but the congenital core of uncon- scious communication. Similarly, affect is un- derstood by Tomkins as natural, a communica- tion of urgency and that something normal ra- ther than pathological is going on. Whereas previous theories had understood affect as in- terfering with normal functioning, Tomkins (1987, p. 143) sees it as innate. He describes a number of innate affects, all of which emerge as an amplification of a triggering stimulus, ranging from mild to severe. They are most clearly shown on the face, and shame is among them.

Tomkins (1987, p. 143) describes shame as an affect auxilliary—that is, a response to anoth- er positive affect, in this case, excitement and contentment. He describes shame as a specific inhibitor of continuing interest and enjoyment.

The links between shame and sexuality are not hard to appreciate. Tomkins (1987) links shame and sexuality by using anthropology: "Shame and sexuality is also a history of civili- zations" (p. 156). Tomkins traces shame asso- ciated with sexuality back to antiquity: from Genesis in the Old Testament, where the source of shame is camal knowledge; through the Greek ethics of perfect platonic love versus transitory, imperfect sexual desire; to the early Stoic Roman privatization of sexuality as hetero- sexual love, located within a monogamous mar- riage viewed as the ideal; to the gradual renun- ciation of individual self-will and physical de- sire in favor of "ataraxia," an indifference to and transcendence of desire itself (p. 157).

Tomkins goes on to describe the self-mastery, ridicule, and control of sexuality and desire de- manded during the Russian Revolution because sexuality and desire were thought to weaken

Marxist ideology. Finally, he links sexuality to Christianity, especially Puritanism,¡ in which sexuality is hijacked into moral and religious domains. There the fall from grace and inno- cence and separation from the love bf God is marked by an individual's sexual behavior, sin- ning, and the threat of etemal damnation.

As Tomkins (1987) summarizes: I Not only has sexuality tumed froni shame and guilt, but a massive burden of terror has been added to the sexual act. Sexuality is no longer aesthetic or unaesthetic, plato- nic or illusory, a threat to the reproduction of the species and to the monogamous family, nor a threat to the will ofthe indi- vidual; it is now above all else a sign of disobedience to the will of God, demand- ing that the individual risk a vaijiety of punishments, including an etemity in Hell. Shame and terror are now tightly fused, (p. 158)

Gender-specific and Genital Shame Gender-specific shame and genital shame are

particularly poignant and painflil, it seems to me. Nathanson (1987) writes of masculine shame, wherein the culturally mediated idea of the excessively excited, lustful male image clashes with and makes shameful the effemi-

I

nate in a male who lacks "masculinity" (p. 39). In contrastas the female whose self-jimage is supposed to be as the object of lustful desire and who, in reality, is ashamed of weakness, prudishness, and ambivalence. This is, again, an example of an intemal experience being un- acceptable and exposed to public view, which results in shame. ¡

Genital shame often finds its roots; in early relationships. For example, a little boy who is interested in his penis, rather than being cele- brated, is viewed as a "cocky little sadist" who needs to be "cut down to size." His penis be- comes an object of disgust and embarrassment. Similarly, the outer genitals of girls and women are named "pudendum," which originates from the Latin pudenda membra, â "part to be ashamed of." Likewise, one ofthe most taboo words in the English language is "cunt'," which is still imbued with a sense of obscenity. Even to write it in this article makes me feeli vaguely

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anxious (or is it shame and excitement?) be- cause it seems like a somewhat risky thing to do. (You may care to check this out by noting your own intemal reaction to reading it here.)

Shame about one's body—or, rather, what we imagine the other is thinking about our body —is widespread. For example, "The shy person . . . is physically and constantly conscious of his body, not as it is for him but as it is for the Other" (Sartre as cited in Evans, 1994, p. 103). As Sartre further wrote, "We often say that the shy man is embarrassed by his own body. Ac- tually this is incorrect; I cannot be embarrassed by my own body as I exist in it. It is my body as it is for the Other which embarrasses me" (p. 107).

The potential for shame is heightened during the period of 18-24 months, when toddlers be- come aware of themselves as objects of obser- vation and become capable of self-awareness and awareness of their own excitement. They also become aware that the m/other does not re- gard their genitals as something of importance, pleasure, and vitality to them but instead views their genitals as something to be ashamed of

I niention all these factors because they high- light the depth and complexity of the mighty cultural introjects, impasses, and embodied scripting that accompany sexuality and shame, all of which are likely to be present in some form in psychotherapy when sexuality is the focus ofthe clinical work.

Clinical Implications Shame about being ashamed of all the issues

raised here appears repeatedly when working clinically with sexuality and excitement. This in- cludes shame about body image, genitals, pre- mature ejaculation, making noise during sexual activity, wanting too much, not being potent enough, the inability to be aroused or reach orgasm, wanting sex for pleasure rather than procreation, not beihg wanted, and so on, rather than the more vital and life-enhancing experi- ences of excitement, pleasure, and satisfaction.

When excitement and a desire for enjoyment and satisfaction bursts through, it often meta- morphoses into crippling shame. In my experi- ence, the all-dominating issue of sexual shame —whether it be cultural, relational (and, by

implication, intrapsychic), embodied, or mani- fested between therapist and client—involves a Type III impasse, which occurs when two self-states are in conflict with each other. In this instance, the battle is between excitement and shame, and it represents a massive "me versus not me" conflict.

Shame and Excitement: A Type.lll Impasse Usually, shame is understood to have its

roots in relationship and to be experienced inter- personally. Nathanson ( 1987), for example, de- scribes the shame experience as always involv- ing a "shamer" (p. 251). However, when one considers the example of intemalized homo- phobia (Shadbolt, 2004) or the manner in which women oppress themselves intemally, it is easy to see how introjects and projections were in existence sometime before they found reconfir- mation in interpersonal experience. Thus, the shamer is intemal as well as extemal.

A Type III impasse involves the intemaliza- tion or introjection of an original interpersonal experience that then becomes intrapsychic. Mellor's (1980) developmental model of im- passes suggests that the Type III impasse origi- nates in very early experience. The experience of shame that hides excitement fits with this schema because both self-states occur without words or cognition and appear to have their genesis in primitive preverbal or protocol lev- els of self-organization.

The impasse of shame versus excitement thus operates outside of conscious awareness and is a whole self-experience. This means that the shame affect (as described earlier) so squelches excitement that it is experienced as "me," whereas the experience of excitement is experi- enced as "not me." The disavowed "not-me" experience of excitement might also be described as containing hope and an intense longing for recognition and acceptance. When this aspect ofthe self and its narcissistic need is wounded —originally interpersonal ly—it is driven under- ground out of fear that the person will experi- ence reshaming rather than being supported or welcomed.

In summary, there is a circularity to shame in that it arises interpersonally, dwells intrapsy- chically, and reappears interpersonally. As a

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Type III impasse, it is resolved interpersonal ly first and intrapsychically later.

Thus, the treatment of issues related to sexu- ality often involves the "treatment" of shame and the recovery of excitement, vitality, and aliveness as well as a resolution ofthe "me ver- sus not-me" impasse. I put the word "treat- ment" in quotes to emphasize the way it seems to convey a sense of doing: of something need- ing to be done by someone to someone else. The idea of needing and getting "treatment for shame" is a contradiction, because the treat- ment of what is wrong is in danger of bringing about the very thing that it is designed to "treat." This is tricky terrain to traverse be- cause, on the one hand, a rupture or reshaming, whether it occurs because of the therapist's own judgments about shame, his or her failure to recognize it in the client, or the unconscious enactment between them, can be seen as an es- sential component to its resolution. At the same time, if awkwardly and defensively handled by a therapist who does not understand the etiolo- gy of shame and its huge cultural and relational roots, shame will probably go underground or into the dark and grow. As a consequence, shame is likely to be experienced and endured but not acknowledged by either client or therapist. What is problematic and pathological is not just the experience of shame itself, unpleasant as it is, but how it is "treated," that is, received and handled by the other.

There are, of course, many transactional analy- sis theories and techniques that can be used in the treatment of shame: script analysis, decon- tamination, ego state analysis, and game analy- sis, to name a few. However, these excellent and time-tested theories and techn iques al I have the quality of someone (the therapist) doing something to someone else (the client). They thus have the potential for reshaming.

In my view, the transformation or resolution of shame arises out of a particular quality of therapeutic relationship, one that involves "be- ing with" rather than "doing to." 1 refer to this as a type of human-to-human attunement that involves a particular use ofthe therapeutic space between therapist and client. This kind of at- tunement has a different quality from the attune- ment described by Stark ( 1999), which involves

both empathy and authenticity. It is worth briefly describing these two natural processes.

Empathy "involves the therapist suspending part of herself in order to enter the client's ex- perience as if it were her own" (Stark, 1999, p. 46). This has the potential to be reshaming be- cause of the risk of exposing the client's shamed self Similarly, authenticity-kiescribed by Stark as "about the therapist remaining cen- tered within her own experience, allowing the patient's experience to enter into her, and tak- ing on the patient's experience as her own" (p. 47)—might also be exjjerienced as intrusive by the shamed client.

There are subtle yet relevant distinctions to be made here. While empathy and authenticity in this context might be conceptualized as transferential ly attaching processes,land while both are essential to create the trust between therapist and client that is required for the suc- cessful resolution of shame, humani-to-human engagement is not characterized entirely as em- pathy or authenticity. Rather, it involves the therapist unself-consciously holding, respect- ing, and keeping safe a therapeutic space in which the client can dwell at the boundary or crossroads of his or her public and private ex- perience. This is the place where the ropt of shame lies and where the dynamics ofthe Type III impasse are to be found. |

Human-to-human attunement involves recog- nizing separateness and differentness. ¡The thera- pist may or may not entirely understand, be em- pathie to, or express his or her authentic re- sponse to the content ofthe client's shame. But this is secondary to his or her recognizing and accepting the client's truth about himself or herself When this is provided, the client can have the experience of being seen by the other as "the other," that is, as a separate person. It is close to the process of mutuality, in which the therapist niay not self-disclose the details of his or her own shame but will convey as another human being (rather than as a transferential ob- ject) that he or she sees and recognizes the cli- ent's pain and responds to it as another human being. When space is provided in which the awareness of difference and the experience of existing separately is accepted, integration and recovery of the "not- me" aspect of the self

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SEXUALITY AND SHAME

becomes possible, and clients can celebrate their excitement, vitality, or whatever they wish with regard to their sexuality. It is in this pro- cess that the Type III impasse is transformed and resolved.

Clinical Example After a long struggle with issues related to

her disappointing sexual experiences, my cli- ent, Kate, and 1 had come to a point where she knew she felt deeply ashamed of being ob- served during lovemaking. Kate did not trust that any partner would not look at her while she abandoned herself to her sexual feelings and experience. Consequently, she remained de- mure, quiet, and controlled, unsatisfied, and thus unable to find her own pleasure or reach orgasm. During lovemaking, she was constantly checking her partner to see if he was watching her. In fact, at one point Kate had experienced just that. She discovered her partner staring wide-eyed at her and smirking; he also made critical and shaming comments about what she looked and sounded like. This had awakened— possibly reawakened—a deep and self-conscious humiliation and shame in her.

As we sat together, saying very little, Kate's face turned a burning red. Her head was down and she slumped. Avoiding my eyes, she even- tually whispered how shamed she had felt, and how ashamed she now was about her sexual identity and appetites and how disgusted she was with herself. I waited. I was, of course, aware that I too was watching her. I am sure she was also aware of this only too well. I did not consciously try to empathize with her exact feeling of being watched or to be authentic in allowing her experience to enter into me. Ra- ther, 1 concentrated on being with her in that space between her private and public experi- ence, on understanding how she was publicly and how she was privately. It was a quiet place of hovering tension, of expectancy and possible emergence. I imagined the space of the "me and not me." Eventually, Kate looked up, met my eyes, and told me clearly what she was ashamed of showing and what she most ur- gently wanted to show. She described how she was sexually, what turned her on, what excited her, how her body responded, how she wanted

the other to respond, and what she wanted to see. She told me how disgusted she was of her- self and her desires in the present and how she loathed herself.

Her sexual identity was not in the least simi- lar to my own, and I could not particularly un- derstand her passions, but I could see her excite- ment and burning desire to be and show her "not-me" self and for this to be OK. Her face was soft and her eyes looked quite different. She scanned my face for any trace of censure or ridicule. If she expected any, she did not find it.

Conclusion In the case study just described, I strove to

provide for Kate—and she seemed to take for herself—the space to experience her different- ness as it emerged between us relationally. As the reader might gather, the moment of her awareness was a careful balance between re- experiencing shame and expressing excitement and satisfaction. The moment of separation was welcomed and "made OK" (though not con- trived) by both of us: me giving, her taking.

The resolution of shame about an individu- al's sexuality amounts to an awareness, accep- tance, celebration, and delight in the person's unique difference or, put another way, separa- tion. For as much as our sexualities depend on attachment and relationship for their develop- ment, they equally depend on separation. Like attachment, separation is fundamental to a healthy model of sexuality.

Carole Shadbolt is a psychotherapist living in Oxfordshire, United Kingdom. She works in London, Edinburgh, and Oxfordshire. A rela- tional psychotherapist by instinct, she has writ- ten a number of articles on diversity and homo- phobia. Her abiding focus and devotion is to clinical practice. Carole can be reached at Hawthorne, Horseshoe Lane, Chadlington, Oxfordshire 0X7 3NB, United Kingdom: e- mail: carolei^hawthornesc.freeserve.co.uk.

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