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The Role of Shame in Bulimia

By Madalyn Oliver

picShame, a key element of Bulimia, is one of the most uncomfortable human emotions we can experience. Brene Brown, a leading researcher of shame, explains that humans have an innate need for connection and that shame is born out of the fear that we are not worthy of that connection and that if others see us for who we really are they won’t accept us (Brown, 2006). This notion can be more specifically referred to as external shame.  Recent research indicates that shame also exists in another form, internal shame. This is the shame that comes from the belief that we have not lived up to our own expectations or standards and as such are a bad person or morally defective. External shame and internal shame can otherwise be thought of as being shamed and feeling ashamed. Internal shame or feeling ashamed has been found to be more predictive of Bulimia (Troop, Allan, Serpell & Treasure, 2008).

Those who suffer from Bulimia commonly experience feelings of shame, secrecy, and self-disgust. Binges most often occur in private and are accompanied by a sense of a lack of control. Once the binge episode ends, feelings of high anxiety, desperation, guilt and shame emerge. Purging might help individuals to temporarily escape these feelings of shame but the secrecy and perceived abnormality of these behaviours cause feelings of shame to grow (Kelly & Carter, 2013). It makes sense that when we feel shame we want to hide and try to minimise it, however, this only makes things worse. To overcome Bulimia, those in recovery will need to learn to face shame head on.

So, how do I face shame head on?

  • One of the ways to face shame is through acceptance. That is, letting go of who you think you are ‘supposed’ to be and instead embracing who you are.
  • Shame can also be healed through connection and empathy with others. This may involve having the courage to share your stories, mistakes and/or feelings of shame with someone (e.g. your therapist) who will listen and empathise without judgement. Empathy is incompatible with shame and judgement as it allows us to recognise that we are not defective or alone in our experiences.
  • When you catch yourself beating yourself up, be kind. If you have binged and/or purged it is important to remember that it does not make you a bad person. However, it is possible to recognise whether you engaged in these behaviours in the first place due to feelings of shame.

References:

Brown, B. (2006). Shame resilience theory: A grounded theory study on women and shame. Families in Society, 87(1), 43-52.

Kelly, A. C., & Carter, J. C. (2013). Why self-critical patients present with more severe eating disorder pathology: The mediating role of shame. British Journal of Clinical Psychology, 52(1), 148-161.

Troop, N. A., Allan, S., Serpell, L., & Treasure, J. L. (2008). Shame in women with a history of eating disorders. European Eating Disorder Review, 16(6), 480-488.

 

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