The Walk of Shame
We can think of everything associated with shame: embarrassment, guilt, humiliation, rejection, scorn, and the list can go well into a whole page.
On the everyday, micro-level of social interactions, we can identify shame-ING when it happens.
We recognise that some cultures and societies shame people more easily than others. We tell parents not to shame their children in front of their peers. We may name and shame someone who has committed crimes – petty and heinous. We know when someone has shamed us through that hot feeling on our face, that pit in our stomach, or that urge to defend our dignity.
On the historical level with its effects into the present day, shame was used to control populations.
Throwing food and objects at the dejected sinner. Parading people into the streets to be made an example. Stripping people of their hair and clothes, and many other forms of humiliation.
Then, there were the ultimate punishments: exile and banishment from one’s native land.
While these seemed physically less intense than the above, they were psychologically so harsh that they eventually became a violation of international law after World War II. Fundamentally, exile was the ultimate form of shame with these chilling messages:
“You do not belong here”.
“You do not exist”.
“You will remain alone”.
“You are bad.”
Coming back to the present day, imagine you are not under threat of being externally exiled and banished anymore. Instead, the exile is completely internal. A voice inside of you says these messages to you every single day. Every time you step foot outside. Every time you may meet someone new. Every time you make decisions. While no authority is officially enforcing it, you have developed your own cage and even reinforced its bars.
This is the essence of the shame that many HIV-positive people bring into the therapy room for healing – sometimes without even knowing it. The threads of shame are not only woven into their stories, but also into their bodies. The internalization of shame can be so deep that the body literally attacks itself – like the experiences of patients with somatoform and autoimmune disorders.
For instance, the association between shame and cortisol production is particularly well-established. People both living with HIV and having higher cortisol levels tend to have higher viral loads, more severe fatigue, more depression, and more state and trait anxiety. Behaviourally, shame can predict transmission risk behaviour, medication non-adherence, symptomatic HIV or AIDS, and symptoms of depression and PTSD.
Dr. Brené Brown says:
“If you put shame in a Petri dish, it needs three things to grow exponentially: secrecy, silence and judgment.
If you put the same amount of shame in a Petri dish and douse it with empathy, it can’t survive,”
In Australia, we have fortunately reached a point where people living with HIV are not only trying to survive, but to also thrive. Quite literally, medical technology is making it difficult for HIV to thrive the way it used to in the petri dish and attack immune systems.
Yet, the petri dish of shame shows that true empathy – whether it comes from our medical professionals, government officials, or any other people delivering services – is harder to come by. It requires difficult self-reflection. This includes evaluating our own capacities to give and receive empathy while still processing our own adverse experiences.
The ability to witness the shame that binds so many of our clients living with HIV is an honour and a privilege. It continues to teach us not only about them, but ourselves.