One of my clients, Nicole, came from a family background with psychosis on both sides. As a teenager, her sister attempted suicide. Her deeply troubled
brother lived at the fringe of society, doing menial jobs, sleeping in his van. When she came to me at the age of 18, Nicole was deeply depressed, with
occasional manic flights into grandiosity. She suffered from mild auditory and visual hallucinations; she cut herself with razor blades. She often felt
persecuted by songs that would get stuck in her head, endlessly repeating and making sleep almost impossible for days on end. To anyone who met her, she
seemed frankly disturbed.
After many, many years of intensive psychotherapy (and without the aid of psychiatric medication), Nicole has grown dramatically. She eventually managed to
put herself through college, build a career, marry another professional, and have children. If you met her today, she might strike you as a bit eccentric
but not disturbed. By most people's standards, she's an accomplished and successful woman. As long as she respects her limits, Nicole functions at a fairly
But she does have important limits. If she takes on too much or life becomes too stressful, she might begin to see spiders moving at the periphery of her
vision. A song might get stuck in her head and keep her up half the night. At very bad moments, she might feel as if she's in danger of falling apart. If
she takes care of herself, however -- doesn't pretend that she's superwoman or convince herself she's "just normal" like everyone else -- Nicole can do
much, much more than anyone might have expected from that deeply troubled teenager who first came to me.
Nicole lives with core shame, the legacy of dramatically bad parenting. She also feels proud of herself for all the hard work she has done, her bravery in
facing psychological pain, and all that she has managed to accomplish. Remaining in touch with shame helps her to make good choices about what she can and
cannot do. Shame keeps her humble and prevents her from taking triumphant flight into grandiose denial of who she is. Shame helps her to respect her
limitations so that she can undertake the possible and continue building self-esteem.
In the years leading up to her son's eighth birthday, Emily Kingsley believed "that she had licked [Down syndrome]; she lived in triumph." After Jason
turned 8 and his intellectual development came to a halt, Emily "began to realize all the things he couldn't do and would never be able to do." In 1987,
she wrote a modern fable called "Welcome to Holland," well-known to anyone in the disability
world. In this fable, she analogizes the experience of having a disabled child instead of a normal one to the disappointment you might feel if you imagined
you were flying on vacation to Italy and landed in Holland instead:
But everyone you know is busy coming and going from Italy ... and they're all bragging about what a wonderful time they had there. And for the rest of your
life, you will say, "Yes, that's where I was supposed to go. That's what I had planned."
And the pain of that will never, ever, ever, ever go away ... because the loss of that dream is a very, very significant loss.
But ... if you spend the rest of your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely
things ... about Holland.
I think about living with shame in the same terms. There's a very real and abiding pain that comes from knowing your childhood has damaged you significant
ways. Don't pretend otherwise, don't ignore shame; but don't dwell on the pain of it, either. Bearing with shame doesn't mean we can't grow and
develop, have satisfying relationships, or find a career that we love. Even with core shame, we can live a meaningful and satisfying life.
In extreme cases, I have patients who feel that their shame is all but a death sentence. It is not; shame is not the enemy. Shame
is an often painful fact of life that defines the gap between expectation and reality, but at the same time enables us to make the most of what's actually