Shame – a forgotten emotion: psychopathology, neurobiology, and therapy of shame in eating disorders

Abstract

The paper focuses on shame in the context of eating disorders. As a common emotion occurring in various spheres of human life, shame is of particular importance in the understanding and treatment of eating disorders as it is one of the key factors in their development and sustenance. There is scientific evidence that individuals with eating disorders experience higher levels of shame and guilt compared to those with other clinical diagnoses, which distinguishes eating disorders from other psychopathologies. Therefore, we present the mechanisms underlying the emotion of shame and its relationship with eating disorders, along with selected therapeutic strategies for overcoming shame. This paper also presents the research on neural correlates of shame and their relationship with the development and sustenance of a disturbed body image, which is one of the key psychopathological aspects of eating disorders. We also discuss the role of work on the patient’s shame in successful therapeutic processes, as well as the possible use of neuroscience in understanding and treating patients experiencing this emotion. Furthermore, we attempted to explain the concept of shame and its possible classification in the context of selected psychological theories. The paper also refers to the concepts of healthy and toxic shame, which are strongly associated with developing a specific type of personality and coping strategies in social relationships, and which influence self-esteem.