Why Does Shame Pop Up in Therapy? And How Do You Deal With It?
First: if you feel shame in therapy… you’re not doing it wrong
Shame tends to show up exactly when you’re getting close to something real. Which is deeply inconvenient. but also clinically appropriate and actually helpful.
Why shame shows up (the actual psychology)
Shame is a threat response to disconnection. Your brain is essentially asking:
“If I show this part of me… do I lose safety, approval, or belonging?”
If the answer has ever been “yes” (hello trauma, masking, invalidation), shame steps in fast. And it often doesn’t just sit there, it pushes you into action.
The Compass of Shame (aka: what your brain does next)
A really useful framework here is the Compass of Shame, developed by Donald Nathanson.
It explains that when shame hits, we tend to move into one of four coping patterns:
Withdrawal → “I want to disappear” (cancel sessions, shut down, go quiet)
Avoidance → “Let’s not feel this” (intellectualising, humour, distraction, Eating disorder behaviours)
Attack self → “I am the problem” (self-criticism, “I’m pathetic”, not sick enough)
Attack others → “It’s not me” (irritability, defensiveness, feeling judged or misunderstood)
These aren’t personality flaws. They are learned strategies to escape the intensity of shame.
Why this hits harder in therapy
Therapy asks for the exact things shame is designed to avoid:
Honesty
Vulnerability
Being seen
So your system goes: “Absolutely not. We’ve done this before. It did not go well.”
This is especially true if you have previously or are currently experiencing:
Eating disorders (shame around food, body, control)
ADHD (shame around inconsistency or “potential”)
Autism (years of masking and being misunderstood)
Trauma (where vulnerability genuinely wasn’t safe)
Why “just challenge the thought” doesn’t work
Because shame isn’t just cognitive. It’s:
A nervous system response
A relational memory
A body-based collapse or urgency
So if therapy skips straight to logic, your system often just doubles down.
How to deal with shame in therapy (without making it worse)
Name it early. Acknowledge it.
“I feel embarrassed saying this”
“Part of me wants to shut down right now”
This interrupts the shame cycle instead of feeding it.
Use the Compass (this is your cheat code)
Ask yourself:
Am I withdrawing?
Avoiding?
Attacking myself?
Getting defensive?
Once you spot the pattern, you can gently pivot instead of getting swept up in it.
Get curious, not critical
Shift from:
“What’s wrong with me?”
To:“What is this protecting me from?”
Shame almost always protects against:
Rejection
Judgment
Being misunderstood
Slow it down (trauma-informed pacing)
You don’t need to:
Say everything
Go deep immediately
Push through overwhelm
In good therapy, pacing is not avoidance; it’s regulation.
Let therapy adapt to you (not the other way around)
If shame shows up, the response isn’t “try harder.”
It’s: make the space safer.
The short version
Shame shows up in therapy because:
You’re being real
Your brain is trying to protect you
You’ve learned vulnerability can be risky
And you deal with it by:
Naming it
Recognising your “compass” pattern
Getting curious about its function
Going at your pace
Working with a therapist who gets it
Looking for a psychologist in Melbourne?
If you’re wanting neuroaffirming, trauma-informed therapy in Melbourne who understands the co-occuring or overlapping nature of:
Eating disorders
ADHD / autism
Shame, burnout, or emotional overwhelm
You don’t need to resolve the shame first. You can literally bring it with you.
Contact us to have a chat to one of our team members to see if we may be the right fit for you.
Note: The information provided in this blog is for educational purposes only and is NOT intended as medical /psychological advice. Please consult a healthcare professional for personalised guidance.
This blog post was created with the support of AI tools to help with clarity and structure and reviewed/ edited by one of our team members. All content reflects the professional knowledge and clinical judgement of the authors.
