The perceived impact of societal codes of shame on Maltese psychotherapists

Abstract

Anthropological literature indicates that Malta, by virtue of its central position in the Mediterranean, is somewhat structured by codes of honour and shame (Bradford & Clark, 2012; Schneider, 1971; O’Reilly Mizzi, 1994). Honour refers to claimed status by an individual and necessitates that the social group affirms that claim. It holds a positive social value. Shame may be understood in either positive or negative terms. When construed in a positive sense it indicates consideration of one’s reputation and standing in the community’s eyes. On the other hand, negatively, shame refers to loss of position and consequent mortification. Shame is also construed as an emotion involving an evaluation of the self as one that is inherently imperfect. Despite the awareness of the potential negative effects of shame on the psychotherapeutic relationship (Gilbert & Procter, 2006; Rustomjee, 2009), shame in psychotherapy has been largely under-researched. The current study is based on the results of a doctoral thesis which explored how Maltese psychotherapists understand and manage feelings of shame in a particular social context. A qualitative approach was taken to explore the individual perspectives of ten Maltese psychotherapists whose years of professional experience ranged between 6 and 28. Semi-structured interviews were conducted and the data gathered from the interviews was analysed by means of Interpretative Phenomenological Analysis (IPA). Four super-ordinate themes emerged: The Therapist’s World of Shame, Beholding Patients’ Shame; A Shared Experience and The Island of Shame. Participants described themselves as having a high propensity for feelings of shame and inadequacy, and referred to their cultural context as “a breeding ground for shame”. Multiple roles in the Maltese professional arena were perceived to augment these difficulties. The findings indicate that feelings of shame and inadequacy were frequently experienced by Maltese psychotherapists in various professional contexts, including clinical supervision. They also emphasise the importance of helping psychotherapists deconstruct and normalise feelings of shame and inadequacy by linking them to social and cultural dynamics. The lived experiences of shame emanating from these contexts are examined and the perceived impact of these dominant societal codes on the therapist’s self and professional practice are considered. Implications for training and supervisory needs of trainee psychotherapists are discussed.