Therapy Judges, But Doesn’t Shame

Some of us live in the world of Platonic forms.

The ancient Greek philosopher Plato believed that the world of forms, the ideas of what things are, their essences, is the only real aspect of the world. According to him, that which we touch, see, smell, and taste is a mere replica, a poor one at that, of its form. Plato pondered in absolutes, rarely inquiring about the actual consequences of his principles (e.g. See The Republic). Thus, he believed that only those who lived up to his ideals – the philosopher kings – were allowed to rule.

Although most people don’t know of or think deeply about Platonic philosophy, many of us live our lives according to it. This means that we aren’t satisfied with our choices when they don’t match our visions of our supposed-to-be selves. And we seldom accept our corporeal limitations, treating them as minor barriers to what’s to come. But, idealism, at bottom, is as much a demon as it’s an angel. Pushing us while scorching us.

Contrary to popular belief, therapy isn’t non-judgmental; it’s non-shaming. Idealists tend to fluctuate between severe self-censure and complete denial; either magnifying a minor mistake or denying a significant misdeed. They cower from shame. But for therapy to be effective, for it to mean anything, shame has to be faced, and we address it, in part, through judgment. Our patients learn to abandon Plato, at least for the time being. So, what’s the difference? Judgment entails assessing the nature and consequences of, and motives behind, your choices. Judgment says, “If you do this, then this will happen.” And, “Although you believe this is helpful, here’s how it’s harming you in the long-run.” Judgment notes the facts; it zeros in on effects. To judge is to form an opinion on what’s good (i.e. what’s beneficial) and bad (i.e. what isn’t). We can’t survive without it. And, interpersonally, judgment aids. Whereas shaming is sadism and selfishness in disguise, used to manipulate, judgement is more altruistic. It risks personal discomfort for another.

On the other hand, shame results from a poor character assessment and an assessment of poor character. Shame says, “I’m bad.” Most of the time, therapy begins with a conflation of the two. So, when you judge, your patient feels shame. I’ve had countless sessions helping my patients disentangle the two, because they’re used to being and feeling embarrassed. For example, they’ll ask, “When you said that I can’t keep avoiding my fear, did you think I was a coward?” Whether the individual is or isn’t isn’t really the point. We can, on the one hand, understand what they believe will happen and what they’re so afraid of and, on the other, help them accept that they should be more terrified of the alternative, in addition to providing them the tools to manage both forms of anxiety. Sometimes, however, shame still ensues despite the lack of rebuke. So, we’re called on to challenge the labels.

Thus, for example, if we were to address the label of coward, we can safely say that each of us are cowards in our own ways. The ancient Greeks died valiantly in battle less so due to courage and more so because of an intense fear of dishonor. Shame doesn’t make sense, because its labels, when applied, should be utilized ubiquitously. So, the stigma attached to various forms of mental illness is merely arbitrary.

Anthropologist Roy Richard Grinker, in his book Nobody’s Normal, argues, “The persistence of stigma… inhibits people from seeking help. Even for the most seriously mentally ill today, the time from the onset of psychiatric symptoms to psychaitric care is startling. In the United States, the average time from first psychosis to first treatment is seventy-four weeks. Despite the recent acceptance and appreciation of human differences, many conditions, such as schizophrenia and substance abuse, are still highly stigmatized and feared because both threaten our modern ideals of self-control and autonomy.” And when it’s argued that therapy is non-judgmental, it’s because therapists fear further stigmatizing their patients.

Yet, self-control, or perfect self-control, is a myth. When patients are judged, they’re helped out of denial, which can be as harmful as shame. In dealing with the same of being a coward, they learn that cowardliness is a mere existential facticity, applicable to the entire species. They learn that “othering” is a process meant to manage one’s own internal conflict, meant to project an ideal that exists only in Plato’s fantastical realm. We consider the practical as our hopes move us toward perfection. But, shame is mitigated when we realize that our internal maps can only take us on journeys to treasure, which will remain forever elusive.

For the idealist, therapy places a pause on one’s fantasies, focusing instead on how the patient interprets being less than perfect. What are the real-world outcomes? Does a mistake mean she’s stupid? Does it mean that she’ll be rejected? Does it make her unlovable?

Check out our episode with Roy below: