Unveiling the hidden self: Developmental trauma and pathological shame

This article focuses on the role played by developmental trauma in generating impairing feelings of shame as observed in several psychological disorders. An understanding of pathological shame is indeed critical for evaluating the psychic functioning of patients who have experienced parental neglect or abuse. A clinical vignette of a patient who suffered emotional neglect and intense role reversal during his childhood will help elucidate how developmental trauma can dramatically affect the patient's personality and behaviours, and ultimately lead to negative expectations towards interpersonal relationships, disturbing feelings of shame, and a sense of a defective self. Shame experiences deriving from the internalisation of bad or unworthy parents are subsequently linked to some psychopathological manifestations, such as withdrawal from social contacts, narcissistic rage, addiction and perversions.