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Quaderni di Psicoterapia Cognitiva - Open Access

Studies and researches

No. 51 (2022)

The treatment of disorders related to shame dysregulation

DOI
https://doi.org/10.3280/qpc51-2022oa15182
Submitted
gennaio 9, 2023
Published
2023-01-18

Abstract

Shame can be defined as the anticipatory fear of being exposed to the negative judgment of others or one’s own. From an evolutionary perspective, shame has a fundamental adaptive value for the individual in that it ensures membership and permanence within one’s social reference group, as it inhibits and limits behavior that would be socially unacceptable and is related to the fear of losing social rank or being excluded from the conspecific group. Shame is expressed through the display of signals that inhibit the dominant’s aggression and usually promote avoidance of potentially humiliating situations by strongly reducing exploration (Gilbert, 1997; Kim et al., 2011).
The therapeutic approach to shame-related disorders is primarily focused on improving the ability to regulate it by exploring and utilizing motivational systems that are poorly present in the patient’s interpersonal repertoire. Recognition of one’s own motivational rigidities enables the patient to understand the main mechanisms underlying his difficulties and also to explore concretely within the therapeutic context the usefulness of other prosocial motivational systems. In the treatment pathway of such disorders, the process of therapeutic alliance building is a central step because it concretely focuses on the use of the cooperative register that constitutes and maintains a strong therapeutic alliance that is an important therapeutic factor in itself and a significant predictor of good outcome. The Evolutionary Theory of Motivation (TEM & Liotti, 1994/2005; Liotti, Fassone & Monticelli, 2017) argues that the cooperative system is a constituent element of the therapeutic alliance and the only motivational system significantly related to the improvement of metacognitive functions (Liotti & Gilbert 2011; Monticelli et al., 2018; Monticelli et al., 2020; Monticelli & Liotti, 2021).

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