Psychiatry Grand Rounds: Shame – The Silent Saboteur

Shame: The Silent Saboteur

Presented by:
Amanda Janner, PsyD
Assistant Professor
Department of Psychiatry

Faculty Disclosure:

Dr. Janner has disclosed that she has no relevant financial relationship(s). No one else in a position to control content has any financial relationships to disclose. Conflict of interest information for the CME Advisory Committee members can be found on the following website: All relevant financial relationships have been mitigated.

Release Date: October 27, 2023
Expiration Date: October 26, 2025

Target Audience: All physicians

Learning Objectives:

As a result of participation in this activity, participants should be able to:

  1. Discuss the development of shame and distinguish it from the other self-conscious emotions.
  2. Explain the role of shame in the development of psychopathology and its contribution to case conceptualization.
  3. Recognize manifestations of shame in clinical presentations and the barriers they pose to effective treatment.
  4. Identify practical interventions to counter shame for improved patient care.

Requirements for successful completion: Certificates are awarded upon successful completion (80% proficiency) of the post-test.

Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Resource(s) for further study:

  1. Black, R. S. A., Curran, D., & Dyer, K. F. (2013). The impact of shame on the therapeutic alliance and intimate relationships. Journal of Clinical Psychology, 69 (6), 646-654.
  2. Brown, B. Daring Greatly: How the Courage to be Vulnerable Transforms the Way WE Live, Love, Parent, and Lead. Gotham Books.
  3. Brown, M. Z., Linehan, M. M., Comtois, K. A., Murray, A., & Chapman, A. L. (2009). Shame as a prospective predictor of self-inflicted injury in borderline personality disorder: A multi-modal analysis. Behavior Research and Therapy, 47, 815-822.
  4. Hazell, C. M., Berry, C., Bogen-Johnston, L., & Banerjee, M. (2022). Creating a hierarchy of mental health stigma: testing the effect of psychiatric diagnosis on stigma. British Journal of Psychiatry Open, 8 (5), 1-7.
  5. Kim, S., Thibodeau, R., & Jorgensen, R. S. (2011). Shame, guilt, and depressive symptoms: a meta-analytic review. Psychological Bulletin, 137: 68-96.
  6. Lewis, H. B. (1971). Shame and Guilt in Neurosis. New York: International Universities Press.
  7. Muris, P. & Meesters, C. (2014). Small or big in the eyes of the other: On the developmental psychopathology of self-conscious emotions as shame, guilt, and pride. Clinical Child and Family Psychology Review, 17, 19-40.
  8. Nathanson, D. L. (1992). Shame and Pride: Affect, sex, and the birth of the self. New York: W. W. Norton & Company.
  9. Tracy, J. L. & Robins, R. W. (2004). Putting the self into self-conscious emotions: A theoretical model. Psychological Inquiry, 15, 103-125.
  10. Tangney, J. P., & Fischer, K. W. (Eds.). (1995). Self-conscious emotions: The psychology of shame, guilt, embarrassment, and pride. New York: Guilford Press.
  11. Griffiths S, Mitchison D, Murray SB, Mond JM, Bastian B. How might eating disorders stigmatization worsen eating disorders symptom severity? Evaluation of a stigma internalization model. Int J Eat Disord, 2018; 51(8):1010-1014. doi: 10.1002/eat.22932. PMID: 30055009.
  12. Buchman-Wildbaum T, Unoka Z, Dudas R, Vizin G, Demetrovics Z, Richman MJ. Shame in Borderline Personality Disorder: Meta-Analysis. J Pers Disord., 2021; 35(Suppl A):149-161. doi: 10.1521/pedi_2021_35_515. PMID: 33650893.
  13. Ronningstam E. Narcissistic personality disorder: a current review. Curr Psychiatry Rep. 2010; 12(1):68-75. doi: 10.1007/s11920-009-0084-z. PMID: 20425313.
  14. Dearing RL, Stuewig J, Tangney JP. On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use. Addict Behav., 2005; 30(7):1392-1404. doi: 10.1016/j.addbeh.2005.02.002. PMID: 16022935.
  15. Neff, Kristin.

If you have any questions please feel free to contact Nancy Boyd at (352) 594-4298 or at