The Science of Shame & Its Treatment



The Science of Shame And Its Treatment 
Gerald Loren Fishkin 
Parkhurst Brothers Publishers, 2016

4/5 Stars 


Dr. Gerald Fishkin, psychotherapist, has put together an empirical and compelling analysis guided by addressing the question ‘What if shame is at the core of emotional and mental illness? How many people could find relief by healing shame?’ Dr. Fishkin is quite matter of fact stating “Shame is one of the least recognized and understood aspects of human behavior and emotional experience.” The Science of Shame and Its Treatment is at once a diagnostic exploration of shame and a therapeutic call to arms.

Dr. Fishkin doesn’t offer simple solutions of the standard self-help fair. Instead, he approaches his topic from a clinical perspective while never veering away from a genuinely empathetic stance, one that’s inclusive and deeply caring. Between his empirical analysis and philosophical investigations, Dr. Fishkin makes sure to include accounts of individuals showing how with therapeutic help lives were changed. 

Shame is approached as an affect that has a profound influence on the formation of “the very foundation of our self, the core of our being.” Dr. Fishkin’s intention “is to wholly refute and empirically invalidate the clinical assumption that our internal dialogue, primarily negative self-talk, causes one’s mood disorder or negative affective state.” His premise is that “unless the shame core associated with early-life trauma, abuse, neglect, abandonment, or violation of any kind is ‘tapped’…and the affective energy associated with core experience is released…no therapeutic approach will have lasting effects toward the reduction or elimination of toxic shame.” The shame we develop first as small children then augment and call upon as adolescents, young adults, and adults is the very foundation of emotional distress.

Dr. Fishkin justifies this by isolating the way through which many and most of us experience shame, that is, negative self-talk which is “a primal function. It forms and feeds our feelings about ourselves.” When he identifies this as our secret, inner voice “feeding us continuous messages that control our behavior,” it ought to be stunningly clear to many Dr. Fishkin is on to something. Quite simply, even those of us who are well-adjusted can and do experience crippling self-doubt which is often understood as an inner voice throwing nothing but negativity at your emotions, options, and choices. 

As the book explores its topic, we quickly realize shame is “a complex structure” as well as “an organic biological response that is expressed as a visceral and not an intellectual reaction.” Shame is an experience that shakes us to our core as an “embarrassing exposure or a painful realization of being seen, a true mortification, a humiliating sense of helplessness and vulnerability, a non-cognitive physiological and neurological experience. They don’t think about shame; they just feel it.” This last sentence is key to understanding shame as the wellspring of a negative sense of self. Our response to shame is often appropriate but it can easily slide into a visceral self-revulsion prompting us into destructive behavior.

Here is one of the several moments where Dr. Fishkin is able to present us with a nuanced conception of self. He makes his contrasts explicit. Shame is not the same as guilt as many of us would be inclined to believe:

‘I’ve done something wrong’; shame says, ‘There is something wrong with me.’ Guilt says, ‘I’ve made a mistake’; shame says, ‘I am the mistake.’ Guilt says, ‘What I did was not good’; shame says, ‘I am no good.’

Similarly, a distinction is also drawn between shame and narcissism. For many and most of us, shame is “associated with the emotions of grandiose pride, guilt, self-blame, and self-esteem” and “seen as the result of one’s failure to live up to the narcissistic standards of the ego ideal.” Dr. Fishkin also makes clear

“Thought and self-talk are not the same. Thought is volitional and involves a particular choice or purpose. We have to think about thinking. Thought is also associated with consciousness. Critical self-talk is passive and negatively oriented, influencing our perception of our self and others.”

Understanding that shame is not equatable with guilt, narcissism, or genuine criticism is vital in overcoming the stigma that is negative self-talk, in becoming and staying healthy.

Dr. Fishkin doesn’t just present readers with the identification and analysis of a problem, he also offers therapeutic solutions. The case studies included in the book give us a sense of the kind of action that needs to be taken. These actions are preventative, pragmatic, and sustainable to maintain lasting healing and foster health. It is no easy task to isolate, identify, or express toxic shame. It is always easier to deal with symptoms rather than the core issue, and this is what makes The Science of Shame and Its Treatment not just compelling but an arresting work. 

Whether or not you are dealing with trauma, emotional distress, or abusive behavior, The Science of Shame and Its Treatment is vital to understanding not just other selves but one’s self. Dr. Fishkin has made a foray into a fresh field of study, one that could aid a myriad of people in a myriad of ways. 



Author Bio


Years of clinical practice and extensive research provided the background for The Science of Shame. Dr. Fishkin earned his Ph.D. in clinical psychology, and has been licensed and worked in private practice since 1970. He has authored three other books including American Burnout: How to Cope When It All Gets to Be Too Much, Police Burnout, Firefighter and Paramedic Burnout, and American Dream. An expert in clinical and forensic hypnosis, Dr. Fishkin has worked with witnesses of violent crimes in scene reconstruction as well as aided in suspect identification. He has authored over 200 articles for a wide range of magazines and newspapers. Dr. Fishkin has taught at University of Southern California, Cal State Long Beach, and for a number of hospitals and police organizations. He has appeared on hundreds of nationally syndicated radio and television shows. He is host of the weekly online show Psyched! available through

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