Shame on You: Self-Blame Can Literally Make You Sick

From the WebMD Archives

March 12, 2001 -- Your stomach is queasy. Something you said or did or even thought is making you feel sick, and you just want to hide. This reaction might be because the shame you're feeling inside is affecting you physically, researchers believe.

However, they say, even though at some point everyone feels guilty about something, guilt is not as likely to make us ill as shame is. Experts say this is because humans have developed built-in ways to cope with that emotion and to reduce stress that comes with it. Without such a release valve, stress can otherwise impact hormone levels controlled by the brain and wreak havoc with your immune system.

A group of researchers at the University of California, Los Angeles (UCLA) recently demonstrated the vicious cycle of shame and illness by enrolling a group of graduate students into a study to examine how their opinions of themselves affect their immune systems. They asked 31 students to write about traumatic or emotional experiences for which they blamed themselves; 18 others were asked to write about experiences that didn't evoke any guilt or shame.

Results of the investigation were presented last week at a meeting of the American Psychosomatic Society in Monterey, Calif.

The researchers, led by UCLA social psychology doctoral student Sally Dickerson, say that those participants who wrote about neutral experiences and those who felt guilt over their experience showed no measurable physical changes that might make them ill. However, the students who felt shame for the incidents they wrote about showed an increase in cytokine activity, as measured by blood tests.

Cytokines are bodily road signs of inflammation, indicating that a disease process may be in progress.

"The people who felt the most shame had the highest elevation of cytokine activity," Dickerson tells WebMD. "But we don't know, at this point, what long-term effect shame may play in physiological changes. It's not clear whether this has a role in the disease process."

These findings are not surprising, says clinical psychologist Mary Turner, PhD, who counsels those with chronic and terminal diseases, victims of violent crime, and criminals. Because of previous research, we know shame is tied to stress -- particularly when people feel they don't have the power, skill, knowledge, or capability to cope with an event -- and stress can impact the human immune system.

Why does shame affect the immune system so much more than guilt?

Our culture has developed a procedure for handling guilt, Turner tells WebMD: You acknowledge you did something wrong, you vow not to repeat the behavior, you atone for your actions, and you accept the consequences. Because of this accepted process of expunging guilt, the emotion doesn't trigger stress, she says, and therefore isn't likely to affect immune system function.

Shame, however -- especially persistent shame -- is another matter altogether.

Shame, Turner says, results when people receive negative messages -- either internally or from others, leading them to believe they're a bad or defective person who is helpless to change that deficit. And when you factor in the feelings of helplessness and powerlessness that often accompany shame, it's no surprise that it produces high levels of stress-related hormones, says Turner, who also teaches part time at the University of Texas Southwestern Medical Center at Dallas.

"So for physical as well as mental health reasons, understanding the nature of shame and guilt and developing good, strong, effective coping skills is important," she says. And for people who harbor these self-derogatory thoughts, therapy is key in helping reverse negative beliefs and in developing coping strategies.

"Many people color the world and themselves in very black and white terms," Turner explains. "If they have made a mistake, then they see themselves as totally bad, stupid, weak, evil, whatever, and feel shame and helplessness. Challenging this faulty logic is a first step in helping them learn to cope with being merely human and therefore prone to the occasional error and its consequences."