Shame and Guilt in Suicide and Survivors

Two of the feelings most commonly reported by suicidal persons and their survivors are shame and guilt. However, they are not always recognized as such, for the feelings take many forms and are often expressed in different terms, such as self-blame, depression, humiliation, rejection, abandonment, loss, worthlessness, failure, embarrassment, unlovability, and others. Literature search over the past half century indicates more interest in shame than in guilt, perhaps because shame has been seen as the more complex subject. Shame especially may be one of the most basic affects in the area of suicide, so it is of interest that one searches almost in vain for the topic of shame in clinical or theoretical presentations in conferences on suicide and crisis intervention. Actually it is only from about the 50’s on that mental health professionals have explored in depth the role of shame in individual and social development. Earlier, Freud [1] had paid scant attention to shame, referring to it neither as an emotion nor as a symptom but rather as a state of tension, originating within the superego, that developed as the child was forced to control his early tendencies toward narcissistic exhibitionism. Piers [2], an early analytic writer on shame, accepted Freud’s concept of shame as a result of tension, but also expanded it by differentiating the superego into at least two parts, the ego-ideal, or the desirable identity toward which the individual strove as he grew, and the conscience, representing morality, or knowing right and wrong and recognizing acceptable and unacceptable behavior. Such limitations, he said, taught the individual the rules by which one functioned in society. Anna Freud [3] and Jacobson [4] were among the early psychoanalytic writers on shame and guilt, most of whom focused on its major function of blocking tendencies toward forbidden exhibitionistic behaviors which were considered undesirable, aggressive, narcissistic and immoral. Anna Freud [3] makes the interesting observation, “The qualities of shame, disgust and pity are known not to be acquired by any child except as the result of internal struggles with exhibitionism, messing and cruelty.” (in Miller, 5: 157.) Some writers felt there were other than negative aspects in the concept of shame. Lynd [6], for example, broadened the context for the development of shame by emphasizing the cultural influences on developing affects; shame