Self-conscious emotions among survivors of trauma

Lewis, Lily and Sellwood, Bill and Simpson, Jane and Fletcher, Ian (2020) Self-conscious emotions among survivors of trauma. PhD thesis, Lancaster University.

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Abstract

A literature review, empirical study and critical review were conducted into the role of self-conscious emotions (SCEs) following trauma. SCEs such as shame (evaluation of the self), guilt (evaluation of behaviour) and self-disgust (disgust directed towards the self) can cause significant distress and may be particularly high among survivors of trauma. Research has focused on individual SCEs in isolation, often using terms for the different SCEs interchangeably. Therefore, the literature review synthesised the qualitative literature on experiences of SCEs as a whole, among survivors of childhood sexual abuse. Fourteen papers were identified and synthesised using the thematic synthesis method. Three themes emerged: What the abuse means about me, (Dis)connection from others, and SCEs in the recovery journey. Within each theme was a tension between contrasting positions. The self was experienced as both powerlessly vulnerable and potently bad. Connection with others was both deeply threatening and a haven from SCEs. SCEs were both inescapable and the route to healing. Disclosure was instrumental in recovery but could be either de-shaming or re-shaming depending on the response received. The empirical paper examined the relationships between reluctance to disclose traumatic experiences, posttraumatic stress (PTS) and SCEs. Adults with experience of trauma were recruited online (n=443) and completed psychometrics measuring SCEs, reluctance to disclose and PTS. Shame and self-disgust, but not guilt, were significantly correlated with reluctance to disclose and PTS. Self-disgust but not shame moderated the relationship between reluctance to disclose and PTS. Among participants who reported sexual trauma, both shame and self-disgust moderated the relationship between reluctance to disclose and PTS. Reluctance to disclose predicted PTS at all but the highest levels of self-disgust/shame. The critical review reflected on issues of parallel process with the research, the importance of cultural context in understanding SCEs, and implications for clinical psychologists in practice.