Home Book Reviews Unshame: Healing Trauma-based Shame through Psychotherapy

Unshame: Healing Trauma-based Shame through Psychotherapy

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Written by Carolyn Spring
Reviewed by Nancy Eichhorn

I follow Carolyn’s blog because her writing fascinates me. She helps people (mainly in the UK) recover from trauma, abuse, and dissociative disorders, heavy stuff. Yet, she writes with a light hand—her use of figurative language, strong nouns and verbs, pacing, structure, and characterization create stories that share the confusion, the pain, the doubt, the suffering, and the dread that come with trauma as well as the desire to surmount it all and be healthy without miring the reader in an abyss of drop-dead emotions.

When I learned about her new book, Unshame: Healing Trauma-based Shame through Psychotherapy, I requested a reviewer’s copy. I was already biased; I appreciate her writing style so assumed I’d like the book.  I do my best to remain neutral when reading and considering a review, and I have to admit that sometimes it’s not easy. Reviews are not supposed to be about me but about the text and its place in our current literature. In reality, however, it’s always about me, as the reader, being immersed in the content. I listen to voices that emanate from the page as my eyes take in words; my brain creates meaning based on intake filtered through what I already know, think and feel.

I think Carolyn’s presence in this memoir is spot on. She shares her six-year journey with her therapist to heal from traumatizing abuse and dissociative disorder. It was, in fact, a ten-year trip. The story is written in retrospect and appears to be based on her journals. Her therapist had her write, and she, herself, used writing to capture what happened during the sessions and then process the material over the week before her next meeting. She single quotes dialogue, which indicates to me that it’s situational—perhaps it’s from her journal, perhaps she’s recalling memories that may not be exact but are close enough, perhaps there’s been some revisions based on the storyline and who she is today. I appreciated the single quote, a sense of honesty, as if she’s saying, here’s my story as I remember it and here’s what I think I said, what she said, and so forth.

I find it fascinating that she does not name her therapist, she is simply the therapist. Despite being nameless, the therapist’s character is fully developed complete with feelings, movements, gestures, facial expressions, tone of voice, emotions, thoughts, etc. She has all the aspects that allows one to connect, to attune, to resonate. And because of who she was (or is), her presence was exactly what Carolyn needed, even if it didn’t feel like it all the time.

Over the course of therapy, Carolyn learned what worked and what didn’t. She demonstrates what doesn’t when her therapist left for an extended leave and she was assigned another female therapist who clearly did not connect with Carolyn. I think one of her most potent messages about working with trauma clients who dissociate occurs during this failed meeting with said temporary therapist.

Carolyn notes what she wished she could have said during their first meeting when she dissociated because of the stress. The therapist was clear that if Carolyn did not control her dissociative states and did not stay present, she could not work with her. Carolyn’s remarks captured the insane demands of therapists who are faced with complicated cases without knowhow—not everyone has the skills to work with clients who dissociate.

Carolyn writes: “Telling a client that you can’t work with them if they dissociate in sessions is like telling a cancer patient that you can’t work with them while they continue to lose weight. The weight loss is a symptom of the cancer; all the more reason to work with them promptly, to deliver effective treatment as soon as possible. Likewise with dissociative clients; the fact that they ‘dissociate’ in sessions, switch to other parts of the personality, lose contact with present reality, are in denial about their trauma, can’t manage their eating or drinking or drug use, or a dozen other “diagnoses’ and labels—all of this is exactly why you should work with them. You don’t tell them to go and sort themselves out, and then you’ll help them recover once they have done so” (pg. 64).

Switching isn’t the problem and behavioral control and ‘grounding’ are not solutions, she writes. Carolyn felt that the temporary therapist in this instance should have focused on connection and attunement, on being present in a supportive, empathic way. Shaming Carolyn for reactions that were currently outside of her conscious control was not helpful. She writes, “The end goal of trauma treatment is for the client to be able to consistently operate in the ‘green zone’, a physiological and emotional state of being where we’re both able to think and feel at the same time, where we’re calm and alert, where we feel safe, and where our ‘social engagement system’ is fully operational” (pg. 64-65).

“The problem we’re trying to solve,” she writes, “is the way that trauma hijacks us, switching us away from daily life mode (green zone) to danger mode (amber or red) and how little control we have over our physiological and emotional reactions” (pg. 66).

Each chapter (there are 20 plus the introduction) deals with one theme that occurs within one therapy session. Shame weaves throughout, i.e., feeling the shame of dissociation, feeling the shame of wanting to be loved and so forth until near the end where Carolyn comes upon the state of unshame. Searching for a word to capture the essence of what she was feeling when she wasn’t full of shame or full of pride, the only word that made sense was unshame. “It’s where you’re just you and it’s okay to be you,” she writes (pg. 191).

I think the following paragraph captures her frame of reference six years into therapy:

“I need a safe space in which I can stand back from my life and rearrange its edges, like breaking up a jigsaw and starting again. I need to find the frame. I need to find some certainties. I need to be able to imagine what it will look like once complete. Because I realise that, so much of my life, I’ve been putting the pieces together upside down: a dull, pale blue cardboard life. But now, here in therapy, I’m going to jiggle the pieces around, turn them over, consider them. And start to construct a new picture. One full of life” (pg. 191).

I wish it was possible to share actual dialogues between Carolyn and her therapist. Their back and forth and to and for, the inquiry on the part of the therapist as she nudges Carolyn to discover what’s going on inside her mind and her body, her feelings, her emotions and her thoughts, and then Carolyn’s responses, it’s a fascinating experience. They both spoke to me.

Suffice it to say that this was one of those once you pick it up you can’t put it down experiences. I was immersed in a world that resonated in many ways with my own history—physical, sexual, and emotional abuse are remnants in my past. And, yes I left my body when bad things were happening. Different personalities show up from time to time: the drama queen, the addict, the hypervigilant watchdog, to name a few. I feel their presence, hear their voices. Today I can listen and not react, not be triggered and take on their traits or their unhealthy coping strategies. And still, reading this book, hearing the therapist’s words to Carolyn, feeling her attunement, her connection, her compassion, her reasoning and her logic, I cried. I yearned for this feeling myself, still do at times. It’s hard to find a therapist who: (1) is a skilled relational body psychotherapist who understands trauma and abuse and dissociative states; (2) has the ability to be compassionate and attune and educate from a neurobiological perspective; (3) can reach out and touch your soul, your inner states of shame and fear and desire and tears and leave you feeling worthy and loved.

Hearing Carolyn’s thought process, her revelations as she makes her way through these interactions brought me inside her pain and confusion, her doubt and self-incriminations and then her awakenings, her reach to touch and feel touched emotionally. I appreciated her authenticity as she presents herself growing in this process, and I applaud her resilience to breathe through her healing and share her presence with others who want to move forward as well.