Shame and Its Role in Eating Disorders and Trauma
Shame. Even reading that word may cause a reaction in your body. Does your face get hot? Do your hands tingle? Does your chest get tight?
Often, shame and guilt are used as synonyms, but the two are distinct. Guilt is “I did something bad.” Shame is “I am bad.” Guilt is about regretting an action; shame is a threat to one’s sense of self.
When Shame Becomes Maladaptive
Shame can be evolutionarily useful — it alerts us when we’ve done something that might threaten our acceptance by others. If you say something cruel to someone publicly and feel shame, that signal is doing its job, prompting you to correct course.
But shame doesn’t stay in its lane. Many of my former clients in eating disorder treatment have described feeling shame when they eat a food they consider “bad,” when they feel fuller than usual, or even when they engage in an eating disorder behavior like restricting or bingeing. In an eating disorder, shame gets hijacked and attached to food itself — as if what you eat, or how much, could make you a bad person.
It can’t. Food carries no moral weight. None.
Shame and Trauma
Shame is also a common and persistent feature of trauma. A 2020 meta-analysis found that across diverse populations, shame is characteristic for many individuals with PTSD, and plays a central role in the emotion structure of the disorder.
This connection makes a painful kind of sense. Our brains want the world to be orderly and causal. When terrible things happen — especially relational trauma like abuse, assault, or domestic violence — the mind often reaches for an explanation: something bad happened to me because I am bad. This logic feels wrong from the outside, but to a nervous system trying to preserve coherence, it offers a kind of stability. It is far harder to live with “bad things happen randomly, to people who did nothing to deserve them.”
This becomes even more true when the source of harm was a caregiver. Primary caregivers are meant to be our first safe harbor, our secure base from which we explore the world. When those same people are the ones causing harm, the mind sometimes performs a kind of gymnastics to preserve them as safe — at the cost of the self. The implicit belief becomes: they are good, therefore I must be the problem. That belief can form in early childhood and quietly organize a person’s self-perception for decades.
The Antidote
Shame thrives in secrecy. Since its origins are likely tied to maintaining social acceptance, being witnessed — truly seen by another person — and still accepted can begin to undo it. This is one of the reasons individual and group therapy can be so transformative. To say aloud the thing you believe makes you unacceptable, and to have someone respond with continued warmth and regard, is not a small thing.
Shame is powerful. It is not, however, immovable.
Source: Shame and PTSD — PMC