One of the craziest things I’ve heard in clinical fields in recent years is that controversy around “stimming”. Let them stim! Let them rock and flap and tap and shake, it’s their character and their divergence! All of these things may be true. But what’s also true about completely dismissing basic social etiquette is that we’re willingly isolating people from social situations because of their behavior. I’ve seen results of this permissive, overly indulgent style of managing people. They usually end up being young adults who cannot make eye contact with an employer, laugh at inappropriate times in conversation, cannot seem to understand humor or sarcasm, and feel compelled to share their life story with people they’ve only spoken to online. Before the hypersensitive, “rejection-dysphoric” tyrants of Instagram come after me, I’ll preface the piece with this: a person’s social or functional ineptitude is not a reason to treat them poorly or discriminate against them. It is a reason, though, to question our culture’s insistence on “destigmatizing” everything.
According to Daring Greatly by Brené Brown, shame is “the fear of not being worthy of connection and belonging”. Whether learned or ingrained by virtue of personality, it is a looming fear that our abilities, and what we give to relationships, is not enough, and that we’re damned to rejection by those we care about most. Using this definition, shame certainly sounds miserable. There have been some arguments in recent years that the triggering of or fight-or-flight response is akin to the startle response in those with Post-Traumatic Stress Disorder. I think it’s both ridiculous and a tad insulting to compare a war veteran to a person who may be overly sensitive to rejection, but I also resonate with the discomfort that comes from wanting approval but not receiving it. The physiological responses to distress resulting from shame can also be pretty pronounced: rapid heartbeat, sweating, flushing of the face.
Shame is largely dictated by social standards, and rightfully so. Shame is what tends to keep people in line, at least socially, in ways that do not require a formal law or regulation. Few people appreciate a sloppy drunk, for example. But sloppy drunks are not arrested and detained because of their inability to handle Natty Light and a few shots. They’re instead scorned by passersby and maybe yelled at by other sauced idiots and wake up the next morning to tell themselves, “I’m never drinking again.” Depending on societal and cultural standards, which tend to change quite rapidly, shame can be inappropriately used and excessively displaced depending on things like social likability or acceptability. While the term “cancel culture” isn’t used as often as it was a few years ago, it goes without saying that this is the epitome of excessive, irrational, and displaced shame.
As an emotion that is considered “self-conscious”, shame can be informative in that it offers insights into our feelings of unworthiness and cues us to do some further digging into our thoughts. Did we commit some form of a moral or social transgression? Public shaming and humiliation have run rampant in recent years and are perhaps better known as DEI initiatives or XYZ Pride Months. With such clear signals about what our culture supposedly values, our unwillingness to conform to these standards could easily trigger a sense of shame. Or, if you’re like me, it makes me roll my eyes to the back of my head while continuing to go about living my day-to-day in spite of stupidity. In my case, then, my failure to meet the current social norm did not trigger this volatile emotion that Brené describes as “shame”. If we did not commit a moral transgression or violate a widely accepted social rule, though, sometimes the shame emanates from a source more… internal.
Our own failure to meet expectations or goals we’ve set for ourselves can trigger shame. If we’re determined to reach a specific athletic goal, like decreasing our mile run time, coming up even slightly short (we’re talking milliseconds) could be enough to induce a shameful self-loathing. Some athletes take months and even years to recover from this feeling, as evidenced by developing a phenomenon known as the yips, or “choking”. Similar to anxiety, when we avoid the very stimulus that induced the discomfort, our hypervigilance to said stimulus grows stronger. You’re not “slowly getting back into the game”, but you’re slowly hindering your performance over time. The athlete who avoids addressing the possible shame that triggered the continuous “choking” is only making themselves more prone to choke in future games. The individual with anxiety who “gives themselves grace” is not engaging in self-care, but securing continued fear responses and growing anxiety. Perhaps it’s useful, then, to split shame into adaptive and maladaptive. Shame that is adaptive is that which may hurt, but changes behavior to that which is more acceptable. In doing so, the person is punished less frequently in social situations and therefore experiences a higher quality of life. Maladaptive shame, which is usually more of the internal, self-loathing kind, can motivate a person to avoid discomfort and/or project their shame onto others in finger-pointing and blame games.
With anxiety being a close cousin to emotions like shame, I believe both can be leveraged to draw out goodness in ourselves and in others. We tend to use our negative feelings, or nearly any negative experience, to justify avoidance of such discomfort. “Well, I’m just an anxious person” has become a universal hall pass, of sorts, that signifies to others: “I’m allowed to avoid things, and you are to comply with this rigid rule I’ve set for myself.” I do understand the pull to use our feelings as conclusions: I’m mad, why should I have to do anything hard the rest of the day? I slept like shit, why should I have to be patient for everyone else around me? I’M AN ANXIOUS PERSON SO HOLD SPACE FOR ME, GODDAMNIT!!! We’ve likely all used these cards depending on how distressing a situation is. With this tendency in mind, though, it’s imperative we recognize how maladaptive and unhelpful these habits are. When we not only adopt negative traits as part of our personality, but use them to avoid any form of criticism or shame we’re incapable of tolerating, we isolate ourselves from the things that matter most. Plus, we become annoying martyrs that people don’t like to be around.
I’ve wondered for years why people are so willing to pay hundreds upon thousands of dollars to go to therapy and boast about it, but are resistant to paying money for their physical health. Part of this, I’ve hypothesized, is because our of our mainstream culture and its mixed messaging. We’ve long since incentivized illness, disease, and sickness in both social and societal ways. Socially, we empathize with those that are struggling and we idolize those who have overcome significant challenges. As the saying goes, “everybody loves an underdog”. Societally, our medical and therapeutic institutions only make money should the client continue to meet the criteria for illness. They only receive “treatment” and subsequent attention, then, if they present as ill. We’ve also demanded that Americans see chronic problems, like obesity, as something that should not be stigmatized or shamed, but accepted as “a different way of being”. I will not even go down the road of neurodivergence, as it’s a concept so utterly stupid it deserves zero attention. All of these examples point to our complete escapism as it relates to feeling shame for things that should, quite frankly, spark feelings of inadequacy. If we’re chronically sick and we’re not taking care of ourselves, in what galaxy is it normal or adaptive to demand people celebrate that?
What if obesity were stigmatized much like homelessness is stigmatized? When we discharge our pride and “sit” with the discomfort of feeling shame, we recognize how powerful it can be in motivating healthier behavior. While I’m not suggesting we treat people poorly because they’re overweight or obese, I do contest that emphasizing the devastating trajectory of life with obesity is imperative should we hope to change society for the better. And I don’t think shaming a complete abandonment of self-care is cruel or mean-spirited--- I think it’s necessary. Meeting people where they’re at in therapy or in any form of a supportive relationship is an important aspect of assessing motivation to change. In my clinical experience, this rarely works. People need to be told to buck the fuck up every once in a while, and they need clinically pull their pants down should they hope to experience any form of meaningful change. In the realm of physical health, I can see why people would be embarrassed to seek out services out of their own pocket. We’re “supposed” to know how to cook for ourselves, put together a meal, write a basic exercise routine, and navigate our day-to-day. It’s understandable that an individual may feel silly spending money to have someone tell them what they need to be eating. I likely do not need to remind readers, though, that wellness industries have been capitalizing on this uncertainty for decades: Jenny Craig, the founder of one of the country’s most popular weight loss programs, is still worth $300 million. Weight Watchers, as of June 2024, is still worth $125 million. Our shame may well be present, but apparently it’s not powerful enough to override our desire to be thinner or healthier. From where I’m sitting, this is highly adaptive shame.
I also believe we need to consider the following question: what if it’s a good thing that we’re a little embarrassed every now and again? After all, we’re adults who are perfectly capable of figuring out, on our own, how to cook for ourselves, how to sleep 7-8 hours, how to exercise, and how to manage our basic needs. If you type into ChatGPT, “Write me a 6-week paleo meal plan” or “Write me a 12-week long periodized strength training plan”, it will do a fairly accurate job concocting a method for you. We claim that “we just don’t know what to do”. I believe a bit of this, and then I don’t. While we are inundated with ridiculous amounts of contradictory information, making it difficult to discern opinion from fact, I also don’t think we’re the damsels in distress we make ourselves out to be. “I just don’t know what to eat!” Yes, you do. You know that a diet consisting of 90% whole foods is necessary, and no, sugar-free Dunkin Frozen Cappucinolattefrappas are probably not “good for you”.
All of this to say… it’s okay to be embarrassed. It can actually be a wonderful thing to feel ashamed that we haven’t taken the time to care for ourselves, considering our body and our health is all we have. What’s wrong with this, aside from perhaps our own ego convincing us it’s rude, cruel, or inaccurate? Why do we try so hard and spend so much money on “reducing stigma” when stigma is probably at the very bottom of everyone’s list of real problems? Not to mention… you know what’s a lot worse than being stigmatized for being obese?
Actually being obese.
Does this mean we’re permitted to be mean or cruel to people who have serious challenges, whether physical or mental? Absolutely not. I see no reason to ever criticize someone’s character or treat them poorly for any reason at all--- but especially not because of the way they look or the manner in which they’ve chosen to manage their problems. But it’s also quite useful to be point-blank in talking to people about their behavior. I love Dr. Nowzaradan from “My 600-Pound Life”--- he’s the bariatric surgeon that works exclusively with morbidly obese individuals who have hundreds upon hundreds of pounds to lose. He’s the epitome of compassion with high standards: while he doesn’t dismiss the reasons people give for not following through, he often responds bluntly with something like, “Well… that’s a problem. You need to do a better job of figuring that out.” The understandable response is often some defensiveness, which I wholly understand. Some even argue and try to formulate nonsensical justifications for their lack of progress. But with each excuse comes Dr. “Now” simply saying, “Uh huh. Okay, well, that’s not good.” The less attention we give to excuses, the more control over ourselves we gain.
I’ll leave readers with this. Take stock of your greatest problems you’re experiencing and ask yourself the reasons why the problems persist. If your first response is that of alluding to you lacking complete control, I want you to reassess the conclusion. When you find yourself attempting to rationalize away something you’ve long since complained about, I’ll pull one of Dr. Phil’s most cited quotes: