Guilt, Shame and Blame
Published on Sep 13, 2016
Presentation given at the 20th Annual Perinatal Bereavement Conference
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PRESENTATION OUTLINE
Guilt, Shame and Blame
Transformative Interventions for the most difficult issues of perinatal death
For handouts referenced in the presentation, please use the following link: https://drive.google.com/drive/folders/0BzB-nEOgOcKaZjFXRlo0T0x1Z1U?usp=sha...
Photo by risayv
Originally presented by Sarah Kye Price
at the International Perinatal Bereavement Conference
Phoenix, AZ
September 2016
Photo by MACSD
Overview
- Describe the bio-psycho-social-spiritual context for guilt, shame, and blame
- Discuss multi-systemic interventions applicable for individual and group settings
- Rehearse and demonstrate interventions in small group settings
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Bio-Psycho-Social-Spiritual Perspective
Grief is multi-systemic
I am speaking to you as a social worker, so I want to start this presentation by inviting you to see grief from a multi-systemic lens. Grief is individual, relational, familial, social, cultural, spiritual/ontological. When we say "no one grieves the same" what we are saying is that no person's systems are all aligned in the same way, at the same time. Although we regard guilt, shame, and blame as emotional responses, our framework today is to see them from a multi-systemic lens rather than purely an individual perspective.
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Attachment Theory
Theoretical Foundation for our Practice Applications
Many people are familiar with the work of John Bowlby (Attachment, Separation, and Loss). Attachment theory offers a very important foundation for grief in general, but even moreso when a death happens during pregnancy or in early infancy. That is the crucial time for attachment formation, and the bio-psycho-social-spiritual impact of grief is magnified during this time in particular.
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Perinatal Death and Attachment
- Internalized responsibility for system stresses
- Heightened social expectations
- Sudden/unanticipated break in attachment expectations
- Lack of social and spiritual rituals
- Normalized resumption of daily life
Photo by danielle.spraggs55
Guilt, Shame, and Blame
Aspects of Broken Attachment
When we bring together this bio-psycho-social-spiritual perspective along with the framework offered by attachment theory, we gain a new vantage point on how guilt, shame, and blame may emerge. Let's spend a bit of time thinking of each of these complex responses in terms of its challenge and its corresponding strength.
Photo by Peter Ras
Guilt --> Forgiveness
Guilt is on a continuum with forgiveness. Guilt is an inward-facing emotion which can be reinforced by the social system or by our own internalized sense of responsibility. Guilt is resident with forgiveness, which offers a profound and transformative release for the one who offers and the one who receives forgiveness. In working with deep guilt, the challenge may lie in extending that forgiveness to oneself.
Photo by @ifatma.
Shame --> Acceptance
Shame often stems from the relational and social messages that are directed at us, or that we carry with us. Whereas guilt eats at us internally, shame is something we confront when re-encountering a social or relational situation in which we feel unworthy. Shame can result from messages the grieved internalizes, implicitly or explicitly. Acceptance realigns the griever with social, relational, and/or spiritual wholeness. To be accepted is to experience love and belonging.
Photo by Nick Kenrick.
Blame --> Reconciliation
Blame is causal; it implies that there is a definite "right" and "wrong" and that the one blamed is in the wrong. Blame places a wedge between the one blaming and the one being blamed but sometimes this isn't fully vocalized. The transformative extension of blame is reconciliation, when we are rejoined to wholeness in ourselves, in our relationships, with family or community or with our belief system.
Photo by Ben Sutherland
Mirroring
An exercise in mirroring is a way to support the affective bonds created in parenting at all stages, while acknowledging the loss.
[Paired demonstration of mirroring exercise; see handout]
[Paired demonstration of mirroring exercise; see handout]
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Externalizing Feelings
Labelling our emotions connects our cognitive and our emotional functions; emotions associated with perinatal deaths may differ from "typical" bereavement so this work is even more vital.
External processors: Individual or group work may be helpful
Internal processors: Journaling and letter writing may be helpful
Tactile processors: drawing, art, working with sand or clay to create emotional representations may be helpful.
External processors: Individual or group work may be helpful
Internal processors: Journaling and letter writing may be helpful
Tactile processors: drawing, art, working with sand or clay to create emotional representations may be helpful.
Photo by Suedkollektiv
Give and Receive Affirmation
An important activity for support groups is to practice giving and receiving affirming messages with each other, not just looking to the facilitator
Cognitive restructuring and thought replacement (components of CBT) can be built around affirmations in order to counter-balance guilt, blame, and shame.
(refer to handout for more information)
Cognitive restructuring and thought replacement (components of CBT) can be built around affirmations in order to counter-balance guilt, blame, and shame.
(refer to handout for more information)
Photo by Steve took it
Spiritual Self-Care
Intentionality of spiritual care is vital to the bio-psycho-social-spiritual continuum.
Examples: rituals, prayers/litanies, continuing bonds, securing a spiritual connection and/or spiritual direction to offer a touch-stone of stability during times of great unknowing.
Examples: rituals, prayers/litanies, continuing bonds, securing a spiritual connection and/or spiritual direction to offer a touch-stone of stability during times of great unknowing.
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Questions and Discussion
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