Body-language and nonverbal communication

Shame and psychotherapy in Chinese culture

Shame and psychotherapy in Chinese culture

The Chinese character of shame has two radicals: an ear on the left; and a stop on the right. Literally, anything you don’t want others to hear would be shameful. Shame can be distinguished from guilt: a total self-failure vis-à-vis a standard produces shame, while a specific self-failure results in guilt.1 The universal view of shame states that shame is one of the quintessential human emotions and feelings of shame are the same cross-culturally, which makes a lot of sense to me. Chinese culture values individuals who have a sense of shame, who know right from wrong and who have an awareness of falling short of a standard. In Western society it is not socially desirable to be shameless either, though what brings it about could be quite different. Culture plays a significant role in what precipitates shame, how shame is expressed and handled.

Thus, what is normal in one culture could be viewed as shameful in another. For example, sending aging parents with dementia to a nursing home for Chinese American caregivers is often viewed as something shameful as it violates the Confucian value of filial piety. Chinese families tend to rely heavily on family resources and …………………….do not seek external assistance until the internal resources are exhausted. Institutionalizing frail elders seems to be abandoning them. While guilt or shame may accompany family experiences in the West, nursing homes are home to many Western elders despite such feelings and the reaction seems quite different.

Slurping noodles while enjoying the deliciousness of the noodle and the soup is culturally acceptable in China, however, it will bring embarrassment and shame if you do this even in a Japanese noodle house on Castro Street in San Francisco.

Slurping noodles while enjoying the deliciousness of the noodle and the soup is culturally acceptable in China, however, it will bring embarrassment and shame if you do this even in a Japanese noodle house on Castro Street in San Francisco. Indeed, I was taught by my English tutor not to make noise while eating before I came to the United States. But something I would see as rude, such as blowing one’s nose as loudly as one pleases in the office, is common practice in the U.S.

Shame also was a theme that emerged in my discussions with colleagues on suicide in China. One colleague told me about his cousin’s tragic suicide in the 1980s in rural Hunan province after finding out that she was pregnant: “She was so ashamed.” Pre-marital pregnancy was often viewed as a moral debacle, but an induced abortion required a marriage certificate or connection with medical staff at that time. Moreover, it could bring shame upon the whole family where the parents would be blamed as being incapable of raising their children properly. The young girl experienced her pregnancy as a failure to conform to the moral standard on her part and used death to get rid of the shameful feeling, at least from the perspective of her cousin.

While some amount of shame in a culture can help people get along, be considerate and avoid hurting others, there is also a downside. In the past decade, researchers in China began to study shame, mental health and personality among college students. Students who were high in shame tended to have a stronger sense of worthlessness and powerlessness and presented more self-denial and escapism in difficult situations.2

A collective, inter-dependent culture with standards that involves a prominent focus on consideration toward others is also more shame-prone. Over time, I learned as a parent, when my son did something unacceptable, to communicate, “I love you, but I don’t like what you just did,” instead of communicating, “You are not a good boy,” so as not to elicit unhealthy shame so common in traditional parenting.

The Western humanistic value of self-actualization can be viewed as shameful in a culture like China that emphasizes conformity, causing clashes between satisfying individual needs and the needs of others. I personally know Chinese American college students who gave up their own career goals to conform to their parents’ demands in order to be dutiful children as valued by the Chinese culture. However, they became very depressed as a result.

Shame would be a very relevant issue to bear in mind when working with Chinese clients in psychotherapy. Characteristics like being incapable of holding down a job, establishing a family, or fulfilling the duty as a child, could be viewed as imperfect in regard to the standards of the Chinese culture and society in which one lives, and are common reason for the occurrence of shame. Family history of mental illnesses, of violence and trauma, especially childhood sexual trauma, is very sensitive information that could be shame-laden.

Therapists first need to be comfortable asking such questions. They may need to provide a rationale for gathering such information and to normalize it as part of a routine procedure while remaining empathetic and supportive throughout. Sometimes, the client may take several steps or sessions to share the information they feel deeply shamed about. Once they do open up, they often experience a huge relief and it can be very healing as, perhaps for the first time, they are able to go through the darker and desperate roads with their therapist’s support and witness

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