Dealing With Shame When You Have BPD

Understanding shame can be important for your health

A sad couple sitting apart, each with a hand on their forehead
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Shame is a powerful emotion that can cause people to feel defective, unacceptable, even damaged beyond repair. But how much do you know about shame? You may sometimes confuse shame with guilt, a related but different emotion.

  • When you feel guilty, you're making a judgment that something you've done is wrong.
  • When you feel shame, you're feeling that your whole self is wrong.

When you feel guilty about the wrong thing you did, you can take steps to make up for it and put it behind you. But feeling convinced that you are the thing that's wrong offers no clear-cut way to "come back" to feeling more positive about yourself. That's one difference between shame and guilt: the way they're defined. But the effect of shame and the behaviors it can cause are far more important for you to know about.

How Shame Happens

From the day you were born you were learning to feel that you were okay or not okay, accepted or not accepted, in your world. Your self-esteem was shaped by your daily experiences of being praised or criticized, lovingly disciplined or punished, taken care of or neglected.

People who grow up in abusive environments can easily get the message that they are undeserving, inadequate, and inferior. In other words, that they should feel ashamed.

Over time, intense feelings of shame can take hold of a person's self-image and create low self-esteem. Feelings of shame often stem from what other people think. The person may become super-sensitive to what feels like criticism, even if it isn't, and may feel rejected by others. Inside, he feels painful self-contempt and worthlessness.

Evidence is increasing that serious problems can occur when shame gets deeply woven into a person's self-image and sense of self-worth.

Shame for People With BPD

Someone who feels deep-seated shame and low self-esteem may not realize that it's the motivation for many destructive behaviors, which can include substance abuse, eating disorders, road rage, domestic violence, and many other personal and social crises.

People who experience traumatic events are also likely to feel shame, particularly if they blame themselves for what happened. In people with borderline personality disorder (BPD), deep-seated shame may account, in part, for their higher rates of suicidal behavior and self-injury.

Shame also affects men differently from women. It's said that men with shame-based low self-esteem tend to "act out," through anger and violent behavior toward others, and women to "act in" by turning their feelings inward and hating themselves.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

A Word From Verywell

Researchers studying the role of biology in the development of shame-based low self-esteem are focusing some of their attention on serotonin, a neurotransmitter (chemical messenger) in the brain. They are exploring the possibility that low levels of serotonin may contribute to submissive behavior leading to feelings of shame.

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  2. Mills RS. Taking stock of the developmental literature on shame. Developmental review. 2005 Mar 1;25(1):26-63. doi:10.1016/j.dr.2004.08.001

  3. Brown MZ, Linehan MM, Comtois KA, Murray A, Chapman AL. Shame as a prospective predictor of self-inflicted injury in borderline personality disorder: a multi-modal analysis. Behav Res Ther. 2009;47(10):815-22. PMID: 19596223

  4. Guimón J, Las Hayas C, Guillén V, Boyra A, González-Pinto A. Shame, sensitivity to punishment and psychiatric disorders. The European journal of psychiatry. 2007 Jun;21(2):124-33.

Additional Reading
  • Davidoff F. Management of Shame in Quality Improvement. Shame: The Elephant in the Room. Qual Saf Health Care. 2002;11:2-3.

  • VanScoy H. Shame: The Quintessential Emotion. Pscyh Central. Published online, updated October 2018.