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Shame is dangerous. I have shared this warning before when reflecting on its presence in my life and the catalog of symptoms it spawns -- isolation, substance abuse, depression, and more. The list is a veritable litany of loneliness and disenfranchisement. Several HIV Plus readers have contacted me recently, expressing appreciation for the emotional honesty in my columns. And while I am a therapist -- and therefore have some reticence to reveal such intimate details about myself in such a public venue -- I am first and foremost a human traveling on the same journey as you. And it's imperative to reveal that I often struggle with a very human condition -- shame -- in order to heal (and help others do the same). You see, in addition to some of the symptoms I've listed above, shame also often results in hiding -- from friends, from family, from reality, even from oneself. So revealing my vulnerabilities helps free me from the self-imposed prison shame too often tries to trap me inside. In my training as a therapist I was taught to assess the impact of stigma and its related shame. Specifically, I was taught to ask some of the following questions: ' How many friends of a similar background or condition does one have? ' How much time did one spend with one's family, peers, community? ' How much was one willing to learn about the history or shared sense of identity with one's peers? The questions make perfect sense: If one is ashamed by one or more aspects of himself or herself, one typically avoids intimate relationships or even friendships with people sharing similar characteristics. They remind us of our own vulnerabilities that we would rather not deal with. Perhaps this is why group therapy and support groups such as 12-step programs or those focusing on HIV or cancer are so helpful and so strongly recommended by therapists. They help one to not feel like an outcast clinging to the notion that others won't understand or 'get' what they're struggling with. Groups also can help break down that prison of isolation where one can pretend problems don't exist or that they can be easily handled alone. Lately, I've recognized the depth of my own desire to hide that which I consider dirty or broken. It's as though I truly believe that if I pretend everything is OK, then everything becomes OK. It's also an extension of the mistaken belief that I often fall prey to -- that people will not like me if I reveal who I really am. The source of my growing confidence that allows me to share what's going on inside me is actually rooted in the sharing one can experience from group therapy or a support group. It provides an experience of nonjudgment and acceptance. And, just as important, it offers a consistent and powerful reminder that no one is alone and that there is no need to cower in isolation. (Although I need constant reminders of this fact; what was learned in 35-plus years does not go quietly into that dark night!) For those of you who find yourselves cowering in isolation and shame, I encourage you to take the brave step of joining a group of like-minded individuals. It very well might hold the key to unlocking your own prison. How remarkable would that be? Fransen is a licensed clinical social worker who is in private therapy practice in Chicago. He welcomes feedback at stillpoint4003@yahoo.com.
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