Date of Award


Document Type

Doctoral Research Paper

Degree Name


Organizational Unit

Graduate School of Professional Psychology

First Advisor

Laura Meyer

Second Advisor

Shelly Smith-Acuña

Third Advisor

Julie Cradock O’Leary


Shame, Clinical psychology, Therapy, Eating disorders, Body image


Shame–understood as a feeling in which one believes that they are inadequate, or wrong to their core–is a painful emotional experience that seems to be at the crux of many mental health concerns. Despite the pervasiveness of shame as an emotional experience, little research has demonstrated if shame is a clinical theme in therapy, and if so, how it is identified and treated. The purpose of this qualitative study was to explore if, and how, shame manifests during therapy sessions with clients who are experiencing eating disorders and/or body image concerns. A secondary purpose was to discover how clinicians’ training addressed the topic of shame in their graduate training and whether there are gaps in that training that should be remediated.

Upon review of data, the researcher found six themes: differentiation of shame from guilt, nonverbal experiences of shame, exploration of shame influences, shame’s effect on quality of life, 5) shame’s absence from graduate coursework, and 6) a desire to include shame, trauma, and body-image training to graduate coursework. Additionally, from these interviews, the researcher identified four “special populations'' that may be especially shame-prone in the context of body shame, body image concerns, and/or eating disorders. These populations included: LGBTQ+ clients, perinatal and postpartum clients, clients who have experienced a trauma related to their body, and clients who acquired chronic and/or life-altering health conditions. Additionally, gaps in training were identified, and proposed areas of curriculum development are briefly explored. Strengths, limitations and future directions are addressed.

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Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

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