Shame and the fear of feeling.

TOPIC: Toxic shame and the concomitant fear of feeling are core issues needing to be addressed during group therapy with adult survivors of childhood sexual abuse.

PURPOSE: To increase awareness of the toxic shame that survivors experience and to describe the impact of group therapy based on a family systems model.

SOURCE: The authors' clinical experiences.

CONCLUSIONS

Symptom management, repatterning of cognitive distortions, and the improvement of self-care strategies are identified as crucial aspects of healing shame-based feelings and behaviors. Group treatment offers members the opportunity to cease reenacting family rules and roles that create toxic shame.