[Voice of shame--silence, eloquence and rage in the therapeutic relationship].

Is shame out of fashion? The first part of this article discusses how the concept of shame has changed in modern western culture, with a shift from collective definitions of norms towards personal experience. The second part is a phenomenological description of shame and how shame can be expressed and experienced in therapeutic relationships. Shame is something we do want, and something we do not want. It regulates both self-esteem and intimate relationships. It protects the psychological self from invasion. But too much shame is destructive. The main expression of deep shame is silence; it is shameful to speak about one's shame. But deep and pathological shame can be masked in other forms of presentation, "the voices of shame". In addition to silence the article describes "the psychopathology of normalcy", hesitation, depression, alexithymia, rage, envy, contempt, grandiosity and shamelessness. Finally, the article discusses how to escape from destructive feelings of shame.