Dolezal Luna, Gibson Matthew
University of Exeter, Exeter, UK.
University of Birmingham, Birmingham, UK.
Humanit Soc Sci Commun. 2022 Jun 24;9:214. doi: 10.1057/s41599-022-01227-z.
In this article, we outline and define for the first time the concept of shame-sensitivity and principles for shame-sensitive practice. We argue that shame-sensitive practice is essential for the trauma-informed approach. Experiences of trauma are widespread, and there exists a wealth of evidence directly correlating trauma to a range of poor social and health outcomes which incur substantial costs to individuals and to society. As such, trauma has been positioned as a significant public health issue which many argue necessitates a trauma-informed approach to health, care and social services along with public health. Shame is key emotional after effect of experiences of trauma, and an emerging literature argues that we may 'have failed to see the obvious' by neglecting to acknowledge the influence of shame on posttrauma states. We argue that the trauma-informed approach fails to adequately theorise and address shame, and that many of the aims of the trauma-informed are more effectively addressed through the concept and practice of shame-sensitivity. We begin by giving an overview of the trauma-informed paradigm, then consider shame as part of trauma, looking particularly at how shame manifests in post-trauma states in a chronic form. We explore how shame becomes a barrier to successful engagement with services, and finally conclude with a definition of the shame-sensitive concept and the principles for its practice.
在本文中，我们首次概述并定义了羞耻敏感性的概念以及羞耻敏感实践的原则。我们认为，羞耻敏感实践对于创伤知情方法至关重要。创伤经历十分普遍，并且有大量证据直接将创伤与一系列不良的社会和健康后果联系起来，这些后果给个人和社会带来了巨大成本。因此，创伤已被定位为一个重大的公共卫生问题，许多人认为这需要一种针对健康、护理和社会服务以及公共卫生的创伤知情方法。羞耻是创伤经历后的关键情感后遗症，并且新兴文献认为，我们可能因忽视羞耻对创伤后状态的影响而 “未能看到显而易见的事情”。我们认为，创伤知情方法未能充分从理论上阐述和解决羞耻问题，并且通过羞耻敏感性的概念和实践能够更有效地实现创伤知情的许多目标。我们首先概述创伤知情范式，然后将羞耻视为创伤的一部分，特别关注羞耻如何以慢性形式在创伤后状态中表现出来。我们探讨羞耻如何成为成功接受服务的障碍，最后给出羞耻敏感概念的定义及其实践原则。
