I spent a good amount of time interviewing William about his life. I am not going to be his therapist for obvious reasons but looking at his case has been useful to think about how others who are suffering can be helped. Here I recommend what I believe to be a good treatment for William and I have added some background detail to his issues.

William’s story unfolds in Day 1, Day 2, Day 3, Day 4 and Day 5.

Will’s life appeared to change when he left home and moved in with his girlfriend. He isolated himself and got involved in drinking to numb his feelings. This was really the first time we lost touch with each other. Interestingly, he never mentioned to me about the drinking in his journals (even though I knew) and I believe he carries a lot of shame about this. There were a few times when people had to be called to get him out of trouble after fighting or collapsing somewhere, intoxicated. His life is indicative of toxic shame being felt on a deep level and he has spent most of his life avoiding this shame. He is not in touch with his emotional self at all and sees emotion as dangerous.

As I go about my job on a daily basis, I realise that Will’s story is not unusual and people do carry shame forward to a greater or lesser degree. It is a product of parenting styles employed a generation ago that were affected by the generation before that. I did some research on this and specifically parenting styles in the 50’s, 60’s and 70’s in the UK. They were all based on patriarchal family systems where the father (emotionally distant) set the tone for discipline and the structure of the family. Especially after the Second World War, men coming back from the front, had a special status in society and everything was done to make them feel special, including encouraging them to be the “heads” of the household. Women played the role of housekeeper and daily caregiver to the children. While this might have changed somewhat after the 60’s, children were treated much the same into the 70’s.

This meant basically that children were tightly controlled and discipline was harsh and immediate in the sense of “do as I say, not as I do”. The schools were no different, using the cane and slipper (and indeed the hand) as a punishment measure. Emotions and expression of feelings were not encouraged and children should be “seen and not heard”. Many mothers were not financially independent and were often given an “allowance” by the man to run the home, which usually didn’t include much leeway for personal spending. This set up could be seen as the forerunner of the codependency issues we face today.

Just where do you start with all of this? For some, they just wouldn’t bother and it would be all too painful. Others would be in a sense of denial or would self-medicate with addictions, as Will did. Some would spend their valuable time blaming others instead of focusing on change. Will has done all these things and more. In my opinion, understanding where you come from is an essential part of understanding who you are. Only then can new realisations be had. If therapy generally can be criticized, then the fact is that it often doesn’t go deep enough, preferring to analyse symptoms rather than causes. For example, toxic shame is often not dealt with (as is codependency) and symptoms such as anger – secondary emotions to cover shame – are.

In William’s case, I would recommend the following for him:

Stage 1: The Inner Self

William needs to get in touch with his feelings and grieve for the lost childhood he experienced. William has been numbing those feelings with self medication, addictions and denial. My first thought would be to get him in touch with his inner child, the deep core wound that he carries. This can be done with visualisation and the results of this can be truly amazing. The method of meeting and getting to know your younger self in a safe space, then talking about and reframing experiences can be very fruitful. The very least that happen is that you can understand what happened to you as a child and how trauma has been carried for years.

Stage 2: Thinking patterns

I am a big advocate of Internal Family Systems therapy and for me, it is the next stage after meeting the inner child. This stage examines the thinking patterns that come from growing up in the environment we did. It is also a very creative way of working through irrational thinking by creating an internal family. This usually includes the Inner Critic, the Escape/Avoidance, the Anger, the Guilt as well as the biggest voice of all, Shame. These can slowly be turned into personalities and these figures can be spoken to and negotiated with. One of the reasons why we feel so stuck is that these voices all want a say. They are protective voices that want us to process childhood pain by actually avoiding it and they motivate by fear. Who hasn’t heard the typical self talk of the critic or the guilt when we say no or set any kind of boundary? Who hasn’t procrastinated over something important to the point of desperation? Who hasn’t got angry when trying to process relationships? These feelings are all driven by shame and there are other emotions we cannot access that we might be able to when we do this work. The idea is to integrate these voices back into our psyche and learn to feel again.

Step 3: Action

In my opinion, therapy is not useful if a point is not reached where action can be taken. When a point of awareness is found, then action is very important as a way of consolidating change. It means putting the awareness into practice. Even though this is often the most difficult step, taken with energy, it can be a very fulfilling experience to finally put everything into perspective.

I only hope that William can get to this point.