Shame is everywhere but nowhere. From the infant’s distress when he first sees disgust or anger in his mother’s gaze, through teenage embarrassment, to adult horror of public disgrace: the experience of shame is so excruciating that avoiding it organises our lives. Normal shame is prosocial, underpinning and defining our social groupings. But when early socialisation goes awry, through childhood neglect, abuse or intrusion, it can cause excessive shame with its close allies, rage and violence. Severe shame incites murder. Yet we further shame those society has failed through blame, exclusion or incarceration. Perhaps we fear contamination by their shame.

Gillian Rathbone is a consultant psychiatrist and group analyst working in the NHS as lead clinician for specialist psychotherapy and personality disorder services in Birmingham.