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To combat recent body image struggles, Nancy plans to head to the gym on her way home from work. It was a stressful day and even though she has her gym clothes in the car, at the last minute Nancy decides she just isn’t feeling it. She heads home and relaxes on the couch.
As she slows down, her inner critic speeds up with messages like: “You’re just being lazy,” and “You never follow through with your plans,” and “You always start things but just can’t seem to stick with them.”
Does Nancy’s narrative sound familiar? Do experiences of guilt and shame motivate Nancy to work out or will they ultimately destroy Nancy’s motivation for being more physically active?
First, does Nancy’s narrative represent guilt or shame? If just guilt was involved, Nancy would feel guilty for not going to the gym and then move on. However, Nancy’s inner dialogue goes beyond that single action and includes labels about her personality, suggesting that shame is involved.
Shame seems to be more detrimental than guilt in terms of our mental health. We often experience shame when we believe we are being judged by others. An individual might feel guilty after eating a large meal, whereas when shame is present the individual believes they lack self-control or are flawed in some way.
There’s some evidence that shame serves a functional purpose, facilitating behavior change and helping the individual to refocus and self-regulate. In the past, this belief led to medical and mental health professionals attempting to motivate their patients and clients through guilt trips. However, more recent evidence supports that shame actually worsens motivation, and has a negative impact on health and well-being.
Pervasive ongoing shame, which is referred to in the literature as “chronic shame” is fueled by the anticipation of shame. It’s a persistent feeling that there’s something wrong or that we are flawed in some way.
Nancy may experience chronic shame linked to her body dissatisfaction. If she experiences weight stigmatizing messages from friends, family members, and health professionals day after day, these negative messages are likely internalized. In other words, she believes these negative messages and this provides a direct path to chronic shame.
A person whose body doesn’t fit the socially accepted mold doesn’t just feel badly for engaging (or not engaging) in a specific behavior, they believe that there is something wrong with their mind or body and that they are to blame.
Researchers have found that shame doesn’t inspire an individual to engage in health-supporting behaviors. Instead, shame does just the opposite. Shame worsens physical and mental health in several ways:
- Biological: Shame results in a stress response which triggers increased cortisol levels, ultimately increasing inflammation.
- Psychological: Shame is associated with poor mental health (depression, anxiety, and eating disorders) along with alcoholism and addiction.
- Behavioral: Individuals experiencing weight stigma (which breeds shame) are more likely to engage in overeating, exercise avoidance, and healthcare avoidance.
- Social: Shame is associated with social isolation. In addition, those experiencing marginalization, or even just the fear or anticipation of social rejection, have worsened health.
What can we do to reduce shame in ourselves and others?
1. Cultivate self-compassion
Notice your inner critic. Is what you are telling yourself something you’d say to a good friend? Would Nancy say “you’re just being lazy” to someone she cared deeply about? Let’s hope not. According to self-compassion researcher Dr. Kristin Neff, holding self-compassion means being kind to yourself.
When you don’t follow through with a plan, it’s more helpful to approach your missteps with gentleness and encouragement. First, acknowledge how you’re feeling. Nancy could have had this thought: “I’m disappointed I didn’t go to the gym like I planned. I think that would have helped me de-stress.”
Next, ask yourself what you would say to a good friend who decided not to go to the gym. Talk to yourself like that instead. Nancy might say, “Today, I made the best decision I could in the moment considering the hard day that I had. And, tomorrow, when I’m in a similar situation I will have more information to make an informed decision about my self-care needs.”
2. Understand the complexities of health
Health outcomes go beyond personal health-related changes. Factors like genetics, the social determinants of health (SDoH), and health disparities of marginalized individuals are all factors.
Our health doesn’t hinge on that single behavior change decision, and while patterns over time may contribute to chronic diseases, there are other very powerful contributors that we often fail to consider. Some people are models of health in terms of eating, exercise, sleep, and avoiding drugs and alcohol, and still experience disease.
The blame game is not only disparaging, it’s also simply untrue. Blaming our physical health outcomes purely on our “lifestyle choices,” habits, and patterns misses significant pieces of the health puzzle that are often completely out of our control. It helps to hold health-related patterns in perspective as one small piece of a very large pie.
3. Communicate empathy and non-judgment
Whether we are talking to ourselves or to others, remember that the guilt trip is unhelpful and creates a lot of negative energy. Trying to persuade others to make a change by outlining why their current patterns are not supporting their health can take a significant toll on your relationship.
Don’t assume that those who are expressing concerns about their habits want your input or opinion. They often just want a listening ear—someone who can empathize and share in a common humanity. Using guilt and shame as a motivation for change usually doesn’t motivate and it more likely will backfire, resulting in inaction and harming human connection.
