TW: mention of medical stuff, sex crimes, and trauma.
Growing up as the kid of a doctor I got to observe a lot more medical treatment than most doctor’s children do. My dad provided free medical treatment to people he knew couldn’t pay - the two conditions were that it had to be treatable at our home, and that they had to come to our home for treatment. (Because once he’s done with his shift he’s not going anywhere except to bed.) I think a lot about some of those moment and how significant they were for me as a kid, even if I didn’t realize it.
One day a kid got brought to our house. His grandpa was a loving man who was trying to take care of his grandson. His grandson had what looked like a big-ass welt on his leg. My dad took one look at it and recognized it as MRSA, a highly contagious and medicine resistant skin infection that can be fatal.
We did our usual “home medical prep” technique of wiping out kitchen take down with bleach. The younger kiddos left the room, but @inbabylontheywept and I stayed to talk to this guy who was about our age and scared as hell. He chatted with us while my dad numbed the infected area and then extracted what seemed to be enough puss to fill a milk jug. This boys leg was so pussy it would legally be denied medical care in the state of Texas. He had medically impossible quantities of goop emerging from his leg at a rate that was nearly audible, like when an upstairs neighbor turns on a shower. He packed the wound with sterile gauze and prescribed the kid whatever meds are appropriate to prescribe for MRSA, Idk I’m not a doctor. But I remember the kid saying that he was relieved that he got it treated early so he could still be ready to play football with his high school team if he was lucky.
I remember an older guy who came into a clinic my dad owned with an ingrown toenail. He’d ignored it for so long, thinking he was just being a wuss, that the toenail - once extracted - was about the size of a small pea. He sighed with relief when it was done and said he was glad to know he hadn’t just been being whiny and wasting people’s time. My dad told him he could have come in weeks earlier and still not been wasting his time. The man laughed, like my dad was kidding, and left the clinic.
I was 16, at a church dance. A girl comes up to my dad. She says she feels sick. Headache, sore throat, nausea, the works. She consents to a physical exam where my dad feels that her lymph nodes are inflamed - a sign of a potential infection. He escorts her out of the dimly-lit dance hall to a brightly lit hallway and sees her earlobes are bright red and almost painfully hot to the touch. He tells her she’ll need to take the earrings out, and when she does a geyser of pus sprays out of each hole in her ears. She has to get her ears re-pierced and is sad about it but happy to feel better.
When I worked with sex offenders we often talked about “The Offense Cycle” or the pattern of behavior typically related to the commission of a sex crime. Over time I came to realize this did not only apply to sex crimes, and in fact applies to most people as it is only barely related to sex drive and much more highly connected to ego/self-esteem. I now call it “The Shame Cycle.” The shame cycle has four parts, all centered around an experience with shame.
These parts are all circling the feeling of shame, trying to keep it subdued, because at the end of the day shame’s purpose is to drive us to hide things. While guilt is prosocial and pushes us towards others, shame pushes us away from others and towards secrecy. We all experience shame, and we all experience it over different things.
The first stage of the shame cycle is isolation. People who feel shame want to run, to withdraw, to hide their torturous evils in the darkest cob-webbiest corners of our brains. It drives us to hide from others, to keep away from them so that they never know what we did and get mad at us or hurt us in some way, be it physical, emotional, or otherwise. The base urge to stay safe is understandable, but it also drives people towards avoiding something. This effort to “not feel bad” is what I often call a “cadaver goal,” a goal to kill a feeling or thought or to experience emotional nothingness. This, of course, does not work, because as Aristotle noted- “Nature abhors a vacuum.” In the absence of feeling and connection, this step inevitably fails and gives way to the next stage of the shame cycle:
The second stage of the shame cycle is “masking,” or hiding our true needs/wants/intentions from others due to the fear that those things would force us to face intense rejection. If the thing we are ashamed about is a part of us, that means not just rejection of a concept but rejection of a part of our Selves, which is painful and challenging to deal with. So we tell ourselves that we cannot, should not, MUST not reveal our true self, but that if we put on a little show for someone to make them happy it’s not that bad, right? The trick here is that we’re trying to contain emotional experiences to a box, but emotions are living things. The town I’m in had to remodel its whole downtown area because we planted trees but didn’t give them enough space to grow. Instead of staying small, fitting within the confines of the space allotted to them, they did what living things do and started breaking shit – concrete sidewalks were ruined and unnavigable, especially for people with impaired movement. The foundations of buildings were being cracked and damaged by tree roots. Sewer lines and water lines were being broken by these invasive roots which, when given no means of egress, were forced to find space for themselves by breaking the nice useful things we’d built around them. And shame, just like so many other feelings, just like so many tree roots, does not go away if ignored. Instead, it cultivates itself. If we do not make space for it, it will make the space itself without any care to what it is shattering, cracking, breaking, splintering, or otherwise destroying as it does so.
This shattering leads into the third stage of the cycle – the “enacting” stage, the stage where the shame is not suppressed any longer because it no longer CAN be. It leads us to do bad things, things we are embarrassed of or ashamed by. For some people, shame about who they are, what they want, what they think, or how they feel can lead to sex crimes or other forms of unacceptable violence. For others, it can lead to relapses, bursts of mean-spirited verbal aggression, fits of rage, or otherwise experiencing what the kids call “crashing out.”
Once the enacting stage is finished, the final stage of the cycle presents itself – the Resetting stage. Without addressing the shame, people reset to the point of isolation, then masking, then inevitably enacting. The shame is sheltered by this cycle, which creates thoughts, feelings, and behavior orbiting around the shame like a pack of animals forming a defensive circle around their young when predators are spotted. Only in this case we are both the predator and the young, and we’re trying to save our self-concept. The Resetting stage is often defined by what is called “victim posturing,” or positioning oneself as a victim of circumstance or life, removing the sense of control allows us to distance ourself from the responsibility we would otherwise feel. The other behavior common to this stage of the cycle is “transitory guilt,” or guilt that pushes us to be kind to others until we feel better about ourselves and not until we have connected with others and restored balance for our untoward actions.
I’ll give y’all an example: There was a period of time where I hated myself. I know what y’all are thinking – a tgirl who hates herself? Color me shocked! But legitimately, it was just ingrained into me. I knew there was some part of me that felt so “wrong” compared to what I could see others feeling that I needed to hide it. I went as far as going on a mission for two years hoping God would see my sacrifice and repay me by giving me a “whatever-the-fuck-this-is-ectomy” but it didn’t work. In fact, immediately after my mission, I was possessed by such intense self-loathing that, had I felt it openly, I would have been crushed. In actuality, I was not crushed when I felt it, but I thought I was weak and incapable and I wanted to be productive so I pushed it down. I isolated myself from myself, and I hid from others. I interacted with people when necessary, such as for work or for class, but otherwise I stayed by myself. I had this horrible feeling inside me that something was going to come out of me – some act, some thought, some feeling, that would show who I really was, and then everybody would know, and they would hate that thing, and I would know that the thing they hated was a part of my soul. I would know that I was uniquely and unavoidably detestable.
So I hid it. I hid it at all costs. And eventually it gave way to masking – by hiding my feelings I fooled myself into thinking I was able to kill that part of me I loathed. But, as is inevitably the case, it came up. The roots of my sickness burrowed through the freshly-laid concrete of my hopes for the future, my comfort, and my connection to myself. Any time I’d get too comfortable with my mask, I would quickly realize that I had done something “wicked” or “evil,” such as asking a girl on a date as someone who was fundamentally Wrong. No matter how well the date went, no matter how charming the mask was, I was never me, and I always ended things before they got serious enough to show whatever was inside me. I flickered between isolating and masking, never quite allowing my roots to break through the concrete enough to get the sustenance they needed, until eventually – to my horror – I made a suicide plan.
The day-of I had everything ready – a loaded pistol, a note, a place to do the deed, and something flipped. I had a good interaction with a roommate. He was kind and told me I looked tired and should rest. I decided to delay the inevitable by an hour and walked upstairs to take a nap. Instead, I found myself sobbing. I cried myself to sleep and woke up hours later – dehydrated, distraught, and defeated. I took the position of the victim, in part because I was a victim – I was a victim of myself and of others. I told myself that nothing I was feeling could be stopped, that I was powerless to save myself, that spending even another second in contact with this pain was going to kill me unless I did it myself.
I also experienced transitory guilt – I couldn’t die unless I proved to my family it was the right thing to do. I wasn’t trying to live because my absence would harm others, I was trying to live so I could feel better about things when I finally did what I was going to do. I called the BYU CAPS center and they helped, but because my providers there could not find the cause of the shame it only reset the cycle. I spent 18 months after that point circling the drain, repeating the cycle, until eventually it happened – a beautiful, smiling transgender woman posted a timeline picture of herself and I realized what I’d been avoiding, what needed to come out of me was HER, the me I hadn’t been allowed to be for so long. Not a feminine man, not a gay man, but a whole person – a woman who could experience joy and reality in ways the now-dying husk of the man I thought I was ever could. The concrete shattered, the water lines were ruined, the foundation of the buildings I had constructed collapsed, and in the wreckage of my old self there was a strong woman with deep, powerful roots that could not be ignored or denied. At long last, with a lot of patience from friends and family, a lot of work on my end, and a significant amount of luck, I was finally able to grow past the confines of the concrete bullshit I had locked myself in. With the cycle disrupted, I was able to examine myself and found that while the false world I had built to house my warped feelings and deluded thoughts had died, the living tree of my soul was now free to thrive on.
When we experience shame we often want to extract that feeling, to remove it and dispose of it, to annihilate it and kill it, and we simply cannot, at least not healthily. We also oftentimes feel the urge to lock it up, to build around it things that are so important and advanced and powerful that we think there is no way the feeling could ever escape and be seen, but just like tree roots pulverizing cement, just dandelions growing in cracks in the sidewalk, just like a caged animal, our living feelings are not content to be restricted by what we feel is best or most logical. Instead, our living feelings need to be cultivated. We need to feel them on purpose. We need to give the feelings somewhere to go. Because with nowhere to go, they do not stay put, they start to damage things in their effort to escape.
When I was being trained on how to provide therapy to people who are grieving I was taught the mantra “grief is just love with nowhere to go, so give them somewhere to put it.” The same goes, oftentimes, for shame. While oftentimes shame is a source of information about wrongdoing, for many marginalized people shame can also be related to self-care. Many people experience shame about needing more time to rest while menstruating, not because it’s bad to need more rest or more time or more patience, but because they have been mocked, bullied, hurt, or belittled for even asking. Many autistic people feel shame when asking for accommodations – not because letting a professor know you need to wear sunglasses inside is bad, but because it’s something that can get us made fun of or belittled. Many queer people feel shame for being queer, not because being queer is bad but because our society, by and large, hates queer people. In this sense, the shame we feel can be reframed as “self love with nowhere to go.” The shame is a way we hide the parts of ourselves too precious to ever willingly subject to harm.
To clarify, if you feel shame because you DID something bad, that is different than the shame experienced by being told that you ARE bad. When sex offenders would come in and say “I hid this from my wife because if she knew she’d be livid” it wasn’t something like “if she knew how lonely I was she’d be livid,” it was always “if she knew that I was grooming her niece she’d be furious,” because of course she would, because that behavior is harming others. Sometimes shame tells us to hide things selfishly, because it keeps us safe from the consequences of our actions, but sometimes shame tells us to hide things lovingly, because it keeps us safe from the consequences of others’ actions. But that can also build up – that man whose ingrown toenail was removed was so ashamed of his own perceived weakness that he waited until removing the ingrown toenail left a wound more reminiscent of a bullet hole than a typical ingrown toenail removal wound. That girl who didn’t want to experience the pain of ear piercing again hid the discomfort she was in until she literally shot pus out of her ear like a squirt gun. Inversely, the boy who had all the pus ever made pushed out of his leg felt better BECAUSE he asked for help as soon as he knew he needed it. When we hide what hurts us, it doesn’t go away, it just forcibly gives the pain more room to grow.
For those readers of mine who are dealing with shame, or who are dealing with some aspect of the shame cycle, know that shame dies in the light. Shame cannot survive contact with reality. Know, also, that shame comes from a place of self-preservation. That you are not broken for trying to stay alive. Know that even if you feel shame that is warranted, such as shame at having harmed someone, that letting the shame out will give you more space, time, and energy to grow. Whether it’s part of an offense cycle or a shame cycle, disrupting the cycle will lead to a better, happier life. Likewise, for those who feel too overwhelmed to function right now, those who just want everything to stop so they can have a goddamn break, remember that what you want is not the absence of a negative but the presence of a positive. You don’t want to stop feeling scared, you want to feel safe. You don’t want to stop feeling sad, you want to feel relieved. If we let the pain bury our wants because it’s safer to want nothing than it is to want something and be hurt by its absence, then we end up not acting in accordance with who we know we are, and that is so much more painful and frustrating.
Be kinder to each other. Be kinder to yourself. Find places to put your self-love. Be gayer, read more Terry Pratchett, and ignore the voice that tells you to suffer in silence – asking for help is the first step to decreasing shame.
