POV: You're looking in the bathroom mirror when an old shameful memory suddenly surfaces. A sense of detachment creeps in and you feel like you're staring at a stranger. Your reflection stares back at you, unfamiliar. This is what shame-induced dissociation can feel like—a sudden rupture between the self and the present moment, often triggered by past trauma. For mental health providers, this visceral survival response to traumatic experiences is one we must understand to help our clients navigate it.
Research by Kouri et al. (2023) demonstrated that recalling shame-related memories elicited significantly higher dissociation levels than neutral memories. Participants reported experiences of depersonalization and emotional numbing when revisiting these moments, suggesting that shame operates as a gateway to dissociative coping mechanisms. Dissociation, in this context, acts as a mental escape from the pain of confronting a diminished self-image. For example, a person might find themselves zoning out during conversations, losing track of time, or feeling emotionally numb when reminded of past shameful experiences.
Clinicians must create a nonjudgmental space for clients experiencing shame-induced dissociation. This means fostering an environment where clients feel comfortable discussing difficult emotions without fear of criticism. It involves validating their experiences, using dual awareness techniques to keep them present, and gently challenging avoidance patterns while maintaining a compassionate stance.
Experiential avoidance is the tendency to resist distressing thoughts, emotions, or sensations. This avoidance plays a key role in the connection between shame and dissociation, often intensifying dissociative responses. Kouri et al. (2023) found that individuals with high levels of experiential avoidance were more likely to dissociate when recalling shameful memories compared to those with lower avoidance levels.
This phenomenon is particularly pronounced in trauma survivors who internalize shame. As Dorahy et al. (2017) highlighted, internalized shame fosters a desire to withdraw from an internalized ‘contemptible self,’ amplifying the need for dissociative escape. In therapy, avoidance can present as “resistance” during sessions.
Reducing experiential avoidance helps lessen dissociation. Individuals with high experiential avoidance often struggle to remain present in therapy, reinforcing shame-driven dissociative patterns. Integrating approaches such as EMDR can help clients process distressing memories safely while fostering an increased tolerance for difficult emotions. Mindfulness-based strategies may also support clients in gradually confronting and integrating their experiences, ultimately reducing the need for dissociative coping mechanisms.
For individuals with a history of interpersonal violence, literal and metaphorical mirrors can become sources of alienation. Studies have shown that mirror-viewing tasks—where participants confront their reflections while recalling traumatic memories—can heighten feelings of shame and dissociation (Caputo, 2010; Kouri et al., 2023). In these moments, the reflection becomes a painful reminder of a fragmented self.
Kouri et al. (2023) hypothesized that the mirror might amplify dissociative experiences. While their findings did not show a significant increase in dissociation compared to control conditions, participants often described a profound discomfort and estrangement from their reflections. Prior research (Freysteinson et al., 2018) also links sexual trauma histories to mirror-related disconnection.
Therapists might consider using controlled mirror-exposure techniques as part of interventions, helping clients re-establish a compassionate relationship with their self-image. For example, a therapist might guide a client through a mirror-viewing exercise where they describe what they see without judgment, gradually shifting their focus from self-criticism to self-acceptance. Over time, this approach can help reduce avoidance and foster a more integrated sense of self. Gradual desensitization and narrative therapy can support this process by providing structured opportunities to process shame while fostering a sense of safety and self-acceptance.
Shame-induced dissociation represents a complex challenge for trauma-informed care. Its roots lie in the interplay between identity, avoidance, and self-perception, creating a cycle of withdrawal and fragmentation. As Kouri et al. (2023) emphasize, addressing these dynamics requires clinicians to focus not only on the traumatic events but also on the emotional states and self-concepts that perpetuate dissociation.
By incorporating approaches that target shame, reduce experiential avoidance, and repair fractured self-images, mental health providers can help clients reclaim a sense of self. These strategies empower individuals to confront and integrate their experiences, fostering greater emotional resilience. The journey is arduous, but with the right tools—such as EMDR, mindfulness practices, and compassionate self-inquiry—it can lead to healing and resilience.
Kouri, N., D'Andrea, W., Brown, A. D., & Siegle, G. J. (2023). Shame-Induced Dissociation: An Experimental Study of Experiential Avoidance. Psychological Trauma: Theory, Research, Practice, and Policy.
Cunningham, K. C. (2020). Shame and guilt in PTSD. In M. T. Tull & N. A. Kimbrel (Eds.), Emotion in Posttraumatic Stress Disorder: Etiology, Assessment, Neurobiology, and Treatment. Elsevier Academic Press.
Dorahy, M. J., McKendry, H., Scott, A., et al. (2017). Reactive dissociative experiences in response to acute increases in shame feelings. Behaviour Research and Therapy.
Caputo, G. B. (2010). Apparitional experiences of new faces and dissociation of self-identity during mirror gazing. Perceptual and Motor Skills.
Freysteinson, W. M., et al. (2018). Body image perceptions of women veterans with military sexual trauma. Issues in Mental Health Nursing.
