Patti Ashley – PESI – Toxic Shame in Clinical Practice: Help Clients Release Shame, Get Unstuck and Improve Treatment Outcomes

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Patti Ashley – PESI – Toxic Shame in Clinical Practice: Help Clients Release Shame, Get Unstuck and Improve Treatment Outcomes

Clinicians often report feeling “stuck” and unsure of the reasons why clinical strategies aren’t working. In this recording shame expert, Patti Ashley, Ph.D., LPC, will help enhance your clinical skills using neurobiological-informed and relational-informed strategies for identifying and treating toxic shame.

Toxic shame is like an infectious disease that lies untreated due to symptoms being difficult to recognize or misdiagnosed. Learning how to recognize and treat toxic shame requires you to be vulnerable and courageous in the therapy session.

Recognizing the signs of toxic shame in the assessment and treatment process can be difficult. Here are some examples of client behaviors to watch for that could indicate shame:

• Frequently cancels sessions
• Terminates treatment early
• Deflects and projects onto others
• Narcissistic self-inflation
• Perfectionism
• Minimization
• Anger, rage and contempt
• and more

This recording will take you back to the origins of shame and help you identify the non-verbal unspoken and unseen aspects in clinical work. Understanding how shame can undermine the therapeutic alliance and using somatic strategies to deepen an authentic relationship with the client are the keys to working with toxic shame in clinical practice.

Dr. Ashley has heard other clinicians who have taken this workshop say they experienced a “sigh of relief.” This is a recording you don’t want to miss!

Speaker
Patti Ashley, PhD, LPC, is a psychotherapist, international speaker and best-selling author of Shame-Informed Therapy: Treatment Strategies to Overcome Core Shame and Reconstruct the Authentic Self (PESI Publishing, 2020).

With over 20 years of experience as a licensed counselor, Dr. Ashley brings unique insights into the identification and treatment of trauma, shame, grief and dysfunctional family patterns. She has counseled individuals, couples, families and groups in mental health agencies, psychiatric hospitals, and practice settings. She currently maintains a practice in Colorado where her Authenticity Architecture model helps clients break through unconscious barriers and rediscover a sense of self-love, belong, and connection.

In addition to her book for psychotherapists, Dr. Ashley is the author of Living in the Shadow of the Too-Good Mother Archetype (Wyatt-MacKenzie Publishing, 2014) and Letters to Freedom (Wyatt-MacKenzie Publishing, 2019). In addition to her clinical work, Dr. Ashley develops and teaches continuing education courses for psychotherapists, physicians, hospital wellness programs, universities, and several organizations.

Speaker Disclosures:
Financial: Dr. Patti Ashley has an employment relationship with Authenticity Architects. She receives royalties as a published author. Dr. Ashley receives a speaking honorarium, recording, and book royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Patti Ashley has no relevant non-financial relationships.

Objectives

1. Summarize the nature of toxic shame as it relates to the therapeutic process.
2. Identify how the different attachment styles play a role in how client’s shame is formed.
3. Discover how toxic shame develops as a core identity and how it can be a roadblock in clinical treatment.
4. Correlate how toxic shame and trauma function similarly to the nervous system and how that relates to clinical treatment.
5. Utilize clinical strategies to help heal shame and get clients unstuck in the therapeutic process.
6. Develop skills to help clients regulate shame triggers both in-session and everyday living.

Outline

PART ONE: HOW SHAME SHOWS UP IN TREATMENT
Toxic Shame

• Research & DefinitionsRuptures in interpersonal relationships create a shame-based identity
• Shame and trauma function similarly in the nervous system
• Subconscious shame effects of poisonous parenting
• Attachment theories as they relate to shame
• D.W. Winnicott’s true self/false self
• Shame in family, culture and other systems
• Limitations of the research

Signs of Toxic Shame:
What to Watch for in Assessment and Beyond

• Individual Therapy – the client who:
  Talks the whole session
  Frequently cancels sessions
  Feels bad when progress seems to have eluded
  Terminates treatment early
  Deflects and projects onto others
  Relapses and does not return
  Minimizes problems
  Excessively intellectualizes and analyzes treatment
• Couples/Family Therapy
  The attack/defend patter
  Anger, rage and contempt
  Judgment of self and others
  Grandiosity, narcissism and self-inflation
  People pleasing and codependency
  Avoidance
  Problems with intimacy
• Group Therapy:
  Cross-talk
  Intellectualizing
  Silence
  Judgment
  Conflict

When the Therapist is Part of the Problem
Rigid Treatment Models May Increase Shame and Decrease Positive Outcomes

• Shame can be activated when therapist appears to be the “expert”
• Some strategies hinder treatment outcomes
• Strategies that may create barriers to creativity and relational presence
• Impact of mirror neurons and epigenetics
• How naming “shame” can be shaming
• Unconsciously enacting shaming parent
• Treating client as appointment or diagnosis
• What to do when your shame is triggered in-session

PART TWO: TREATING THE TOXIC SHAME
Effectively Treat Toxic Shame
Implications for Treatment to Move Forward with Clients

Right and left brain integration

• Bottom-up versus top-down treatment approaches
• Modeling, engaging and sustaining self-compassion
• Repair the interpersonal bridge to self and others
• Courage and vulnerability in right-brain regulation
• Sustaining empathy in parallel process
• Transference and counter-transference in treatment

Therapeutic Strategies:
Putting It All to Practice

• Build a Safe Therapeutic Holding Environment
  Establish safety and trust
  Set a stage for treatment
  Strong foundation for therapeutic work
• Build a Solid Relationship
  Therapeutic empathy as the antidote for shame
  Connect and establish equal power
  Mindfulness and compassion
• Bridge the Head and Heart
  Psycho-education to demystify shame
  ”I” statements to identify shame-based feelings
  Going beyond cognitive therapy models
• Witness and guide clients through deeper layers
  Return shame to its origin
  Somatic strategies
  Re-wiring new neural pathways
• Experiential Tools and Techniques
  Creative arts, writing and movement activities
  Mindfulness and meditation
  Archetypes, story-telling and mythology
  Music and sound healing
  Journaling and letter-writing
• Working with Secrets
  Patience and compassion
  Deeper shame
  Tolerance and non-judgmental witnessing
• Creativity
  Every client is unique
  How therapy is like art
  Goodness of fit
• Research limitations and potential treatment risks

Target Audience

• Counselors
• Social Workers
• Psychologists
• Case Managers
• Marriage & Family Therapists
• Other Mental Health Professionals
• Chaplains/Clergy

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