Bruce Alan Kehr, M.D. is the Founder and President of Potomac Psychiatry, ranked “Best Psychiatry Care Provider in Maryland” in 2020 by Global Health & Pharma. He has been named a Washingtonian Magazine “Top Doctor” for each of the past eight years. Dr. Kehr is a best-selling author whose works have been read by over 800,000 people in 206 countries. In 2020, Dr. Bruce Kehr’s blog was ranked #2 in the nation among mental health-related blogs. Dr. Kehr’s book, Becoming Whole: A Healing Companion to Ease Emotional Pain and Find Self-Love, is an Amazon Best Seller in the self-help categories: Happiness, Counseling, Healing, and Self-Esteem.
Whatever happened to the protective virtues of self-control and self-restraint? What became of the capacity to feel shame, as a way of helping to govern one’s public behavior? Where is the empathy and compassion toward others, even when we disagree with them? If anything, unfettered egotism may be worse than ever, as around us we observe progressive political polarization. In “Empathize with Your Political Foe,” Arthur Brooks wonders “So what can we do to make compassion and empathy less rare and random in America today?” He calls for a national movement of American renewal to counter the toxic anonymity of social media; by putting an end to what is known as “othering,” the perception that we are good and virtuous, while they are inhuman and evil. This “othering” feeds the shameful behaviors of hatred and bigotry, thereby deepening societally induced humiliation. Rather than “othering” others, what about a willingness to learn about them as people, to discover what is truly in their hearts?
I was out to dinner with an old friend of mine the other night that I had not caught up with in years. As we filled each other in on the details of our lives, he asked me a thoughtful question: As a psychiatrist who has been in practice for almost four decades—who has worked with literally thousands of patients, some over the course of years of psychotherapy—what keeps me passionate? How is it that I haven’t grown cynical about my career or burned out by the human condition? It’s a fair question. There is nothing I love more than learning about the human heart and brain, and helping someone recover, and find happiness at work and in love—but often, when passions become crossed with careers, people can come to resent the very thing they once treasured. And yet, I had an answer for him right away. It’s simple: So much has happened over the course of my career that has transformed our culture and influenced my patients—some for good and some for ill. Some of what they care about has changed. But human nature remains a constant, regardless of societal shifts or accelerating technologic innovations that impact our lives moment-to-moment. Our need for love, self-respect, dignity, passion, meaning and purpose is timeless. Emotions are felt as deeply as ever—and some emotional scars may never go away. Nowhere is this more true than with public shaming (one form of “othering”), which brings about humiliation and trauma. With the internet at our fingertips, always offering a veil of anonymity and disconnection from consequence, it has become easier than ever to hurt people in the public eye—to publicly shame them—and that humiliation hurts deeply. Perhaps it is the most painful of all emotions. While the moral arc of our society may indeed attempt to bend toward justice, public shaming on social media may be at an all-time high. And trauma from both physical and emotional abuse, past or present, remains one of the most predominating issues in many of my patients. In this new year, in the wake of movements like #MeToo—where we are seeing both trauma and humiliation play out in a very public sphere—I’d like to share with you my three-part blog series on Trauma, Humiliation, and PTSD.
Humiliation is a “public emotion” in that it involves a belief that others will view us as diminished, and will likely mock us. When we are humiliated, particularly by someone that we love, or in the course of a major career or business setback, it can engender deep feelings of disappointment, hurt, anger, and even rageful or suicidal behavior. If the humiliation occurs at a time when one is also feeling generally despondent about their life, the predisposition to depression, anger and rage is even greater.
Humiliation may create a higher risk of suicide[v], which we witnessed during The Great Recession. When previously employed men and women suffered the humiliation of losing their jobs, incomes, and much of their assets, they would commit suicide at higher rates.[vi] [vii] [viii]
Humiliation increases one’s emotional vulnerability, and reduces “emotional reserve,” which may lead to a downward spiral of hopelessness and a feeling that “there is no way out,” and wanting to disappear from view forever. Suffering deep humiliation, in the absence of sufficient resilience and social support, can increase impulses to kill oneself.[ix] [x]
Have you been knocked down many times in your life, and have you endured many painful and cutting blows that leave you filled with despair, fury and degradation? Have some of the cuts and blows been delivered as others were watching? Has it left you feeling humiliated? Who hasn’t had this experience in their life? How deeply rooted is it in your emotional makeup, and how is it affecting your current relationships with others and yourself? What are the various causes that lead to struggling with deep feelings of humiliation? Why is this dynamic important to recognize, prevent, and treat?
To begin to understand the root causes of humiliation in an effort to help you untangle your life, we will begin with childhood experiences. Broadly speaking there are two types of stress that predispose to depression and anxiety – learned helplessness and social defeat stress. Learned helplessness is where one repeatedly experiences emotionally painful events that one is unable to predict or halt, and social defeat stress is where one is repeatedly dominated or bullied in one or more important relationships. If you stop and think about it, each of these types of stress bring about feelings of humiliation, and may characterize some of our important childhood relations. Let’s go over some examples.
Many of the anger management and depression challenges presented by my adult clients are rooted in persisting childhood experiences of humiliation by one or more parents, or by friends or teachers. As a humiliated child they felt “even smaller,” and at times the feeling of humiliation was so intense that they would feel like disappearing altogether, just to escape the emotional pain. A berating or overly critical parent; the persisting educational challenges posed by Attention Deficit Disorder, or other disabilities; a loss of socioeconomic status; a parent suffering from mental illness, alcohol or drug abuse; poor athletic ability; racial or sexual orientation discrimination; delayed physical maturation; or an older sibling with far greater talent can all contribute to childhood feelings of humiliation, and a persisting vulnerability into adulthood.
From the standpoint of preventing these long term effects, praising a child when they behave in a way that makes them and you feel proud, helping a child gain confidence and mastery in their life by supporting activities about which they feel passionate, and helping them over life’s hurdles (without stepping in to take care of the problem, unless absolutely necessary) can assist a child in building healthy self-esteem that provides greater resistance to feeling humiliated. There is no absolute means of prevention, as the experience of humiliation is inevitable; but providing empathic parental support goes a long way toward restoring positive self-esteem.
Treatment involves uncovering and exploring the childhood experiences of humiliation
Treatment involves uncovering and exploring the childhood experiences of humiliation, and all of the attendant feelings that once came along with these events, as well as developing a new perspective on them, in the context of an empathic and supportive therapeutic relationship.
At times, medication can be helpful in treating an underlying mood or anxiety disorder that has increased one’s vulnerability to further humiliation. For those who feel depressed, have withdrawn from friends and family, feel anxious or have panic attacks, and find that their brain just isn’t working the way that it used to, these symptoms in and of themselves can make one feel humiliated, and alleviating them with medication can really help.
Sometimes during talk therapy “the cure can feel worse than the disease.” But through a diligent and persistent untangling of the sources of humiliation, the client can learn to understand the origins of their vulnerability, how they repeatedly play out its effects, or even unconsciously bring it about in present day life, and then learn to leave it behind and move on to a healthier, more positive and resilient way of living.
* This is the first of three installments on Humiliation. Next week we will explore the story of a 50 year old man, “Ken,” who came to see me because he was suffering from anxiety, panic attacks, and depression related to deeply humiliating childhood traumas.
If you would like to read more about trauma, humiliation, and PTSD, I encourage you to check out my book, Becoming Whole: A Healing Companion to Ease Emotional Pain and Find Self-Love; and Session 4: Help Your Child Following an Emotionally Disturbing Experience, or Session 10: Trauma and Intimate Relationships, or Session 11: Transcending Sexual Abuse.