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Lewis, H.B. (1971). Shame and Guilt in Neurosis. Psychoanal. Rev., 58(3):419-438.

(1971). Psychoanalytic Review, 58(3):419-438

Shame and Guilt in Neurosis

Helen B. Lewis, Ph.D.

The role of the malfunctioning superego in the production of neurotic symptoms out of ordinary human misery has been frequently traced, especially since Freud's The Ego and the Id.6 Freud had traced the role of unconscious guilt in producing the disorders he called “moral masochism.” The role of shame in producing neurotic symptoms out of difficult life experiences has been less clearly traced. A search for an improved technique of dealing with neurotic patients has drawn me, in recent years, into a microanalysis of the functioning of the superego, and especially into a study of the phenomenology of states of shame and guilt, with particular attention to shame.

The phenomenological attitude toward shame and guilt itself proved to be useful therapeutically. In addition, it became apparent that unanalyzed shame in the patient-therapist relationship is a special contributor to the negative therapeutic reaction. Dissection of the psychological states of shame and guilt as they operate in waking life helped to clarify the still mysterious “primary process” by which strangulated affect finds compromise expression in neurotic symptoms. In this paper I can sketch only a few highlights from a recently completed book on shame and guilt in neurosis.14

Another influence propelling me into the microanalysis of shame and guilt has been my work with the construct of psychological differentiation in association with H. A. Witkin and others.18

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