musingsonwomenshealth.com

Reflections on 40 years as a doctor in Women's Health

Shame, shame, shame!


“You should be ashamed of yourself, G!” That was what Geoffrey said to me with a twinkle in his eye. We were having coffee in the Food Court at the mall that morning, and I had grabbed more packages of sweetener than I needed. Well, I do actually need them at home, but I suppose I was rather obvious in stuffing the extras in my pocket. He was smiling when he said it, but he doesn’t usually notice the number of sweeteners I take. It caught me off guard, and for some reason, I actually felt embarrassed; I think that was when I started wondering about shame.

I have to say, his accusation really bothered me for some reason. It wasn’t so much his reason for the shaming, as the shame he invoked. Once the allegation had been levelled, the contents of Pandora’s box (or whatever container Hesiod originally described in Greek mythology) were liberated and I wondered if it referred to something terrible about me as a person.

I mean, I know that shame is often defined as something like ‘a painful feeling of humiliation or distress caused by the consciousness of wrong or foolish behaviour’ and yet its effect seemed even more personal than that: as something that suddenly reversed my sense of being an agent who was acting on the world, to feeling that the world was acting on me. I had become an object for others, not the other way around. In a very interesting way, it was both revealing, and at the same time, disempowering; I was somehow being opened up and dissected like the cadaver I remember from medical school.

I had something of an epiphany in that ‘Geoffrey moment’: although appropriately targeted shame can serve a useful purpose, enabling as it might the regulation of our behaviour and coaxing us to fit into acceptable social norms, in the process, shame can also make us uncomfortably aware that we have become an object for others -a target. I began to see just how damaging shame could be for others who perhaps deserved it even less than me. I had always had a strong sense of who I was -of control, perhaps- but suppose I hadn’t? Suppose I had been subjected to unfair objectivization for most of my life; what would additional shame then contribute to my ability to thrive in such a society? My thoughts turned quite naturally to the commodification of women I had noticed throughout my career.

I had only recently retired after over forty years of practicing as a medical specialist -a male obstetrician/gynaecologist, in fact. It was soon after I started my practice in what, at the time, was a male-dominated specialty, that I began to appreciate the fundamental inequities in how the two sexes were treated -to say nothing of how the LGBTQ communities were regarded. I remembered something the American philosopher Sandra Lee Bartky wrote in her book Femininity and Domination that a patient had given me sometime in the 90ies. Even though I only skimmed through it, there were a few things I found quite profound; I believe I even jotted down some particularly salient quotes from it, but was only reminded of them in a more contemporary article[i] on shaming. Shame, the essay contended ‘unlike guilt – which is related to actions – is called forth by the apprehension of some serious flaw in the self’. Shame, Bartky wrote, requires ‘the recognition that I am, in some important sense, as I am seen to be’.

So, in a far less important context, what was I seen to be by Geoffrey? Should I have been diminished by his observation? Should I have simply laughed it off and accused him something equally nefarious? Or, as was obviously the case, should I proceed to examine it further?

Empathy is something that most of us hope we have, and yet empathy can be incredibly difficult for someone not equally affected by the problem either to be seen as understanding, or even capable of understanding the effects on those who have to endure them. The years have tugged on my allegiances, I suppose, and the view is much easier now that most of my branches are bare of leaves. That is not to say, of course, that I have abandoned the forest, but merely that as a retiree, I am a member of none of the socially valued teams nowadays. And yet, some of the old biases likely still hang from my twigs, although they no longer have the power, nor even the justification, they once had. Age has a habit of blurring differences, disguising values.

For example, I can more easily see that ‘Shame has long been an instrument of oppression, a way of regulating and policing the behaviour of women, [and] of queer people… Shame is individuating; it makes us feel ourselves as ourselves, in our painful individuality. In all its unpleasantness, shame is ‘nothing less than the fundamental sentiment of being a subject’… We experience ourselves as individuals at least partly thanks to the workings of shame – which means that shame is therefore developmentally necessary to the workings of society.’[ii] So, out of this, I gather that shame is both a gift, and a burden.

But, although shame may allow you access to your self, does it only work if it is shared with others? Only work if others are also aware that you feel shame, in other words? I’ve wondered about that as well.

I have to admit that I felt uncomfortably pulled into the shell I sometimes wear -even at Geoffrey’s (hopefully) innocent jibe- but should there have been another reaction? Should I have attempted to extract consequences through some sort of disabling rejoinder? Would that have made his remark less painful for me, or only goaded him to extend the scope of his criticism? What if we’d been strangers? What if I’d been a woman sitting at the next table…?

I realize that I shouldn’t extrapolate too extensively here -I don’t mean to trivialize the issue of shaming, and I certainly don’t want to re-erect a gendered barrier; I just want to know how it should be dealt with, however trivial. However monumental.

Is ignoring the shamer a good idea? Is confronting them a better choice? Even though Bartky suggested it, in shame am I really who I am seen to be? Have I been appropriately depicted by the perpetrator, or is there an I peeking out from behind the curtain who still has a sense of their correct identity? An I who is still in touch with their own ‘still small voice’?

That’s important, don’t you think?

[i] https://aeon.co/essays/shame-heaps-upon-shame-in-womens-memoirs-of-suffering

[ii] Ibid

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