Clinical Round Table 3 - Beyond the Shadows: Addressing Shame in Anxiety, Obsessive-compulsive and Related Disorders

CBT models tend to focus on anxiety as the primary driver in anxiety, obsessive-compulsive, and related disorders. However, shame–a potent but frequently overlooked emotion–profoundly affects many individuals with these conditions. Shame can exacerbate symptoms, deter treatment-seeking and symptom disclosure, and contribute to adverse outcomes, including depression and diminished quality of life (Weingarden & Renshaw, 2015; Swee et al., 2021; Szentagotai-Tatar et al., 2020) This clinical round table brings together a diverse group of specialist clinicians and clinician-researchers to explore the complex, deleterious role of shame across various anxiety-related disorders, including social and performance anxieties (such as shy bladder syndrome), OCD, body dysmorphic disorder, trichotillomania, and excoriation disorder. The discussion will examine the manifestation and impact of shame in these disorders, highlighting both unique and common themes, and the complex interplay between shame and symptoms. Drawing on clinical observations and scholarship, panelists will consider possible psychological and social contributors to shame within these disorders, ranging from personal experiences and distorted self-perceptions to societal representations. Attention will also be given to how experiences of marginalization and discrimination (e.g., among trans individuals, people of color) may uniquely influence shame.
In line with this year’s conference theme of inspiring community engagement and advocacy, panelists will discuss how the CBT field can more effectively address shame, both at the individual therapy level and through broader societal advocacy and education efforts, aiming to reduce suffering and improve outcomes. Panelists bring diverse perspectives and extensive experience from clinical practice, research, and leadership in national organizations, contributing to a rich dialogue on conceptualizing and addressing shame within these conditions. This transdiagnostic conversation aims to deepen the understanding and enhance care for those affected by anxiety and obsessive-compulsive disorders, while aligning with ABCT’s goals of advocacy and overcoming barriers to treatment.