The shame response is a primitive physiological response to a rejection of oneself by another. The discomfort of this response may vary from intense physical pain to one that is barely noticeable, if at all. When this pain is sufficient, it causes anger that may be directed outward against another or inward against oneself. The intensity of the shame response, hence the intensity of the pain and anger, is related to the significance of the other, the significance of witnesses to the rejection, one s vulnerability, whether or not the rejection is of oneself or an aspect of oneself, and if the rejection comes as a surprise. When most intense (i.e. most painful), the shame response may include a tightness of the throat, nausea, stomach pain, and a sense that the contents of one s chest and abdomen are collapsing, exploding, or imploding. In reviewing what preceded an act of violence, it is necessary to determine whether the assailant had experienced a shame response and how intense it was. Understanding that a shame response can lead to anger and violence allows for the prevention of violence. This requires that individuals do not experience rejections that are so painful as to lead to violence.
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Herbert E. Thomas, M.D. is a psychiatrist / psychoanalyst practicing in New York City. Born in Quebec City, Canada, he is a graduate of The Royal Canadian Naval College, McGill University and Queen s University School of Medicine. He interned at The Henry Ford Hospital in Detroit, Michigan and did his psychiatric residency at The University of Michigan Medical Center in Ann Arbor, Michigan. He moved to Pittsburgh in 1961 with a joint appointment in the Department of Psychiatry of the School of Medicine and the School of Law at The University of Pittsburgh. He graduated from the Pittsburgh Psychoanalytic Institute in 1974. Dr. Thomas consulted for 30 years in the maximum security prison in Pittsburgh while practicing in New York City. He developed his theory of the shame response during these years working in the prison system. He was, until 1999, a Clinical Professor of Psychiatry of the School of Medicine at the University of Pittsburgh and until 1993 was an Adjunct Professor of Psychiatry and Law, School of Law at the University of Pittsburgh. Dr. Thomas was a founding member and past president of the American Academy of Psychiatry and the Law. He is a Fellow of the American Psychiatric Association and a member of the American Psychoanalytic Association. Dr. Thomas currently practices in New York City. He was also the psychiatric consultant for the Youth Development Center in New Castle, Pennsylvania and has worked in programs for chemical dependency at St. Francis Medical Center, Pittsburgh. He is a member of the Board of Fellows of the National Center for Juvenile Justice, Pittsburgh.
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