Shame in Context: Susan B. Miller. Hillsdale, NJ: The Analytic Press, 1996, 241 pp., $37.50

In this useful book, Susan Miller provides readers a thorough and thoughtful overview of theories of shame, weighing each against the others and laying out a panorama of the subject. But the value of her overview depends on definitions both of shame and of the context that she believes is necessary if the concept is to be at once more intelligible and more useful to clinicians. To say that shame should be placed in context raises a variety of questions about what kind of context Miller is searching for, and to what end.

What makes the phenomena of shame intelligible in clinical situations? Miller does not really address this question, and she is certainly not alone in struggling for an epistemological footing for the descriptions of the phenomena she seeks to explain (see Kilborne 1997). In her opening chapter, Miller notes that shame is difficult to define and that she wishes to consider it “as a dynamic element within the overall ecology of mental functioning” (p. 2).

It soon becomes clear that Miller, however carefully she has reviewed the literature, has her own theoretical positions to defend. “I would see aggression not as a primary, discrete impulse,” she writes, “but as a derivative of the inclination to use an array of more circumscribed motor, communicative and other endowments, both for the pleasure in their employ and to engage and influence the environment.” Despite the woolly use of language, one suspects that she is coming down on the side of defect rather than drive, suggesting a self psychological orientation. And indeed at the end of the opening chapter, “Foundations,” she summarizes what she refers to as the main arguments of the chapter: that shame represents “the combined influence of inherited structures and human category formation” (what emotion does not?); that the earliest shame experiences require “a sense of the self as agent … but not descriptive concepts of the self …