Shame, a major yet neglected regulatory affect, is the emotion signalling threat to significant social bonding. Shame is often hidden or veiled by depression, guilt, anger or nonspecific psychic pain. Suicidal persons become flooded with shame if optimal distance to supportive persons is not maintained and the patient feels overregulated, abandoned or exposed as incapable of sustaining meaningful attachments. Details of the patient's sense of shame and protective manoeuvres to avoid shame should be sought in the patient's early familial background. Shame dynamics in current familial functioning or dysfunction should be clarified for effective clinical intervention. Illustrative cases are presented.