Primitive shame experiences may occur in the first one and a half years of life before objective self-consciousness is acquired. They occur in the context of interest, joy or excitement when inefficacy experiences or unexpected events result in a sudden attenuation of such positive affects. Shame seems always to involve an element of cognitive shock—a discrepancy between expectation and actuality. The link between shame and the instinctual drives is not as simple as many assume, and the view of shame as a reaction formation is rejected.

Shame experiences disrupt the silent automatic functioning of the sense of self, and shame is therefore considered to be the basic form of unpleasure in disturbances of narcissism. The grandiose self is viewed as an evolving compensatory formation instigated in large part by primitive shame experiences.