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April 1, 1963. GUILT, SHAME, AND IDENTITY. Edith Jacobson, M.D.
Dr. Jacobson demonstrates that shame can be separated from guilt both clinically and theoretically. Shame arises in reaction to pregenital strivings, especially those that are anal and exhibitionistic. Failure of instinctual controls or physical defects (castration), when exposed, initiate feelings of shame which early become manifestations of an internalized conflict. In contrast, guilt conflicts seem to have a peculiar reference to hostility and harm to others, and to object relations in general. Guilt refers chiefly to verbal criticism (or failure to comply with verbal demands or prohibitions), whereas shame refers to visual exposure. Shame reactions are severely self-annihilating because of their broad basis and the archaic types of anxiety they induce. They may be displaced onto intellectual failures where, however, one can detect that the performance rather than the quality of the content leads to fear of exposure.
'Inferiority' conflicts arise as a reaction-formation to early narcissistic injuries and failures, not to specific instinctual strivings. Essentially, concern with the self distinguishes shame and 'inferiority' feelings from guilt conflicts. Because shame can be somewhat integrated into the complex response of the ego to the superego, shame reactions tend to range between the narcissistic