Shame is discussed and contrasted with guilt. Guilt involves internalized fear of another object and the agency of the superego. Shame involves the self, as in "I am ashamed of myself." Shame thus involves both a condemnation of the self and a heightened awareness of the self. In a vignette provided, when the patient felt herself to be merging with others, she longed for someone to rescue her and at the same time felt intensely ashamed The feeling of shame heightened the awareness of herself and thus helped her defend against, or be rescued from, the feeling of merging. Shame is associated with being looked at, and with sexuality, especially during infancy and adolescence. Rage and guilt are frequent defenses against shame. If with narcissistic patients one focuses on this guilt and rage instead of on the underlying shame, a therapeutic stalemate may ensue.