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In this concise volume, Herbert Thomas opens to us a very important moment in the dynamic of shame: the shame response. According to Thomas, the shame response is a physiological response to rejection of oneself by another. This can be reflected in intense physical pain or by a barely noticeable response. Behind the shame response is a hurt causing great pain. While this hurt can cause anger which may be directed outward against another or inward against oneself, the aggression or depression should not be misunderstood as the problem. Instead, it is important to enter into the moment of the shame response in order to seek to resolve the hurt behind the anger or depression. The intensity of the shame response is related to the significance of the other who rejects or by the significance of the witnes to the rejection, as well as to vulnerability of the one rejected, whether the rejection is of the total self or of an aspect of the self. Whether or not the rejection comes as a surprise is also a factor. In its most intense and painful forms, the shame response may include a tightness of the throat, nausea, stomach pain, and a sense in one's chest and abdomen of collapsing, exploding or imploding. Thomas also examines the relationship of violence to the shame response, when the experience of rejection is so painful that violence is the reaction.
Among many valuable insights, Thomas's book allows us to see the profound meaning of the shame response, how difficult it can be to detect, and how necessary it is for one to return to this shame response in order to really be able to deal with the hurt. To react to the anger or to simply try to reassure the patient that there is no need to be upset fails to address the deepest core of the problem and to touch into the profound hurt.
In numerous clinical vignettes, Thomas illustrates how this takes place. In one account, he tells about an inmate who begins to serve tea in the cafeteria of a prison which is against the policies an