Self-alienation is an expression of deeply internalized shame. The self-alienated individual feels trapped, imprisoned by shame. Psychotherapy patients with significant relational trauma typically reveal a persistent internal battle against self-doubt, self-condemnation, and often self-loathing. They are referencing shameful fears and beliefs about themselves that are born from problematic attachment and developmental experiences. The author provides illustrations of work with self-alienated individuals integrating psychoanalytic principles with concepts from contemporary traumatology, with a focus on helping patients develop self-compassion as the chief agent of therapeutic healing and growth.