Overcoming Shame while Seeking Mental Health Support
Shame can affect your confidence, relationships and willingness to seek mental health support. It often creates feelings of inadequacy, self-criticism and a desire to hide your struggles. You may believe you should cope alone or worry that others will judge you for needing help. You don’t need to eliminate shame before seeking support – but you can learn practical skills to reduce its influence and take steps towards improving your wellbeing.
Understanding Shame and the Shame Cycle
Shame is the painful feeling that something is wrong with who you are. Unlike guilt, which says, “I did something bad,” shame says, “I am bad.” Shame often follows a repeating cycle:
Trigger → Harsh self-judgment → Withdrawal → Increased shame
For example, you experience anxiety and think, “I should be able to cope.” You avoid telling anyone because you fear being judged. This isolation reinforces the belief that something is wrong with you. Recognising this cycle helps you interrupt it before shame leads to further withdrawal.
CBT: Challenging Shame-Based Thoughts
What it is:
Cognitive Behavioural Therapy (CBT) helps you identify and question harsh beliefs about yourself. Rather than accepting negative thoughts as facts, you learn to develop more balanced and realistic perspectives.
Why it helps:
Shame often involves distorted thinking, such as assuming others will judge you or believing that needing support means you are weak. Challenging these assumptions reduces self-criticism and makes seeking help feel more manageable.
Example:
Sarah feels ashamed about her anxiety and thinks, “Seeing a psychologist means I’m a failure.”
She asks herself:
What evidence supports this belief?
Would I judge a friend for seeking help?
Is there a more balanced explanation?
She develops a more realistic thought: “Seeking professional support is a responsible way to look after my health.”
Try it: Write down one shame-based thought and identify a more balanced alternative.
ACT: Cognitive Defusion and Values-Based Action
What it is:
Acceptance and Commitment Therapy (ACT) helps you step back from painful thoughts and take actions guided by your values, even when difficult emotions are present.
Cognitive defusion involves noticing thoughts without treating them as facts or instructions.
Why it helps:
Shame-based thoughts can feel convincing and prevent you from seeking support. Defusion creates space between the thought and your behaviour, allowing you to make choices based on what matters rather than what shame tells you.
Example:
James feels embarrassed about discussing his depression. He notices the thought, “I’m weak for needing help.”
Instead of arguing with it, he says, “I’m having the thought that I’m weak.”
He reminds himself that his health matters and books a counselling appointment, even though shame is still present.
Try it: Notice a difficult thought, add “I’m having the thought that…” and choose one small action that supports your wellbeing.
DBT: Check the Facts and Opposite Action
What it is:
Dialectical Behaviour Therapy (DBT) teaches skills for managing strong emotions without acting in ways that make situations worse.
Check the Facts helps you distinguish what happened from your interpretation. Opposite Action involves acting against an emotional urge when the emotion or its intensity does not fit the facts.
Why it helps:
Shame often encourages hiding, silence and avoidance. Checking the facts helps determine whether shame is justified, while opposite action can reduce unnecessary withdrawal.
Example:
Emma feels ashamed about struggling with her mental health. Her urge is to isolate herself.
She checks the facts:
Fact: “I’m experiencing mental health difficulties.”
Interpretation: “People will think I’m weak.”
Balanced perspective: “Struggling doesn’t make me weak or undeserving of support.”
Rather than withdrawing, Emma contacts a trusted friend and asks for help finding a psychologist.
Try it: Identify one shame-driven urge and choose a small, safe action that moves you towards connection.
Self-Compassion: Softening the Inner Critic
What it is:
Self-compassion means responding to your difficulties with understanding rather than harsh self-judgment.
Why it helps:
Shame encourages self-attack. Self-compassion acknowledges emotional pain without turning it into a negative judgment about your worth.
Example:
Instead of saying, “I should be coping better,” you might say, “I’m having a difficult time, and it’s okay to need support.”
Putting It All Together: A Practical Scenario
You want to seek mental health treatment but feel ashamed.
CBT: “Needing help doesn’t mean I’ve failed.”
ACT Defusion: “I’m having the thought that others will judge me.”
ACT Values: “Looking after my health matters.”
DBT Check the Facts: “Experiencing distress doesn’t make me unworthy of support.”
DBT Opposite Action: Contact a psychologist rather than avoiding the appointment.
Self-Compassion: “I deserve kindness and support while I’m struggling.”
Key reminders:
Shame may not disappear immediately. Each time you question self-critical thoughts, respond with compassion or take a small step towards support, you begin to weaken its influence. You don’t need to overcome shame before asking for help. Seeking help can be part of overcoming shame.
