Shame plays role in health

Wales On Sunday - - NEWS -

DOC­TORS could im­prove pa­tients’ health if they were more aware of the se­ri­ous im­pact shame has on the body, re­search sug­gests.

Stud­ies have shown that peo­ple feel­ing shame avoid seek­ing med­i­cal treat­ment or telling doc­tors the truth about symp­toms.

Chronic shame is as­so­ci­ated with weight gain, heart dis­ease, hard­en­ing of the ar­ter­ies, and de­creased im­mune func­tion.

In a new study ex­perts at the Univer­sity of Ex­eter have recommended doc­tors should be trained to be­come aware of the shame felt by a pa­tient.

The use of sham­ing and stigma to tackle obe­sity or ad­dic­tion in health cam­paigns can also make peo­ple’s health worse rather than en­cour­ag­ing them to live a bet­ter lifestyle, the ex­perts warn.

Dr Luna Dolezal, who led the study, said: “Shame’s in­flu­ence is per­va­sive and per­ni­cious.

“It is im­per­a­tive that [shame’s] vi­tal role in health, health-re­lated be­hav­iours and ill­ness be recog­nised and as­sim­i­lated into med­i­cal, so­cial and po­lit­i­cal con­scious­ness and prac­tice.

“When in­di­vid­u­als feel the threat of shame this can lead to fail­ure to seek treat­ment.

“Fail­ure to dis­close the full de­tails of one’s men­tal or phys­i­cal ill-health, one’s sit­u­a­tion or iden­tity ... may re­sult in in­ad­e­quate or in­ef­fec­tive treat­ment be­ing pre­scribed.

“They may fail to com­plete treat­ment and con­ceal a di­ag­no­sis from their fam­ily and friends.

“The use of stigma and shame in pub­lic health cam­paigns ... for ex­am­ple, when con­sid­er­ing con­di­tions such as obe­sity, sex­ual health and ad­dic­tion, where in­di­vid­u­als are seen to be mak­ing ‘choices’ that af­fect their health, should be care­fully re­con­sid­ered.

“Ex­ac­er­bat­ing shame for pop­u­la­tions that are likely to be deal­ing with chronic shame and marginal­i­sa­tion may lead to a wors­en­ing of over­all neg­a­tive health out­comes.”

Sci­en­tists have shown that shame puts a phys­i­o­log­i­cal strain on the body and its sys­tems be­cause of chron­i­cally el­e­vated hor­mone lev­els.

Shame has also been as­so­ci­ated with al­co­holism, ad­dic­tion and eat­ing dis­or­ders, where peo­ple are try­ing to “numb” them­selves from neg­a­tive feel­ings.

Pa­tients can feel shame be­cause of their poverty, race or gen­der, or be­cause they feel phys­i­cally or so­cially in­ad­e­quate.

They can also feel shame be­cause of age­ing, dis­fig­ure­ment, in­fec­tious dis­eases, men­tal health issues, obe­sity or in­con­ti­nence.

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