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The development of a theory

Several decades ago I began to think aboutshame, and anxiety. I began to explore theirmy patients and in my articles and booksnotice that whenever someone feels one 0:underlying feelings of helplessness and dif(Breggm, 1991). Guilt, shame, and anxieabout how we want to carryon with our,ing lights to cease and desist assertive behavanyone of these emotions can become paraus unable to manage ordinary life challenwhelming depression, shame can make us "\II

into psychosis, and anxiety can keep us irruAfter the breakthrough in discovering t

always associated with our negative emoticthe differences in how these emotions assigfeeling guilt, we typically blame ourselves 2.

Unfortunately, positive psychology large!tional impediments that interfere with selfSeligman, 1995). Meanwhile, important socemotions have not sufficiently influenced clScheff & Retzinger, 1991). Because they igrsuperficiality reigns in many contemporary IA scientifically valid model for understan

emotions, although rooted in part in biologyjustify psychiatric diagnoses such as found irelation's (2013) Diagnostic and Statistical M,categories for human suffering lack a genuiimpose a 'medical model' that does more haluseful model should recognize that our emotties are partly given to us by genetics and biobut that mind, spirit, and choice can triurnan ideal of emotional freedom.Human emotional suffering is universal.

every individual. Although in part rootedbiology and genetics, there is nothing 'metional suffering, even when it is self-destrof suffering and despite inevitable variabilitessentially the same conflicts and emotionalfeting usually depends upon the severity ofand neglect in childhood, as well as mist(Breggin, 2014).

68

Although Pies claims the biochemical imbalance theory was never 'seriouslypropounded by well-informed psychiatrists', nearly all psychiatrists are stilltelling this lie to patients to push them into taking psychiatric drugs. He isright, however, in his implication that the theory is fakery driven by drugcompany money.Non-medical frameworks, such as positive psychology, emphasize liv­

ing by better principles and attitudes, and this can be very valuable.

And, yes - the 'chemical imbalance' image has been vigorously pro­moted by some pharmaceutical companies, often to the detriment of ourpatients' understanding. In truth, the 'chemical imbalance' notion wasalways a kind of urban legend - never a theory seriously propounded bywell-informed psychiatrists. (p. 1)

I have spent more than half a century as a psychiatrist and psychotherapisttrying to understand human suffering. Why does every single one of us comeout of childhood suffering from guilt and shame? Where does anxiety fit in?How much influence does bad parenting have in causing these emotions?How can we limit their painful impact on ourselves, our children, and thosewe seek to help?In recent years, too little attention has been given to these critical issues

about human suffering and psychology. The dominant medical model com­pletely ignores underlying psychological or emotional issues and leapsto irrational, unproven, and unfounded conclusions about biological andgenetic causes (Breggin, 1991, 2008; Moncrieff, 2008; Lacasse& Leo, 2012).Ronald Pies (2011), Professor of Psychiatry and Editor-in-Chief Emeritus

of Psychiatric Times, recently ridiculed the biochemical imbalance theory:

Peter R. Breggin

5Understanding and OvercomingGuilt, Shame, and Anxiety: Based onthe Theory of Negative LegacyEmotions

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8

Guilt, shame, and anxiety are naturalour enormously conflicting tendenciesin our closest relationships. These inhunleashing of wilfulness and aggressioibands and wives, friends, and perhapsclan. Natural selection favoured humwilfulness and violence against stranger.ing built-in inhibitions against expresemotions in close relationships (Breggin,shame, and anxiety in close family relsurvival and the capacity to reproduc

The birth of a new theory

Over the past few years, I have been dismayed by the junk science being pub­lished in the name of evolutionary biology and neuroscience. Neurosciencein particular has been making outlandish claims for understanding the con­nection between brain and behaviour. Funded largely by the pharmaceuticalindustry, researchers were making absurd claims about connecting aberrantbrain functions to 'mental illness'. The drug companies aimed at encourag­ing people to view their brains as their problem so they would more readilyaccept drugs as their solution (Breggin, 1991, 2013a). I was in the processof writing a book about 'neuromania' when I discovered that many otherswere already soundly dismissing the false application of biological sciencesto human conduct (e.g., Legrenzi & Umilta, 2011; Tallis, 2011). Ironicallyand unexpectedly, thinking about the limitations of evolutionary biologyand neuroscience was leading me to ponder how these sciences, if con­ducted properly, might contribute to our understanding ourselves as humanbeings.Whilst considering the spectrum of human behavior and emotions, rang­

ing from extremes of tenderness and compassion through to torment andviolence, I was surprised to find that even the most seemingly shy and'harmless' people often harboured the deepest resentments and violent feel­ings. Biological evolution and human history, as well as contemporary times,

From an unexpected direction

confirm that human beings are and haxtures on Earth and yet the most social axthat several hundred thousands of year:butchering animals larger than moder:more than pointed sticks as weaponsPrehistoric Elephant Slaughtered by Eet al., 2009). Bringing down these hu,spears must have required enormous Jsocial cooperation. I came to describe 1wilfulness and violence versus empathjOur nearest relative, the chimpanzee

tively peaceful, never making war on i'truth came out - even chimps at tinencounters (Goodall, 1999; de Waal, 2of all other creatures in having this uni.life and propensity for violence. Thesesocialization and wilful aggression are IEarth not only in the political arena btand in the raising of our children.Given that violence is so deeply em

seemed inevitable that people would lxand at risk of hurting not only strangerin close proximity. The survival of huntional responses that would help us to rin close personal relationships, especialence most dangerous in close personaprovoked by the inevitable conflicts amrelationships. I began to ask, 'How didmanage to survive without destroyingevolutionary line to an inglorious viole

When feeling shame, we feel that others are doing something to us, and wetend to shift our blame and anger outward.Anxiety was more difficult to understand until I realized that anxiety tends

to obliterate blaming and to disperse anger. In an anxious state, we may feelincompetent and we may blame 'life' for our feelings of helplessness; but ourfeelings remain vague and effective. Although philosophy has argued thatanxiety is existential in nature and although the behavioural sciences areresearching anxiety as derived from our awareness of death and mortality(e.g., Klackl et al., 2013), in therapy this rarely seems to be the cause ofsevere anxiety. The roots of overwhelming anxiety can usually be traced backto primitive emotions that were amplified in childhood through conflictand the breakdown of the security of early relationships (e.g., Breggin, 1991;Bowlby, 1998).Taking a moment to summarize, I had developed a concept easily applica­

ble in life and therapy, that guilt, shame, and anxiety are always associatedwith feelings of helplessness, and that each has a different method of direct­ing blame and anger. I still did not have a good explanation for whychildhood generates so much guilt, shame, and anxiety in every person.It was also unclear why these emotions become most overwhelming whenthe child is abused or neglected. In short, the function of these painful andoften dreadful emotions remained elusive.

70 Understanding and Overcoming Guilt, Shame, and Anxiety

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It is easiest to understand how guilt inhibits our wilfulness and violence.When in conflict with other people, and tempted to be angry with them,guilt instead makes us blame ourselves and direct our anger inward. Whenin conflict, shame makes us feel too impotent, worthless, or inconsequentialto assert ourselves aggressively.Instead, we act shyly or withdraw. Anxiety,when we are in conflict, makes us feel so incompetent, baffled, and emotion­ally stupid that we can do nothing effectively.Ifwe assign blame, it may bevaguely at our supposed incompetence or at 'how the world keeps comingat me'. This too keeps us from unleashing violence.Eachnegative legacyemotion in its own waymakes us feel sohelpless that

we cannot assert ourselves.When taken over by anxiety, wemost openly feelthe raw emotion of helplessness, but it is associated with all three negativeemotions. Byrendering us helpless at critical moments of personal conflict,these emotions help to rein in our wilfulness and violence.Guilt, shame, and anxiety aim at stopping us dead in our tracks, prevent­

ing us from asserting ourselves against the people closest to us. Developedby natural selection, they are neither fine-tuned nor very effective. Theycan backfire destructively, leading to destructive reactions that harm us orthe people closest to us. When guilt feels intolerable, we can become suici­dal. When shame seems intolerable, we can break through our feelings ofimpotence and worthlessness, and strike back violently. From school andworkplace shootings to domestic violence, nearly all personal violence isdriven by shame and humiliation (Breggin,2014).

Their prehistoric qualityThe origins of guilt, shame, andselection are deeply buried wittthe fabric of our brains and bodimental events in childhood. Laguilty or ashamed or that we arwe were programmed by biologthis way.They are also prehistoric in tr

vidual lives in childhood beforegoing on, so their stimulation ihood. 'Self-understanding' or 'SE

smack into biological reality - wanxiety, and how we respond I

understanding and self-analysisand the lost recesses of childhosome of the stimulating eventshood - and this can be very helpat the tip of an iceberg that is suin the prehistory of childhood a

Their simplistic qualityBecauseguilt, shame, and anxleticated cultures and because thelegacy emotions are rather simjindividual to individual. This mselvesand other people but alsotherapist becomes attuned to idapparent in the first fewminute:at least at this moment, by ontimes the individual's carriage aof these emotions. Identifying'apy, but learning to apply thisgreat deal of work on the part 0

How negative legacy emotions work

Although guilt is the primaryand anxiety can also fuel suicideConversely,although shame is tlto resentment and anger, and amately aggressive.These complithe complexity ofhuman relatioitheir survival and reproductive,ships) from their unintended corsuch an extreme that it breaks 01

react with wilfulness and violence especiallywhen frustrated or threatenedby one's mates or children.Individuals with the innate capacity for guilt, shame, and anxiety, and

the groups within which they lived, developed a survival and reproduc­tive advantage in competition with other humans or human-like crea­tures (hominins). They would be favoured through natural selection. Sincehumans and hominins have been both violent and social for probably a fewmillion years, nature has had time to ensure that every human being is bornwith the capacity to feel guilt, shame, and anxiety in close relationships(Breggin, 2014). These emotions would inevitably be elicited or triggeredearly enough in childhood to help control the extraordinary wilfulness andpotential for violence that even children display, especiallywhen thwartedor frustrated in their relationships with siblings, parents, and caregivers.To designate their origins in evolution and in early childhood, and to

emphasize their function, I have given the name negative legacyemotions toguilt, shame, and anxiety (Breggin,2014). Understanding guilt, shame, andanxiety as negative legacyemotions has many implications and applicationsin therapy and in everyday life.

72 Understanding and Overcoming Guilt, Shame, and Anxiety

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Except in a most speculative fashichildren raised in modern familleto control their wilful aggressive]averagecircumstances will developin their closestrelationships, therein order to behave themselves ardeprived of normal nurturing isshame, and probably no one growWell-meaning parents often try

anxiety in their children; but theyative legacy emotions are so thereand bodies, as parents we will ushame, and anxiety in our childcontrol the negative impact of theMeanwhile, psychologists and s

aware that from birth onward infto the people around them. Reseaanywhere from the nursery whercrying (calledcontagion as if it WEoffer comfort to other children anAfew years ago, I was happily I

of a fewmonths old infant. My n

Do children need to feel guil1

In my clinical and forensic W(

guilt, shame, and anxiety withoutheir behaviour or situation. Oftenthough the individual has little or]ious, or ashamed about. Much of tpeople see that these emotions ai

feelings of helplessness that inter:development and maintenance ofMany people commit crimes in,

ative legacy emotions, but they IIanxiety about doing something going to find and build a loving relatin the same person - lack of negaover-abundance of them about haThese conclusions shed enormc

how to run our own lives. If we wiwant to succeed in our own lives,shame, and anxiety have no placereplacedwith reason, sound princi

Their primitive qualityGuilt, shame, and anxiety are primitive emotions. Built into us throughoutmillions of years of evolution, we were struggling with them long beforewe evolved into Homo sapiens approximately 150,000 years ago (Breggin,2014). They are Stone Age emotional reactions. They are also primitive inhow they were triggered and moulded when we were infants and small chil­dren incapable ofmaking rational ethical judgements. It is therefore unlikelythat guilt, shame, and anxiety reactions would turn out to be consistent orreliable guidelines for mature adult reasoning, ethics, and choices. For thisreason, guilt, shame, and anxiety can be seen as primitive, prehistoric, sim­plistic emotional reactions that do not accurately reflect on either our realvalue as persons or on how we should live our lives. A mature life can belived with reliance on reason and love as its guidelines.

Emotional freedomThe realization that Stone Age negative legacy emotions too often ruleover us provides the foundation of my theory in Guilt, Shame and Anxi­ety: Understanding and Overcoming Negative Emotions. The book provides thescientific basis and research basis for my concept of negative legacy emo­tions. It shows how they easily become the weapons of perpetrators in theform of child neglect and abuse, bullying, and domestic violence, offeringseveral approaches to identifying these emotions in ourselves and in thosewho wish to receive our help. It describes the three steps to emotional free­dom: identifying, rejecting, and triumphing over and transcending guilt,shame, and anxiety, as well as its derivative of chronic anger and emotionalnumbing.

Why guilt, shame, and anxiety have no redeeming featuresThe revelation that guilt, shame, and anxiety are prehistoric and primitive inorigin leads to the conclusion that they are unlikely to correspond to soundvalues or rational ethics that can be used to guide a successfulmature life.They are the combined product of natural selection and the influence ofmostly early childhood triggering events. They are results of biological evo­lution selecting for rudimentary controls over our wilfulness and violence inclose personal relationships.If in adulthood, for example, we feel guilty about rejecting someone close

to us, the guilt will not necessarilyhave any correspondence to what is goodfor us or even for the person we are rejecting. Or, ifwe feel ashamed aboutwanting to express ourselves in a new and creative way, shame is likelyto inhibit us without any regard for how other mature people will in factreact to our innovative efforts. Similarly,if we become anxious about beingabandoned, that emotional reaction will have no necessary connection towhether or not we are in reality facing abandonment or whether beingabandoned by the particular person is good or bad for us in the long run.

74 Understanding and Overcoming Guilt, Shame, and Anxiety

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(1) We treasure those who seand inviolable trust. Wiprivilege of being therapi:

(2) We rely upon relationshengagement, and mutual

(3) We bring out the best inothers.

(4) We create a safe space forby holding ourselves to testy, informed consent, (respect for personal freed-

(5) We encourage overcom:responsibility for ernotiorliving a self-determined li

(6) We offer empathic underunderstanding to offer illfulfilment of personal gm

(7) When useful, we help tlchildhood and adulthoomore effective choice-rna

(8) We do not treat people athreats, manipulation, or

(9) We do not reduce othersthat diminishes personadency on authority, andencourage people to undand complexity of their u

(10) We do not falsely attributies to genetics and bioclcapacity to take responsitown life.

With the help of Advisory Ccof Empathic Therapy, I develcTherapy (Breggin,2011):AsEmpathic Therapists -

Guidelines for empathic tl

negative legacy emotions, ancattitudes such as personal resp'2014). The most important facshame, and anxiety, and fillecwithin professional boundaries

Do guilt, shame, and anxiety account for all or nearly all human psychologi­cal suffering?I think so,but I have not yet reached the point of applying thisunderstanding in detail to all of what we call 'mental illness' or emotionalsuffering.Here is a brief sketch of how the theory can be used in clinical prac­tice in helping deeply disturbed persons. When people are overwhelmed bydepression, most clinicians would agree that it is probably driven by guilt,along with varying measures of shame and anxiety. When people withdrawinto psychotic states, including what gets called schizophrenia, they are typ­ically feeling overwhelmed by extreme shame and humiliation (Breggin,1991). When people feel overwhelmed with panic or anxiety, the negativelegacy emotion of anxiety is likely to be driving it. Obsessions and compul­sions can be driven by guilt, shame, or anxiety. Child abuse and neglect andtrauma can also produce varying degrees of all three emotions.When recovery from traumatic loss or bereavement seems impeded, guilt,

shame, and anxiety are usually interfering with healing. Child abuse andneglect gets its traumatizing power from the guilt, shame, and anxietyinflicted on the individual. From child abuse and neglect to traumatic lossesand events in adulthood, negative legacy emotions play a major role incausation and/or in preventing emotional and spiritual recovery (Breggin,2014).Since feelings of helplessness are at the root of all negative legacy emo­

tions, it follows that most emotional suffering and personal failure is rootedin these subjective feelings of helplessness. A key challenge in empoweringourselves and in helping other people is to address and to overcome feelingsof helplessness.As a clinician, I have found that emotional freedom from almost any

expression of psychological suffering and personal failure, including themost extreme, can be largely understood and healed with the use of thismodel of negative legacyemotions in a caring, empathic relationship. It canbe enormously liberating when clients learn to identify and reject their

A theory of all emotional suffering?

him in my arms, and on awakening we beamed into each other's faceswithsuch joy that we seemed to glowwith inner spiritual light in the photo thatcaptured the moment. Undoubtedly, these very early experiences are elic­iting the infant's innate capacity for empathy and bonding that positivelyinfluences both infant and caretakers.I believe that only good can come from avoiding triggering guilt, shame,

and anxiety in children while encouraging empathy and love from the earli­est possible age. This same is true in our adult relationships with each other.Emotional freedom is achieved in part by refusing to inflict and refusingto accept communications corrupted by guilt, shame, and anxiety (Breggin,2014).

76 Understanding and Overcoming Guilt, Shame, and Anxiety

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American Psychiatric AssociatiorDisorder, Fifth Edition. Washing

Bowlby, ]. (1998). A Secure Base: .ment. New York: Basic Books.

Breggin, P.R. (1991). Toxic Psychthe Drugs, Electroshock and BiocMartin's Press.

Breggin, P.R. (1997). The Heart oJPresence. New York: Springer PI:

Breggin, P.R. (2008). Brain-Disabthe Psychopharmaceutical Com;Company.

Breggin, P.R. (2011). Guideline:Study of Empathic Therapy (aFounding-Guidelines.html.Ret

Breggin, P.R. (20 13a). PsychiatricPatients and Their Families. Nev

Breggin, P.R. (20 13b). Empathy,therapist. In: Kirkcaldy, B.D.Essays on Recovery, Chapter 16,

References

The medical approach to emgood and should be replaceduniversal nature of human SI

psychological, and spiritual Iemotions - their impositionexperiences - can help us tohelp us and our clients to S(

does not reflect on our valueidentification of guilt, shamtions, and the underlying hican provide the theoretical fof whatever theoretical consiwill be most effective when :that is free of guilt, shame, ar

Final thoughts

After leaving guilt, shame,in our work or our relationshdaunting but instead increasiihow to sweep out negative lelinspiring values and attitudes,Someonegreater than ourselvihuman nature, we can triumjin favour of our infinitely gre.

As I describe in my new book Guilt, Shame and Anxiety, emotional libera­tion can take place in three overlapping steps. First,we identify our negativelegacy emotions. Second, we reject them as having no worth or redeemingfeatures in our lives.Third, we replace them with reason, ethics, and love asour guidelines. Is it easy? No. Does it take time and effort? Yes.Is it worthit? It is a giant key to living a happy life and to being as useful as possible toother people.Instead of suppressing our painful emotions with psychoactive drugs,

including psychiatric medications (Breggin, 1991, 2013a), we can liber­ate ourselves from guilt, shame, and anxiety, learning to require mutuallyrespectful relationships in which love can thrive. Aswe leave these negativelegacy emotions behind, life becomes much easier and richer. We becomeinfinitely more able to love.

Becoming the person you always wanted to be

The application of the theory of negative legacy emotions is representedin the fifth guideline: We encourage overcoming psychological helplessness andtaking responsibility for emotions, thoughts, and actions - and ultimately for livinga self-determined life.

(11) We recognize that a drug-free mind is best suited to personal growthand to facing critical life issues. Psychiatric drugs frequently cloudthe mind, impair judgement and insight, suppress emotions and spir­ituality, inhibit relationships and love, and reduce will power andautonomy. They are often anti-therapeutic.

(12) We apply the Guidelines for Empathic Therapy to all therapeutic rela­tionships, including persons who sufferfrom brain injuries or from themost profound emotional disturbances. Individuals who are mentally,emotionally, and physically fragile are especially vulnerable to injuryfrom psychiatric drugs and authoritarian therapies, and are in need ofthe best we have to offer as empathic therapists.

(13) Because children are among our most vulnerable and treasured citi­zens, we especially need to protect them from psychiatric diagnosesand drugs.Weneed to offer them the family life, education, and moraland spiritual guidance that will help them to fulfil their potential aschildren and adults.

(14) Becausepersonal failure and suffering cannot be separated from theethics and values that guide our conduct, we promote basic humanvalues including personal responsibility, freedom, gratitude, love, andthe courage to honestly self-evaluateand to grow.

(IS) Becausehuman beings thrive when living by their highest ideals, indi­viduals may ",'ish to explore their most important personal values,including spiritual beliefs or religious faith, and to integrate them intotheir therapy and their personal growth.

78 Understanding and Overcoming Guilt, Shame, and Anxiety

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Research in health-relatedmedicine has traditionally eidysfunction. Though this altant to understand the factorto flourish. The past two deof a complementary approaapproach, now referred totive well-being (SWB)as OP]causes and correlates of hun

Introduction

Health-oriented research, inchas emphasized identifying 0

this approach has proved v,human experience that resealand dysfunction, it is importpast two decades have witnetary approach to cataloguinreferred to as positive psychbeing. New studies are idenhope, and life satisfaction inbeing (e.g., friends, spiritualrepresents only the initial stanext and critical stage of IE

to develop and assess strateenhancements of children'ssome of the relevant researcteral possible intercessions, baand practitioners might emp

Mark D. Holder and Robyn

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80 Understanding and Overcoming Guilt, Shame, and Anxiety