‘I was supposed to know better’: therapists’ reflections on their shame and guilt

This study investigated therapists’ experiences of shame, a common yet underexamined emotion related to their influence on clinical practice. Sixteen therapists, working in various orientations and with varying years of experience, took part in interviews and drawing tasks. Interpretative phenomenological analysis (IPA) revealed three principal themes. Shame and guilt were perceived as interconnected yet distinct emotions. When left unprocessed, these emotions negatively impacted the therapists’ presence, flexibility, and ability to establish relational connections, leading to concealment, over-cautious behavior, burnout, and, occasionally, withdrawal from the profession. Conversely, when recognized and reflected upon, shame and guilt served as signals that facilitated ethical sensitivity, empathic attunement, and professional development. Finally, the therapists’ capacity to manage these emotions depended on relational and reflective resources, including supervision, collegial support, and self-compassion. By framing shame and guilt as clinically significant rather than merely prevalent, the findings have major implications for therapeutic outcomes, supervision, and professional training.