Shame And Social Phobia: A Transcultural viewpoint

Okano K

Bull Menninger Clin

Vol. 58 No. 3 Summer.1994


Copyright by Bull Menninger Clin

SHAME AND SOCIAL PHOBIA: A TRANSCULTURAL VIEWPOINT Shame is given different meanings in various cultural contexts. In Japan, shame-prone and self-effacing behavior tends to be given positive functional value and is actively promoted by society. In the United States, society tends to prohibit such shame-prone behavior and the show of one's vulnerability, while encouraging the visible demonstration of one's power and capacity. The author shows that these different meanings given to shame reflect different values of secretiveness in these two societies. He concludes by suggesting an alternative view of shame that encourages flexibility rather than an exclusively positive or negative value of secretiveness. (Bulletin of the Menninger Clinic, 58[3], 323-338) Shame may be one of the most hidden human feelings. People are reluctant to talk about their own shameful experiences and often do not even want to admit having this feeling, even though shame is ubiquitous in our daily emotional life. It is the nature of shame to hide feelings of inadequacy or inferiority, either from ourselves or from others. Unlike guilt, shame has never been a central theme in the classical psychoanalytic literature, despite some significant contributions on this topic by such authors as Erikson (1950), Piers and Singer (1953), Lynd (1958), and H.B. Lewis (1971). Morrison (1989) stated that "shame generates concealment out of a fear of rendering the self unacceptable," in contrast to guilt, which "invites confession and forgiveness" (p. 2). This fear of rendering the self unacceptable makes it difficult for us to face shame either as a general human emotional experience or as a daily personal experience. Fortunately, however, there has been a rapidly growing interest in shame in the current psychoanalytic literature in the United States. This recent burgeoning of publications on shame may be apparent even to those who are not particularly sensitive to this topic. As some authors suggest, there has been a "cultural conspiracy to avoid discussing shame" (Broucek, 1991, p. 4) that we are now overcoming through our own analytic scrutiny. Others note that this new wave of interest in shame goes hand in hand with the interest in narcissistic pathology (M. Lewis, 1992; Morrison, 1989). However, the reasons for the current interest in shame (and the relative paucity of interest in the past) seem to be much more complex. One characteristic of recent publications on shame in the United States is the wide variety of viewpoints that they provide. In contrast to the unitary drive/instinct conceptualization that Freud and his immediate (as well as some of his remote) followers developed, current authors have evolved their own positions, which differ from drive/instinct theory and shed light on the topic from multiple angles. These authors use psychoanalytic (Bursten, 1973; Chasseguet-Smirgel, 1985; Morrison, 1989; Wurmser, 1981), developmental (Broucek, 1991; M. Lewis, 1992; Tomkins, 1962), philosophical (Broucek, 1991), and sociocultural models (M. Lewis, 1992). Most of the issues bearing on shame have already been covered, explored, or at least alluded to by these studies. Yet, despite the variety of current viewpoints, there is still a dominant and, in my view, narrowly conceived doctrine espoused in this literature. This doctrine asserts that shame is basically a negative feeling and that the clinical objective is to help patients become aware of it and then get rid of it. A few authors hold the opposite view and focus on more positive and functional aspects of shame (Broucek, 1991; Goldberg, 1991; Schneider, 1987), but they are in the minority. The major objective of this article is to provide a wider and more relativistic view of shame by bringing a transcultural perspective to bear on this phenomenon. This perspective is based on my personal experience as a practicing psychiatrist in two different cultures (American and Japanese). Since, with the exception of M. Lewis (1992), the current American literature pays little attention to shame in different societies, clarifying the contrast between the American and the Japanese views may well enrich our understanding of shame, as well as of social phobia--the typical pathological manifestation of shame. In my view, these two culture-bound approaches are complementary, pointing out each other's blind spots. I wish to suggest an alternative view that can encompass both perspectives. Before proceeding, however, I would like to stress that the following transcultural approach to shame never eliminates the significance of innate temperament, which could determine one's shame-proneness and propensity to social phobia. All human beings definitely share a potential for experiencing shame. It is the meaning people attach to the experiences of shame that is dependent on the sociocultural context. This is what I will discuss in this paper. In the following sections, I will first describe the almost opposite Japanese and American viewpoints on shame and social phobia, and then present my alternative perspective. Shame and social phobia in Japan Since Benedict's (1946) penetrating but rather simplistic formulation of Japanese society as "a shame culture" (as opposed to American society, which she termed "a guilt culture"), shame as a psychosocial phenomenon has been a continuing topic of discussion in Japan. Sakuta (1967), a Japanese sociologist, argued that Benedict's dichotomous view considered only one aspect of the shame experience among the Japanese. Relying on Scheler's (1913/1957) theory of shame, Sakuta divided shame into what he called "private shame" and "public shame." The former is what an individual experiences privately in terms of personal inferiority and inadequacy, whereas the latter is what is experienced privately in direct social contact with other people who have noted public manifestations of the person's inferiority and inadequacy. Sakuta contended that Benedict focused only on public shame in the Japanese, whereas actually the Japanese also have an internalized form of shame (i.e., private shame). This private shame is an internal sanction akin to guilt, which Benedict assumed governs people in Western society. Using Sakuta's formulation, Inoue (1977) further classified shame-related feelings into three categories: (1) public shame, (2) private shame, and (3) shyness. Most current Japanese authors agree with this classification. Historically, Japanese people have become used to being characterized as shame-prone, shy, self-effacing, reserved, and apologetic, even though they show some resistance or reservation in accepting the designation of their culture as a "shame culture" with its rather negative connotations. Japanese psychiatrists regard shame and shyness as playing an important role in the pathogenesis of several mental disorders, including social phobia, dysmorphophobia, paranoia, and depression (Uchinuma, 1983). Among these conditions, it is the pathological shame reaction, social phobia, that I will discuss at length in this paper. Generally speaking, Japanese authors appear to assume that the culturally encouraged show of shame-proneness among the Japanese is enough to explain the reported high prevalence of social phobia among them. Many authors argue that social phobia has a much higher prevalence in Japan than in the Western world (Kasahara, 1974; Kora, 1955; Yamashita, 1977). However, it is not easy to demonstrate this presumed higher prevalence in Japan with relevant statistics, primarily because of the lack of extensive comparative epidemiological data on social phobia in the United States and in Japan. Kasahara (1974) reported that 10% of new students in a Japanese university who were under psychiatric care had a diagnosis of social phobia, and that its prevalence was second only to depressive reactions and psychosomatic disorders. A report by Uchinuma (1983) indicated that 2.5% of psychiatric outpatients in a Japanese mental hospital had a primary diagnosis of social phobia. Furthermore, it is widely believed that there is a large "subclinical" population of persons with social phobia among the Japanese. One study showed that nearly a third of new students in a Japanese university believed that they flushed easily or that they were overly aware of the gaze of others (Uchinuma, 1983). Another report indicated that about 50% of students in a university in Japan had a tendency toward social phobia (Fukui, 1984). In Japan, a cluster of neuroses with socially phobic features as well as hypersensitivity and pervasive hypochondriacal concerns has been called "shinkeishitsu," which a Western textbook of psychiatry describes under the rubric of "cross-cultural syndromes" (Kaplan & Sadock, 1988). Half a century ago, Morita (1960), a pioneer in the study of shinkeishitsu, postulated that there is a shinkeishitsu-prone innate temperament that he called "hypochondriacal temperament." According to Morita, people who are born with this temperament are overly sensitive, self-reflective, and notice even minimal changes in their mental and physical states. He stated that the cure for these people is to get rid of their tendency toward excessive self-reflection. Morita Therapy advocated that these patients establish a state of "arugamama," which is the readiness to admit the nature of their own symptoms and anguish. Instead of resisting or rebelling against them, patients learn to accept them as part of their existence. For the past half century, Morita's theory has been widely accepted among Japanese clinicians as well as lay people (Takahashi, 1989), with the establishment of self-help groups among people suffering from shinkeishitsu. The popularity of Morita's theory could be accounted for by the large prevalence of clinical and subclinical populations with shinkeishitsu. It could also be ascribed to the fact that the basic principle of Morita Therapy fits well with the philosophy of Zen Buddhism that the majority of Japanese people are familiar with, especially its discouragement of opposing natural as well as bodily phenomena, including physiological manifestations of social phobia such as flushing, palpitations, and hand tremor. As the principle of Morita Therapy indicates, in Japan shame tends to be considered a feeling that all human beings share, and it is the failure to accept one's feelings of shame that could create problems. It even seems as if something in the Japanese culture is actively promoting, facilitating, or at least allowing people to show manifestations of the experiences of shame and related feelings such as shyness, secretiveness, embarrassment, and a sense of inferiority. If the core emotional experience of social phobia is an intense and disabling feeling of shame, the high prevalence of subclinical social phobia symptoms in Japan compared with Western society could be related to the socially promoted show of shame among Japanese people. In this context, I (1991) once described Japanese society as a pseudo-sociophobic culture, because so many cultural phenomena that are considered proper in Japanese society are phenomenologically isomorphic to attenuated subclinical forms of sociophobic symptoms. I want to stress here that what is promoted by Japanese society is not the feeling of shame itself. It is rather the external manifestations of the feeling of shame in the sociophobic-like symptoms, which could occur even without actual feelings of shame. In other words, what is promoted is not exactly shame per se, but the "sense of shame" (i.e., one's awareness and sensitivity to the shame experienced by oneself or others). Typical Japanese examples of this culturally promoted show of shame include: It is considered impolite to stare at people, especially one's elders or superiors; and it is often regarded as improper to be verbally assertive and to make one's opinion too clear and distinct in public. Generally, it is not wise to show off your competence and competitiveness to others. It is also regarded as taboo not to be in touch with one's own feelings of shame, and in the Japanese language "a man who does not know what shame is" is equivalent to a "thickskinned" and "insensitive" person who is practically unfit for society. Therefore people are even required to "fake" sociophobic-like manifestations to be accepted in the society (hence my term "pseudo-sociophobic" society). Accordingly, it is a reasonable expectation that a certain number of people who live in this society will develop "real" symptoms of social phobia, such as a fear of eye-to-eye confrontation and oral communication. People may feel free to show these symptoms, which are already encouraged by society. The question may now be posed: What purpose does this shame-promoting culture serve? The most obvious function of these sociophobic-like behaviors is to reduce the envy-ridden competitiveness among people. Every show of an individual's strength and assertiveness is carefully modified or camouflaged in this society so that an individual is better accepted. Verbal assertiveness and staring straight into another person's face are discouraged because they are regarded as a provocative, defiant show of one's own power and strength. On the contrary, one's bashful and overpowered looks, lack of verbal assertiveness, and avoidance of gaze that mimic the appearance of "true" sociophobic symptoms demonstrate one's weakness, limitations, or inadequacy, which reduces the potential of arousing jealousy and feelings of competitiveness in others. Thus, as I suggested earlier, shame is not a feeling to be avoided, but instead it is considered a feeling that can be actively used to reduce friction in one's relationships with others. This readiness to show one's feelings of shame probably reflects a belief that most Japanese people share: One's importance, power, or value should be only implied or suggested, but not revealed openly. This belief implies that what is hidden is powerful. On the other hand, what is manifest has already lost its power or value. This belief goes hand in hand with the Japanese pseudo-sociophobic attitude, because the latter does not threaten one's narcissism as long as the belief asserts that hiding one's strength and value does not mean that one does not have them. Doi (1986) suggested that this belief has a long history in Japanese culture. He quoted the following statement by Zeami, a master of Kado (the art of flower arrangement) in the 15th century, which most Japanese would immediately agree with, even in this modern era: Know the concealed flower. "What is concealed is the flower. What is not concealed cannot be the flower." To know this distinction is the flower, and among all flowers this flower is the most important. From the beginning, the respective houses in the various ways and arts have called all matters pertaining to their disciplines secret, precisely because great work is done by making these matters secret. (p. 110) If what is essential is always hidden according to what the Japanese believe, then strength and capability are covert. Even though the society discourages the direct show of strength, this does not militate against a basic narcissistic need, such as possessing strength or identifying oneself with strong others. However, because an essence must be hidden to be truly essential, true strength should be hidden by the very people who have it, unless it reveals itself naturally. It is not that one should not be strong and capable, but rather that the person should not reveal these traits spontaneously, which proves the individual's real strength and capacity. In a pseudo-sociophobic culture, what is discouraged is the striving to show one's strength and capacity in an overt way, but this does not mean that it also discourages the individual from being really capable and strong. Rather, a well-adapted sociophobic-like individual should have an inner strength and confidence that makes the individual immune to the culturally promoted submissive and self-defeating attitude, which otherwise would hurt the person's pride and narcissistic self-image. Kitayama's (1985, 1987) recent psychoanalytic contributions shed another light on this issue of truth and strength in what is hidden. In a study of an old taboo found in Japanese folklore against seeing and then revealing, Kitayama (1985) argued that the preoedipal "prohibition of 'don't look'" (p. 177) is repeatedly observed in this folklore. He pointed out that in many Japanese stories, when the hero (usually a man) violates the prohibition of "don't look"--that is, when he breaks a promise to his attractive lover or wife not to look at her in certain situations--he usually sees, instead of a beautiful woman, an animal that is "an ugly mixture of split 'good' and 'bad' mothers" (p. 184). Even though this taboo is eventually to be violated (as opposed to the oedipal incest taboo, which is never to be violated throughout life), the abundance of this type of folklore in Japan indicates the belief that revelation will spoil one's positive values, such as beauty and attractiveness. In another contribution (1987), Kitayama pointed out that the Japanese language is generally used loosely and is grammatically ill-structured. He contended that "to a large extent the Japanese communicate ideas while keeping them unspoken" (p. 499), implying that this is a manifestation on the level of language of the previously mentioned Japanese propensity to hide in order to preserve values. Of interest to our topic is that Kitayama also suggested a possible relationship between the ambiguity of the Japanese language and the high prevalence of social phobia. His idea of a "morbid fear of ambiguity" (p. 501) refers to the Japanese paranoid fear of being misunderstood by others because of their secretive and ambiguous mode of speech, which is inherent in the sentence structure of Japanese language. To summarize, in Japan shame tends to be regarded as an important and functional emotional experience. The society promotes a sociophobic-like attitude, with humility and self-deprecating gestures in social relationships and with a resultant proliferation of shame-prone, avoidant, and sensitive demeanor similar to social phobia. This "feigned" socially phobic attitude has at least two adaptive functions. First, it inhibits envy and competitiveness that a show of one's capacity and strength would elicit in others. Second, it protects both one's strength and vulnerability by keeping them invisible to others as well as to oneself, so that they remain unchallenged and unharmed by others. Despite these merits, however, the abundance of pseudo-sociophobic attitudes among the Japanese tends to facilitate the occurrence of true sociophobic symptoms, which are maladaptive and dysfunctional. Shame and social phobia in the United States Even if Benedict's (1946) dichotomy of the Japanese shame culture versus the American guilt culture is too simplistic, American people would never assert that they are shame-prone, or that American society in general facilitates sociophobic-like symptoms as does Japanese society. Although the literature on shame is rapidly increasing among current American psychoanalytic authors, they unanimously agree that shame has traditionally been a widely neglected topic in their field. As Nathanson (1987) noted in his monumental monograph on shame: "Shame seems to be an emotion little discussed in our clinical work" (p. vii), and there has been a "culture-wide avoidance of pertinent discussion" (p. viii) on this topic. In this section, I would like to consider this "culture-wide avoidance" in two respects: (1) its sociocultural implications, and (2) the classical psychoanalytic movement's deterrent effect on the discussion of shame. ociety, American society has few moral or ethical codes that appear to promote sociophobic-like behavior in individuals. Regardless of any statistical data, it is clear that there are few customs or moral codes in American society that promote self-effacing, inhibited, and avoidant attitudes toward others. Let us take the same examples we considered in the previous section as indications of a pseudo-sociophobic Japanese society. In the United States, it is generally not considered impolite to gaze at people. Rather, avoiding eye contact is often interpreted as a show of vulnerability, insecurity, or even dishonesty. Also, American society rather actively promotes verbal assertiveness and making one's opinion as clear and distinct as possible in almost any social situation. Lastly, those who are shame-prone are considered less likely to prosper in American society because of their lack of competitiveness. In American culture, showing one's ability and power in a most visible and tangible manner, such as through verbal assertiveness, publications, or publicity in the mass media, seems to be a royal road to success. In The Culture of Narcissism (1979), Lasch suggested that this tendency is even more pervasive recently in modern society, where people are devoted to superficial images and personal advancement. He also asserted that "narcissism appears realistically to represent the best way of coping with the tensions and anxieties of modern life" (p. 50). For the sake of highlighting the contrast with Japanese pseudo-sociophobic society, we could call American society a narcissistic society, in line with Lasch's assertion. American society constantly pressures people to manifest their strengths and abilities in the most overt and visible way, if they want to thrive socially. However, the narcissistic quality of American society, which appears to be the opposite of the pseudo-sociophobic society, could serve as a strong protection against one's vulnerability to feelings of shame and inferiority. As I suggested, shame could be a universal feeling that every human being shares across the sociocultural context. What differs is how this vulnerability to shame is translated and (de)valued, which varies widely in given sociocultural situations. In the United States, what we are witnessing in people's narcissistic strivings could be a show of active avoidance, or even a counterphobic attitude toward admitting their experiences of shame. H.B. Lewis's (1971) notion of "bypassed shame" refers to this type of shame, which people experience without realizing it. The narcissistic society dictates that the winners will be those who successfully hide their vulnerability to shame and their sense of inferiority behind their narcissistic grandiose facade. The "culture-wide avoidance of pertinent discussion on shame" (Nathanson, 1987, p. viii) is endorsed by a belief of the American people regarding what is hidden and unseen, which again is in sharp contrast to the belief generally held by the Japanese. Instead of believing in the true value and essence of what is hidden, Americans generally believe more easily in what is visible and obvious, which typically characterizes their narcissistic society. Doi, a Japanese psychiatrist with extensive clinical experience in the United States, is well aware that this view of secretiveness is typical in Western culture. Referring to this Western attitude, Doi stated in his Anatomy of Self(1986) that "the tendency to think of secrets as something that should not exist, and ultimately as something that must not exist, is a phenomenon of the modern age" (p. 108). If what is hidden is to be revealed in this modern Western age, then the general trend in current American psychiatry represents this tendency in a salient manner. Some recent and currently hot topics in American psychiatry are clearly under the influence of this revelatory zeitgeist. Topics that we traditionally have had a strong reluctance to fully discuss, such as death, sexuality, and violence, have been argued more openly, and their related psychopathology has been more systematically formulated. For example, Kubler-Ross (1969) described the mental process of dying people and delineated several steps of the process that have specific characteristics. People are increasingly aware of the glaringly high incidence of marital violence and incest as well as sexual abuse in childhood. Related pathologies such as multiple personality disorder (now termed "dissociative identity disorder" in DSM-IV, American Psychiatric Association, 1994) and posttraumatic stress disorder are both currently a major focus of American psychiatry. Because the modern American zeitgeist is to reveal and disclose what has been hidden, shame is bound to be a negative feeling with its inherent secretive nature. If what is hidden lacks the value and truth of what is manifest, people will not be encouraged to assume a self-effacing sociophobic-like attitude toward others, because it only hurts their narcissism with a crude sense of worthlessness and shame. This lack of a pseudo-sociophobic attitude may be a strong deterrent to true sociophobic manifestations, because these symptoms are not well tolerated by this society. Consequently, the result could be either an underdiagnosis of social phobia or a belated recognition of its true prevalence. I will discuss this latter possibility at the end of this section. In addition to the American sociocultural prohibition of shame, classical psychoanalysis has provided people with a "shame-free" theoretical basis for human psychology. As several authors have already pointed out (Goldberg, 1991; Morrison, 1989; Nathanson, 1987), shame has been neglected since the beginning of the history of psychoanalysis. lt is often argued that Freud did not do justice to the feeling of shame, focusing instead on the pathology of guilt and the Oedipus complex, as well as on the superego as its "heir." The analytic literature since Freud has only occasionally referred to shame, in contrast to guilt, which has always been in the limelight of psychoanalytic discussions. Although Freud (1905/1953, 1932/1961) discussed shame to some extent, his attitude toward it was rather misleading and simplistic. In his view, shame has almost uniquely been dealt with as a defense against exhibitionistic instinct. As Morrison (1989) aptly summarized, "Freud (1905) introduced shame as a 'resistance' against these drives, which 'impede the course of the sexual instinct and, like dams, restrict its flow--disgust, feelings of shame, and the claims of aesthetic and moral ideals'" (p. 23). Freud's basic understanding of shame was passed on to his direct followers, such as Alexander (1938) and Fenichel (1945). Most current authors of shame-related literature stay away from this Freudian instinctual/libidinal view of shame and instead take diversified approaches to the topic. However, there is a widely held assumption, or a "central dogma," in most of the current literature on shame. This dogma dictates that the feeling of shame is not a healthy emotional experience and that the goal of treatment is therefore to diminish or eliminate it. Only a minority of authors, notably Schneider (1987) and Broucek (1991), challenge this dogma. Schneider (1987) stressed that even though shame has been treated with disrespect in our society, it is a mark of our humanity, given that the interplay between covering and uncovering is a part of human nature. Broucek (1991) also stressed the "shamelessness" (p. 135) in our modern society, which coincides with my argument of the relative ignorance of shame in this society. So far, I have asserted that shame has traditionally been rather avoided as a topic in American psychiatric literature, primarily for two reasons: the sociocultural implications of shame, and classical psychoanalytic theory's deterrent effect on the discussion of shame. However, my basic contention again is that shame is a universal emotion that all human beings are vulnerable to and defend against, whether it is overtly manifested or not. A recent study on the constitutional basis of shyness (Kagan, Reznick, & Snidman, 1988) supports this contention. Shame-proneness could be reflective of one's temperament, which is found across societies. (This idea has much in common with Morita's notion of "hypochondriacal temperament," discussed in the previous section, which is manifested by the individual's shame-proneness and sensitivity in interpersonal relationships.) If my contention is correct, then there should be some manifestations that people experience shame in American culture as much as they do in Japanese culture. In my view, there are two current indications. One is the rapidly growing literature on shame that we have witnessed for the past several years, which successfully shows the significant role that shame plays in the pathology of narcissism (Broucek 1991; Morrison, 1989; Nathanson, 1992). The second indication is the relatively high prevalence of social phobia recently reported in the United States. The recent expansion of the literature on shame is demonstrated by PsycINFO, a computerized database on psychiatry and psychology compiled by the American Psychological Association. A search of PsycINFO found that the number of uses of the word "shame," compared to the total number of records in the database, has doubled in the past 15 years. (Interestingly, the word has not been used as an indexable thesaurus term until 1994.) This new interest in shame has been attributed especially to the rise of self psychology and the growing interest in the pathology of narcissism. Most current authors of articles on shame discuss the relationship between shame and narcissism. Their general consensus is that shame is at the center of narcissistic experience. Morrison (1989) summarized the consensus of these authors, which is that narcissistic grandiosity and the desire for perfection are the underside of the sense of self as being inadequate, inferior, and shameful. This theory is in accord with my own argument regarding pseudo-sociophobic Japanese culture and narcissistic American culture. If Japanese society conditions people to openly accept their feelings of shame, American society works in an opposite way to powerfully suppress the acknowledgment of shame, leading rather to narcissistic manifestations in society. If we follow this logic, the prevalence of narcissistic pathology indicates how strongly shame is suppressed or denied in the individual. One of the salient discoveries of the current study of shame is this recognition of the strong relationship between shame and narcissism, which actually endorses my assumption that every human being is equally vulnerable to shame. The American attitude toward shame is different from the Japanese only in that Americans deal with shame in a rather counterphobic manner. Another indication of the American vulnerability to shame can be found in recent reports on the increasing prevalence of social phobia in the United States. In the past, especially before the advent of DSM-III (American Psychiatric Association, 1980), which was actually the first official recognition of social phobia in American psychiatry, social phobia was always considered a rather rare condition. Despite little systematic statistical evidence, social phobia was considered to have a low prevalence rate, compared to the high prevalence rate in Japan and several other countries (Kora, 1955; Yamashita, 1977). Liebowitz, Gorman, Fyer, and Klein (1985) stated that even though social phobia is still "neglected" among the anxiety disorders, the prevalence of this condition may be much higher than previously thought. They indicated that the prevalence of social phobia equals that of panic disorder and agoraphobia. A recent report (Schneier, Johnson, Hornig, Liebowitz, & Weissman, 1992) again pointed out that too little attention has been paid to this disorder, which actually affects 2.4 out of every 100 people among American adults. The most recent epidemiological study (Kessler et al., 1994) indicated that the lifetime of prevalence of social phobia is as high as 13%. Even though the estimated prevalence of social phobia varies among authors, there seems to be a parallel correlation between the attention that social phobia is currently attracting in the literature and its assumed prevalence among the general population. In my view, this belated recognition of the relatively high prevalence of social phobia indicates the cultural reluctance to acknowledge social phobia in American society, although Americans are as vulnerable as the Japanese to shame. An alternative view of shame This alternative view of shame is provided by a revision of the markedly different attitudes between Japanese and Americans toward what is hidden. As we saw earlier, typical Japanese and American views provide either positive or negative attitudes toward what is hidden. However, the act of hiding itself is neither good nor bad, and it would not cause problems unless an individual is no longer aware of what he or she is hiding and for what purpose. In other words, the act of hiding could become pathological when it involves hiding from oneself. In psychoanalytic terms, we find an analogous argument in repression and its pathological significance. Like what is hidden, repressed wishes and impulses are not altogether pathological. It is rather their loss of readiness to come back to awareness when necessary that gives rise to their psychopathology in the individual. Freud's view of guilt and its psychopathology is well in accordance with this flexibility of what is repressed (i.e., hidden to oneself), even though he did not relate this issue to shame. In "The Ego and the Id," Freud (1923/1961) indicated that guilt would cause problems when it is either totally repressed (in the case of hysteria) or "over-strongly conscious" (p. 51) (in the cases of obsessional neurosis and melancholia). Based on this idea, guilt would not become pathological if the individual gives it free rein to be either conscious or unconscious. As a matter of fact, that is the only way that the person can be at peace with guilt-provoking wishes and thoughts. The individual should understand that guilt should be neither totally repressed nor constantly under the scrutiny of consciousness; instead, it should be able to move back and forth from unconscious to conscious, depending on the circumstances. This pendulum-like flexibility and mobility should occur rather naturally, because any guilt-provoking wish has a reason to be both repressed (because of its potentially unethical and sinful nature) and in full awareness (because the person cannot always afford to use mental energy to repress it). Again, the rigidity of the wish's relationship to consciousness and the unconscious is what causes psychopathology. We can apply this view of repression almost exactly to our generalized discussion of what is hidden. From this viewpoint, neither American nor Japanese attitudes seem concerned about the importance of the flexibility of what is hidden. The Japanese tend to glorify and attach too much value to what is hidden, whereas Americans in general tend to devalue and minimize what is hidden and instead try to disclose it. The lack of flexibility in what is hidden in different cultural contexts has already been hinted at by Doi. In a 1973 article, he discussed the different mentality of the Japanese and the Americans concerning secrets. Regarding the Japanese people's attitude toward secretiveness, he stated: "To cultivate or pursue secrets leads rather to the establishment of one's separate self and the mastery of the world," but the Japanese "have not given free rein to them for some historical or sociological reason" (p. 177). Then he discussed the difficulty that Japanese people have with entering the stage of psychological "hide-and-seek," where making and discovering secrets is involved. What Doi meant by this analogy was not that the Japanese could not easily hide things. Rather, Doi implied that they have difficulty disclosing what is hidden, and that they sometimes need to pretend that they are not hiding anything to avoid having to disclose it. As I suggested previously, one reason for this reluctance to disclose is the belief that the value of what is kept hidden will be impaired in the process of emotional "hide-and-seek." If we could play and enjoy our emotional "hide-and-seek," it would mean that we are in control of the act of hiding, fully in charge of deciding when and what to disclose or not to disclose. The alternative view of what is hidden provides the basis for a new attitude toward shame that is different from both Japanese and American ones. This alternative attitude toward shame is a hypothetical and idealistic one that Americans as well as Japanese would adopt if their view of what is hidden gains flexibility, instead of attaching exclusively positive or negative value to what is hidden. If the Japanese would give up their belief in the unconditional value of what is hidden and kept secret, they would lose their shame-proneness and sociophobic-like attitude, because their self-deprecating attitude and low profile in society would only hurt their narcissism. If Americans would no longer attach an exclusively positive value to what is manifest and visible, with a concomitant neglect of the value of secretiveness, they would feel less need to resort to their narcissistic strivings and would more readily admit their painful vulnerability to shame and a sense of inferiority. They would then believe that they could still be valuable even if they do not visibly appear to be so. From this standpoint, Freud's rather defensive attitude toward his own secretiveness (Barron et al., 1991) may be consistent with his practical neglect of the significance of shame. Some authors even suggest that Freud's sensitivity and discomfort in dealing with shame prompted him to emphasize "an emotion with which he was more comfortable--guilt" (Goldberg, 1991, p. 124). In other words, with a little more flexible attitude toward what was hidden in himself, Freud would have shown much more interest in an alternative to the psychology of guilt: the psychology of shame. Acknowledgment The author thanks Herbert Spohn, PhD, for his critical review of this manuscript and his helpful comments. References Alexander, F. (1938). Remarks about the relation of inferiority feelings to guilt feelings. International Journal of Psycho-Analysis, 19, 41-49. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. 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