Avoiding Eye Contact and Shame: When do we discuss it?

It was deeply satisfying to present again to the LACPA SIG chapter this month to such a responsive audience. We were looking at how shame shows up in a session. As I see it, a person who presents with depression, envy, grandiosity, aggressive anger and contempt is likely to have underlying shame that begs to be addressed. Recorded material helped us to get a clearer idea about DEFT interventions and role-plays helped us to practice them. When I invited a shame-based client to have a conversation about her difficulty making eye contact with me, a participant raised a great question about whether and when such directness is beneficial.  I thought a discussion of it would benefit others.

When a client is having significant difficulty making eye contact, I typically find a way to talk about this guided by a heightened sense of shame sensitivity, even in a first session. There is a widespread perspective that it is best to wait a period of time, perhaps weeks or months, to develop sufficient connection with the client to address something as intimate as eye contact. Therapists have understandable concerns that such directness will lead to even greater shame. There is truth in the fact that anytime we draw attention to shame, especially the avoidance of eye contact, there will be a temporary increase in shame. Shame never wants to be seen and interpersonal exposure mobilizes shame. If it’s not handled helpfully, therapists have an understandable concern for potential malattunement. Therefore, I don’t advise therapists to draw attention to shame, especially the avoidance of eye contact, without having some skill development in shame work and emotional attunement.

Some of the elements of such shame work include: seeking permission to speak about non-verbal and body-based responses; differentiating compliance from a try alliance; putting the shame response into a normalizing context; tracking co-mingling anxiety; having the skills to work with projection of judgment; developing observing capacity so the shame response can be seen as separate from the core self; offering alternative paths to the shame state; creating enough safety in the relationship to support this degree of intimacy and deeper work.

I really empathize with the therapist who had reservations about stepping into this kind of shame work, and her fears were grounded in some realities. I myself felt the same for many years. However, I now have a different perspective having discovered that delicate shame work can be successful early in treatment, depending as much  on HOW something is done as on WHAT is actually done. When certain elements are not present, any intervention can backfire including addressing the avoidance of eye contact, whether the intervention is made in the first session or the thirtieth. I’ll speak more about them in a moment.

So why would we forge ahead and deal more directly with avoidance of eye contact? The reality exists that when someone is afraid to look at us, this person does not feel safe with us and is threatened, either consciously or unconsciously. This is a state of distress that is usually accompanied by a deep sense of unworthiness and self-judgment that is being projected onto the therapist. There are different approaches that can, over time, help build a greater sense of comfort with the therapist and reduce shame, but when the forces that cause someone to look away from us are not addressed directly, the client remains unconscious of them and therefore largely at their mercy until such time as help is provided. When shame is dominant, it will close doors to emotional intimacy and stall the therapeutic process until it releases and becomes less of an obstacle.

I remember one of my teachers saying to me something like, “Why not interrupt suffering sooner rather than later?” This really stuck with me and has caused me to stretch myself in my work by trying out greater directness and openness with my clients. This doesn’t mean that I just jumped in and said what I’m thinking or observing without first reading a number of signals from my client that indicate an alliance is operating. These include subtle signs of reduced fear in the eyes or a drop in muscle tension as well as verbal affirmations that tell me I have a partner who wants to take this track. Moment-to-moment feedback that my client has explicitly chosen to walk the path of internal exploration with me, including bodily and emotional exploration, is so vital to a successful process.

Let me share a segment of a powerful first session with a woman I would consider to be a victim of spousal abuse. It was impactful because both of us acknowledged that something deeply moving had occurred, and it began a journey of change and highly productive work together. When she started the session, her speech was pressured to a very noticeable degree. She spoke almost breathlessly and rapidly, describing different facets of her recent separation from her husband. He drank too much and could become scary and also treated her very dismissively. He didn’t bother to invite her on weekends away and eventually became involved with a friend of hers, which was devastating to her. She sunk into depression. Her body was locked in pain in a very visceral way. Her tears were just traces of the mountain of grief and rage she had no idea she was containing at an unconscious level. She presented mostly like a tightly controlled, very pleasing young woman who at one time was a popular cheerleader.

I began to take particular notice of her difficulty with eye contact when she commented on her husband’s affair with her friend. I very gently began to inquire about this in the context of compassion for her discomfort. Tone is everything here. I also immediately asked her permission for us to have this conversation. When I do this, I am very careful to be sure my question is raised in an open-ended way, allowing space and acceptance for the client to decline. Any signal that such exploration is unwanted would stop me immediately.

However, as frequently occurs, she indicated that we could proceed. I should emphasize that this was not the first question or second or third that I asked. There was some time in which we had exchanges that indicated she saw me as being in attunement with her and also felt some confidence in my ability to help. Also, it was important that I did not tell her she had a difficulty meeting my eyes. This would definitely have been shaming. I posed this as an inquiry, inviting her collaboration as a co-observer. Did she notice what I noticed? I also put in in a context so as not to suggest she never makes eye contact. I mentioned that her tendency to look away from me seemed to happen as she was describing the breakdown of her marriage. Again I enlisted her help as a co-observer, “Does this seem true for you?”

She did in fact have a very good capacity to observe herself, and I complimented her for this ability. A big door opened as she told me how ashamed she was that her marriage had failed. She saw herself as a failure at her age and as a woman with little hope for the future. She blamed herself for having deficiencies that would cause her husband to stray. Her self-diminishment was heartbreaking.

Her reaction suggested she probably imagined I saw her in the same way she saw herself. So I asked her sense of how I was feeling and reacting to her disclosure? Not surprisingly, she confirmed that the projection was operating. She hadn’t been conscious of her tendency to project, but began to be curious about it. Rather than just tell her that I did not see her as she assumed I would, I suggested she could, if she wanted, take a look into my eyes and see what she actually saw. It was entirely up to her. She very tentatively began to move her eyes closer to mine, and there were several minutes that were among the most beautiful I have experienced in practice. I felt my whole body infuse with compassion that was soft, tender and embracing. It was a feeling that just swept over me. Within myself was an intention that she would see in my eyes pure acceptance and even love.

After a significant period of time, she suddenly broke into sobs. She later affirmed that she had seen the compassion in my eyes and it was a new, deeply felt experience for her. Working with shame so often goes beyond the verbal or intellectual dimension. It is a state of being that is transmittable and transferrable when it is genuine and authentic. It seemed like a transfusion of compassion for self. And of course this could not take place without sufficient willingness to receive. In this woman’s case, we also addressed in this session her extreme harshness towards herself. Not only was she reeling from the wound of betrayal but also from her own condemnation of herself, which justified her husband’s deceitful actions and pushed her rage out of awareness. We would discover how greatly she wanted to protect him and keep her attachment to him alive.

I attempted to make very clear that her ability to move forwards in her life, to find greater peace and satisfaction, would depend on her active intention to keep compassion for herself alive within her. Her avoidance of eye contact with me was the key signal, in this first session, to her enormous sense of unworthiness. If you’ve ever had the experience of a deeply satisfying massage, the practitioner probably had a way of moving her hands towards those points in the body that require attention and attuned pressure to release. The psyche is very similar. We can massage around the knots for long periods of time, but when we have permission to bring our touch to the points that are tightly held, the release can be exhilarating for both the therapist and client alike!

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