Name It, Shame It, Call It Out?

We can’t ignore it. The Scarlet S – shame – is everywhere in the news. And it’s a coin with two sides. On one side of this coin, the Scarlet S is riding high. Women are shaming awful men who assaulted, abused, and harassed them. And everyone is hoping for a turning point toward a more just and equitable culture.

But the other side of that coin is the dark side of shame. It’s the nature of shame to inflict great personal harm.

A Force for Good?

Reflecting on the ongoing wave of sexual abuse scandals, Joseph Burgo makes the case for the Scarlet S:

Shame may also serve as a force for good when we direct it at behavior damaging to the social fabric. As recent studies have shown, shame originally evolved as a means of promoting obedience to the rules that helped humans live and survive together; it deterred actions that might harm the individual as well as the tribe. In our modern world, too, a fear of being publicly shamed encourages adherence to the rules and standards that enable us to live together in a civilized way. When we turn shame upon individuals who violate those standards, we press them to desist.

A Disaster for Health

For promoting health, though, the Scarlet S is a disaster. Three decades of public health policy to address obesity has failed to arrest its growing prevalence. Much of that policy relied on promoting awareness of obesity as a health threat, but in the process, stigmatizing people with obesity. “Personal responsibility” has been the rallying cry. Shame and blame have been the implicit pillars.

The result? People who are susceptible to obesity avoid healthcare providers who shame them. Social isolation ensues. Health outcomes grow worse. And the prevalence of obesity continues to climb.

Shame and Tobacco Dependence

Some folks erroneously cite tobacco control as an instance where shame has worked. Their thinking holds that by shaming smokers and making them huddle outside to smoke, public policy has nudged many of them to quit.

But the fact is that restricting opportunities for smoking is not the same thing as shaming a person. Massey University’s Marewa Glover has worked on tobacco control for 23 years. She offers us wise perspective:

Shaming someone for smoking to try and get them to stop smoking must be one of the most illogical public health strategies there is. Shame is a negative, potentially crushing, emotion. Negative affect, that is, negative emotions are the number one trigger to smoke and to relapse to smoking.

The impact of shame will vary depending on the individual, their resilience to being publicly mocked and shunned and how much other shame is being heaped on them. It is no wonder then, that the groups who find it hardest to quit, are the groups who are getting it in the neck every which way they turn.

Toxic Physical Effects

The fact is that the Scarlet S is toxic to health. When shame evokes distress, cortisol rises and systemic inflammation gets to work, wreaking havoc on a person’s health. It is more than coincidence that famous folks who are publicly shamed sometime die quickly thereafter. Think for a moment about the cases of Joseph McCarthy, Joe Paterno, and Roger Ailes.

So, maybe shame has a role to play in public life and the social order. But for public health, it’s worse than useless. It’s toxic.

Knock it off.

Click here for more from Joseph Burgo. For more on the physiologic response to shame, click here, here, and here. If you want perspective on shamelessness in public life, check out Jill Locke’s new book, reviewed here.

Christine Lagarde and Charlie Rose, photograph © International Monetary Fund / flickr

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November 23, 2017