The Evolution of Anxiety Starts at Shame

Social anxiety disorder and paranoid anxiety disorder linked to internal and external expressions of shame

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Charles Darwin’s ideas of evolution are supported yet again, this time by psychologists studying anxiety.

While investigating the pathologies of social and paranoid anxiety disorders, researchers determined that unique expressions of shame cause the underlying disorders.

Social anxiety disorder (SAD) patients tend to feel personally shameful where those with paranoid anxiety seem to be ashamed of others.

"Talk to a therapist about treatment options to help with feelings of shame."

“Social wariness and anxiety can take different forms,” explains senior author on the study, José Pinto-Gouveia, M.D., Ph.D. “Paranoid anxiety focuses on the malevolence of others, whereas social anxiety focuses on the inadequacies in the self in competing for social position and social acceptance.”

Dr. Pinto-Gouveia used self-reporting questionnaires to assess the impact of shame on 328 everyday people. The assessments asked about memories associated with embarrassment or trauma as well as diagnosis questions to assess for symptoms of paranoia or social anxiety.

The results concluded that feelings of distaste or regret for others manifest themselves in paranoia while self-loathing causes social anxiety. In both cases, shame memories functioned as a central point of reference for the individual’s life story.

People suffering from both paranoid anxiety and social anxiety identify themselves by their ideas of shame, creating an on-going environment of judgment in their minds.

“Shame and shame memories are distinctively related to paranoia and social anxiety,” states Pinto-Gouveia. “External shame is especially associated with paranoid ideation, whereas internal shame is specifically linked to social anxiety.”

dailyRx contributing expert, Peter Strong, Ph.D., practices cognitive therapy online via Skype, frequently dealing with mental health issues related to shame.

Dr. Strong explains, “Shame is a core emotion that is in great need of our care and attention." He expresses to dailyRx that acceptance of shameful thoughts, whether they be internal or external, is the “key” for recovery from pessimistic thoughts and shameful emotions.

According to Dr. Pinto-Gouveia, the traumatic impact and ever-presence of shameful memories could be used in the future to diagnose paranoid anxiety disorder, and according to Dr. Strong, the eventual acceptance of shame could be a crucial turning point in the road to recovery.

Both mental health professionals believe that treatment of social or paranoid anxiety should incorporate specific therapies to address shame and shameful memories.  

This study was published in the journal Clinical Psychology and Psychotherapy through the Cognitive and Behavioural Research Centre at the University of Coimbra and the Mental Health Research Unit at the University of Derby in Portugal.   No conflicts were reported.  

Reviewed by: 
Review Date: 
February 2, 2012
Last Updated:
February 3, 2012