Shame is a basic human experience which is a destructive part of our culture. We all go to dental seminars featuring slides of perfectly shaped and colored crowns with perfect margins over perfectly pink gums. I attended a meeting recently where the presenter stated he never caused bleeding while preparing a crown. Huh? Is my dentistry good enough? Am I good enough? What about Dr. So-and-So down the street? I wonder how good he is. He’s probably better than I am. He says so in his ads.
We dentists practice on small islands isolated within a sea of perfectionism. Our concept of that perfection is often unrealistic. We can’t settle for just being good. We need to be perfect. Notwithstanding noble efforts to connect through our association and study clubs, we also are in many ways disconnected. This disconnect, coupled with our profession’s striving for perfection, can lead to a sense of shame, a sense that we in some way fall short.
Disconnection is both the source and consequence of shame. Shame is the fear of disconnection, of being perceived as flawed or unworthy. Conversely, shame keeps us from telling our stories or listening to others’ out of fear of not belonging. Humans are “wired for connection” to others, but shame unravels this connection. Inside all of us is a need to be accepted and to belong, but the culture of dentistry, in dictating what is acceptable and what is not, can unknowingly shame us through its messages and expectations.
We can never resist shame completely, but we can become resilient to it. The antidote is courage, courage to speak from our hearts about who we are and about our experiences - both good and bad. This courage comes with risks, of course. Your words may be misinterpreted, for one. You may be judged, for another. You may expose yourself to the self-righteous – in response, getting, “I’ve never had that problem,” instead of, “Me too!” You may get silence. You may walk away feeling worse and them feeling better. Those are the risks you take by being forthright. The pay-off is you being you — honestly without apologies. Most appreciate that. Brené Brown in her book I Thought It Was Just Me (but it isn’t) defines this as “ordinary courage”.
Besides the courage to speak the truth, empathy with our colleagues and their plights arms us against shame. It helps us understand others and enriches our relationships. “The prerequisite for empathy is compassion.” To be empathetic we must be willing to listen. Compassion is not a birth-right. It is a commitment which we freely choose.
As well, shame is not guilt. Shame is “I am bad.” It is about who we are, and it is paralyzing. Guilt is “I did something bad.” It is about our behavior, and it is a positive motivator for change.
We experience shame from community-wide sources – mass media, family, friends, co-workers, church, music, teachers, etc. They dictate to us who, what, and how we should be. These sources make up what Brené Brown calls the “shame web”.
On the other hand, we can build “connection networks” of people and organizations who connect through “mutual support, shared experiences, acceptance, and belonging”. They are those with whom you can just be yourself. Shame is silent, secret, and undetected. By exposing shame and reaching out, these networks build our resistance to it.
Remember also that we are incredibly hard on ourselves. We are often a member of our own shame web, and actively contribute to our own shame. Instead, we must join our own connection network, not indulging in self-judgment, but practicing self-acceptance. Additionally, when problems arise at work, claim and acknowledge your strengths and use them to make changes. We cannot change and grow when we are in shame, and we can’t use shame to change ourselves or others! Why do we focus on our shortcomings and take our strengths for granted? Instead, build upon your strengths and use them to meet your goals.
Be authentic! Have a clear sense of who you are and what you believe in. Communicate that to others. Be who you are no matter who you’re with or what the circumstances. This is the essence of authenticity. Being something you’re not only creates more shame. Unfortunately, our need to “fit in” or appear normal often supersedes being real, genuine, or sincere.
A relationship with God, a higher power, or the spiritual world can offer resilience to shame. Faith nurtures the best in us, and shame moves us away from that. Sources of shame are connected to the earthly, man-made expectations we have, and move us away from spiritual growth. By having a relationship with a God who loves you as you are, the worse shame is dissipated.
Brown offers help to combat shame by her Shame Resilience Theory, part of which is to:
1. Recognize shame and what your specific triggers toward shame are.
2. Develop a critical awareness or understanding of the link between your personal experiences of shame and the larger community. Shame is like the zoom lens of a camera. In shame, the camera is zoomed in and all we see is ourselves- flawed and alone. When we zoom out, we see the larger landscape - others are in the same boat, and we discover “I’m not alone!”
3. Reach out to others.
4. Speak shame so you can communicate how you feel to others.
We must in dentistry nurture a culture of connection. How can we do this? Mavis Leno, women’s rights activist, in April 2006 said, “If you want to make a difference, the next time you see someone being cruel to another human being, take it personally. Take it personally because it IS personal.” If you want to change something, make it personal. It doesn’t take earth-shattering events — it “takes critical mass”. Small changes in each of us lead to big changes. Real change begins with ordinary courage.
As Brené Brown puts it in the introduction to her book, “Real freedom is about setting others free. In the spirit of that powerful definition, my greatest hope is that we will reach out across our differences and through our shame to share our stories and to connect with those who need to hear, ‘you are not alone!’”
Please e-mail us at firstname.lastname@example.org or fax us at (612) 339-3618. We look forward to hearing from you not only regarding this article, but also if you have any ethical dilemmas you would like to present to the membership. Perhaps we can help you decide what to do.
*Dr. Churchill is Chair of the Minnesota Dental Association’s Committee on Ethics, Bylaws, and Constitution. He is a general dentist in private practice in Minneapolis, Minnesota.
**Information and quotations for this article are from I Thought It Was Just Me (but it isn’t) by Brené Brown, Penguin Group (USA), Inc., 375 Hudson Street, New York, NY, 10014, copyright 2007.