Since the previous Clinical Tip was about guilt as an emotional cause of disease, it makes sense to discuss now shame as an emotional cause of disease. I think that shame is as common as guilt in Western patients while it could be argued that Eastern societies are more prone to shame than guilt. Shame may be caused by a feeling of shame about one's behaviour in breaking society’s rules or customs; more commonly, it is an in-born feeling of shame due to one's upbringing. It is a feeling of blame which often makes one feels “dirty”; with shame, one feels that one has to hide from the frowning look of society. One feels observed all the time. According to Solomon, in small doses, shame is an affirmation of one's autonomy, a confirmation that one will live by one's standards and accept responsibility. In small doses, shame is conducive to self-esteem. However, in larger doses, shame is overwhelming and it is self-demeaning, making one extremely defensive and impotent. As a ...