Among the strong emotions we feel, shame is among the most painful. It is a feeling that one, as an individual, is not “good enough.”
Shame is different from guilt in that guilt arises from our actions that we believe violate others. Guilt is centered on our ability to empathize with how others perceive our actions, even if sometimes the root of our guilt is more perceived than actual. For example, we may perceive that we are not as good of a parent as another, when in reality, no parent is perfect but it is how we deal with our imperfections that positively influences our children more so than the imperfections themselves.
Instead, shame is an internal feeling of unworthiness or worthlessness. There is little room for empathy in shame, because we are so inwardly focused on our perceived faults. Guilt, when managed in a healthy way, can effectively motivate us to improve. Shame motivates us to hide parts of our emotional selves in an attempt to protect our hearts. Shame is a strong component of emotional trauma, a very uncomfortable and pervasive state of being.
Here to shed more light on emotional trauma — how it happens and how to heal — is Daniela F. Sieff, PhD, author of Understanding and Healing Emotional Trauma: Conversations with pioneering clinicians and researchers, a unique and very valuable collection of her conversations with pioneering clinicians and researchers in the area of shame, through this interview with API:
API: Thank you, Dr. Sieff, for this opportunity. To begin, please share about yourself and your background.
Dr. Sieff: Whilst growing up, I was curious about what made us who we are. I was equally curious about the different types of lives that people might live. And so, as an undergraduate, I did a wonderful interdisciplinary degree in which I studied anthropology, evolution, and psychology.
I found the evolutionary perspective particularly exciting. It encouraged me to think about being human in new ways. Keen to do my own research, I embarked on a PhD in which I explored how evolutionary processes contribute to shaping human social behavior.
This research took me to a wilderness region of Tanzania to live with the Datoga, a traditional cattle-herding society. Living with the Datoga brought deep learning, both academically and personally. It gave me extraordinary insights into lives that were both profoundly different to my own, and that had significant underlying similarities.
However, in time I came to feel that the formal world of academia was not for me. I also wanted to start exploring how internal dynamics shape us. In particular, I wanted to understand what I carried inside my own mind and body. My life had been very rich in terms of what I’d done, but my emotional life had often been painful. Wanting to change that, I committed myself to a therapeutic process, participated in workshops and studied books about trauma and attachment. Bringing together my personal experience with what I was learning through study, is what I mean by having “an active interest” in the dynamics of the psyche.
Dr. Sieff: My understanding of myself was changed by ideas that I came across, and I wanted to share those ideas in a way that was accessible to a wide range of people.
In particular, I wanted to present the ideas in ways that would connect with people who were trying to understand their own trauma, irrespective of whether or not they had a background in psychotherapy.
I also wanted to help parents, teachers, and social workers learn about the latest research. And I wanted to offer mental health professionals an opportunity to learn about approaches that were different to the ones in which they had been trained.
Interviews seemed the best way to achieve these goals. Interviews are informal, personal, and engaging. Yet at the same time, they can be structured to provide an in-depth and meaningful overview of crucial ideas.
Further, as the interviewer, I hoped I could articulate the perspective of the reader — asking the questions that had been important to me, and that might resonate with others.
Finally, because relationships are crucial to healing emotional trauma, it felt right for the book to have a relational structure.
It took me 8 years to gather the interviews and write this book!
Whilst working on each chapter, I took time to explore what was coming up for me personally. The people I asked to be interviewees had already made a profound contribution to how I experienced myself, and as I approached each chapter my psyche saw an opportunity to work with their insights more deeply.
API: The interviewees in your book come from different perspectives. What drew you to an interdisciplinary approach, and how does each perspective help to understand trauma?
Dr. Sieff: Trauma is a multi-layered phenomenon, and so it is best addressed in a multi-disciplinary way.
Further, each perspective — and indeed each interviewee — helps us to become more conscious of a different aspect of trauma. Lastly, what emerges when different perspectives are interwoven can be very refreshing and exciting.
The 3 perspectives explored are the ones that had contributed most to my own journey:
- Psychodynamic perspectives explore how trauma affects our unconscious world, our subjective experience of ourselves, and our relationships with other people. The psychotherapists interviewed for this part of the book are Donald Kalsched, Bruce Lloyd, Tina Stromsted, and Marion Woodman. Drawing on their professional and personal experience as well as on myths, poetry, and fairy tales, they invite us into the inner world of the unconscious mind and body, and articulate how it feels to live with trauma. They also bring to life the work required for healing.
- Neurobiological perspectives explore how the structure of our brains, neurobiology, and hormonal systems are affected by trauma. The therapist-academics interviewed in this section are Ellert Nijenhuis, Allan Schore, and Daniel Siegel. Drawing on professional experience, case studies, and literature as well as on attachment theory, developmental psychology, interpersonal neurobiology, and endocrinology, these interviewees help us see our life’s trajectory within a modern scientific framework. They also help us to understand the biological mechanisms that underlie healing.
- Evolutionary perspectives explore how our species’ deep past shapes the dynamics of emotional trauma. The academics interviewed here are James Chisholm, Sarah Blaffer Hrdy, and Randolph Nesse. Drawing on studies of hunter-gatherers, western societies, and non-human primates as well as on modern evolutionary theory, attachment theory, and developmental psychology, these interviewees take us into the world of our distant ancestors to show us why we are predisposed to find certain childhood experiences traumatizing. They also help us understand why we respond to traumatizing experiences in the ways that we do.
API: How do you define trauma?
Dr. Sieff: Popular culture tends to define trauma as being the victim of harm, and it portrays trauma as being located in the harmful experiences themselves. This is a problematic misunderstanding that hinders healing.
The word “trauma” means a wound, shock, or injury. Thus, trauma cannot be defined only by the negative experiences we suffer. Equally important is the impact of these experiences upon us. A painful and frightening experience might overwhelm one person and leave them with lasting emotional wounds, but not cause as much damage to another. It will depend on their age, innate sensitivity, unique personal history, and whether they have support.
When we experience pain and fear that overwhelms us, we develop an unconscious conviction that our life is at risk. As a result, survival systems are activated in our minds and in our bodies. These systems have evolved to protect us against dangers that arise both externally — from other people and the world in which we live — and internally: from within ourselves.
With the activation of these systems, we move onto a different developmental path to the one we would have followed, had we not been traumatized. Once on this pathway, we live our lives from inside an altered biological and psychological
I’ve called this altered reality a “trauma-world.” It is the entry into a trauma-world that defines trauma, not the experiences we’ve suffered.
API: What constitutes a trauma-world?
Dr. Sieff: That varies from person to person, again depending on our individual experiences and unique disposition. However, 3 systems form the core of all trauma-worlds:
- We perceive the world through a veil of fear — We are intrinsically wary of the world around us and mistrustful of other people. We are equally uneasy about what lies inside us.
- We disconnect from aspects of ourselves — We dissociate overwhelming emotions, we bury any parts of ourselves that attract disapproval, and we separate from our bodies.
- Our identity becomes interwoven with shame — We live with a visceral and pervasive feeling of being fundamentally flawed and inadequate.
Fear, disconnection, and shame distort both our inner and outer reality. They distort inner reality by compromising our relationship with ourselves, and they distort outer reality by compromising our relationships with others.
Moreover, if a trauma-world is created during childhood, these distortions become our “normality,” and we are unable to recognize what we are living. Then, we have little choice but to behave in ways that create repetitive and self-perpetuating cycles of trauma, both in ourselves and others.
Entering a trauma-world does not happen as a result of a conscious decision. It is what human brains and bodies have evolved to do in the face of overwhelming pain or fear. What is more, a trauma-world is not created in the relatively accessible cognitive systems of the brain. Rather, it is “hidden” in the biological systems — muscles, hormones, nervous system, and brain structure — that underlie our feelings and our ways of perceiving and engaging with the world.
API: What kinds of experiences leave us at risk of creating a trauma-world?
Dr. Sieff: The most obvious are those that cause acute pain or fear, such as overt abuse or neglect, [as well as] growing up amongst violence, experiencing war, or witnessing atrocities.
Less obvious, but equally damaging is the insidious, chronic, and ongoing pain and fear of growing up feeling unloved, unvalued, or inadequate. The consequences of what we didn’t have are often hard to identify, but they can be just as wounding as the consequences of what happened to us. From the perspective of attachment theory, this can be seen as growing up with an insecure attachment pattern.
Attachment research also shows us that trauma is triggered in infants and young children when parents or caregivers are unable to attune to them sensitively — perhaps because the caregivers are themselves stressed, depressed, ill, or carrying trauma.
Sometimes, trauma comes to us across generations. When our parents and grandparents carried unresolved trauma, we inherited their fears and distorted perceptions and our trauma-world is built around their experiences. Research is revealing that it is not pain and fear alone that constellate trauma. Rather, trauma is constellated when we experience pain and fear, and there is nobody present to help us process these emotions.
An evolutionary perspective suggests why this might be the case. For our ancestors, being part of a social network was crucial to survival. In the environment in which we evolved, children and adults who had no social support were likely to die. Consequently, we feel safe when accompanied, but in very real danger when alone. Suffering trauma, and having no support, will heighten our fear and contribute to the sense that our life is at risk.
API: Can you talk about the fear at the core of a trauma-world?
Dr. Sieff: In response to experiencing overwhelming pain or fear, biological changes occur that leave our minds and bodies extremely sensitive to potential danger.
There are many harmful consequences to having a sensitized fear system. However, if we live in a dangerous environment, suffering these consequences is the lesser of two evils, because without being alert to danger, we are likely to die young. In fact, the ability of minds and bodies to become more fearful in dangerous environments is the product of evolution, and exists in many different animal species.
We are particularly alert to danger around the original traumatizing experiences. At the center of a trauma-world is the imperative to avoid retraumatization. Often, this imperative is held unconsciously, so we don’t know that it is driving us. All the same, it impacts our lives in ways that can cause as much, if not more, pain than the original wounding.
Sometimes, it is impossible to avoid situations that appear similar to the one that traumatized us. When this happens, our old trauma comes back to life — not as a memory of the past, but as a fear-driven, knee-jerk reaction. I’ve called these “trauma-reactions.”
Trauma-reactions are generally built around the mammalian responses to danger: freeze, flight, fight, and submission — though in each of us they will take a unique form.
Trauma-reactions seem to come out of nowhere. That is because of the way that traumatizing events are recorded in our memories. Normally, when we commit an event to memory, a tag is added to the event recording when and where it occurred. When these memories are activated, the tags inform us that the experience happened at a particular moment in our past. In contrast, overwhelming painful and frightening experiences are committed to memory without being tagged with a time and place.
Consequently, when these memories are activated, we aren’t aware that we remembering the past. Instead, we relive the visceral feelings and reactions of earlier experiences as if they were present reality. This kind of memory is called “implicit” or “procedural” memory.
It is easier to get a sense of implicit memory if we think about riding a bicycle: When we get on a bicycle, we don’t consciously remember learning to contract this muscle, or to lean in that direction; rather what we learned during childhood is implicitly written into our nervous system and muscles, and that memory comes alive as a set of lived reactions.
The advantage of implicit memory is that it enables us to react almost instantaneously, and it is easy to see how that is valuable with a skill like bicycle-riding. Similarly, growing up in a dangerous environment, the ability to react virtually instantaneously can save our lives.
However, with trauma-reactions this instantaneous response can also be problematic, because the implicit memory will sometimes be activated when there is no danger. Worse, because we will be unaware that our traumatic memories have come back to life, we’ll be convinced that what we are feeling is happening right now. As a result, we are likely to behave in ways that recreate the very situation we are trying to avoid.
When thinking about childhood trauma, we need to be aware that throughout our evolutionary history, danger hasn’t only come from predators and illness — it has also come from parents.
In fact, anthropologists now know that for our ancestors, the greatest danger faced by infants was being abandoned to die by a mother who didn’t have the resources to care for another child. It could be that the mother already had a nursing child, or she might be lacking in social support, or there could be a famine. Either way, for ancestral human infants, an inattentive mother would have been implicitly terrifying, because it would have indicated that the infant’s life was at risk.
API: Disconnection is the second system that you include in a trauma-world. Can you tell us more about disconnection and trauma?
Dr. Sieff: Disconnection involves cutting off from some aspect of ourselves. There are different forms that disconnection can take. All provide us with some kind of protection, but all are ultimately harmful, because they leave us cut off from our own internal reality and from the reality of the external situation.
Disconnection first occurs during the original traumatizing experience. In the midst of a terrible situation, the release of opiates from within us blocks the pain and fear coursing through our bodies, and we are numbed to the feelings. This is an adaptive response, because it means that if we get a chance to escape, we can take it — whereas escape would be impossible if we were incapacitated by pain and fear.
Once we are out of danger, and if we have enough support, we may be able to reconnect to our pain and fear, and process them. However, without support, our unprocessed emotions remain locked away in our unconscious minds and bodies. This is because we simply can’t function if we allow overwhelming emotions into awareness.
There are many harmful consequences of remaining disconnected from the traumatizing pain and fear we’ve experienced:
First, we are compelled to avoid anything that might bring our unprocessed emotions into awareness. This compulsion to protect ourselves from what was once overwhelming poison in our relationships, creates a desperate need for control and prevents us from taking new opportunities. It can also lead to attempts to sabotage the healing process.
Second, having locked the overwhelming pain and fear in our bodies, we must disconnect from our bodies to prevent these feelings from surfacing. This creates new layers of suffering and difficulties:
- Bodies that carry unprocessed pain and fear can become distorted. Parts of our body may be chronically frozen, collapsed, tense, or inflamed. Our posture might be off-kilter. Our breathing shallow. We might stutter.
- We may be at risk of being drawn into addictions, both those that take us out of our bodies, and those which represent our bodies’ desperate attempts to be noticed and nurtured.
- Needing to understand why we ended up traumatized, it is all too easy to blame our alienated bodies. Thereafter we try to perfect our bodies through compulsive dieting, obsessive exercising, or an endless string of plastic surgeries. In so doing, we become further alienated from our bodies.
- We lose access not just to the original pain and fear, but to emotions more generally. Because emotions arise in the body, when we disconnect from our body, we prevent all emotions from making their way freely into our awareness. As a result, we may feel flattened, dulled, and lacking in vibrancy. Additionally, emotions evolved to guide our responses to the world, so when we can’t access this information, it is as though we have lost our compass, and the sense of danger that is already part of our trauma-worlds becomes more intense.
Third, in its most extreme form, the drive to separate from the pain and fear of the original trauma can result in a dissociative identity disorder.
Underlying the disconnection that I’ve just discussed is a deep fear of the unprocessed and overwhelming emotions that we experienced during the past, as part of the original trauma. There is another kind of disconnection, too — one which is underlain by fear of being attacked or abandoned in the present. This typically occurs when certain parts of ourselves are unacceptable to our family, teachers, or society. Under these circumstances, we cut off or bury the unacceptable parts in an attempt to protect ourselves from the possibility of being retraumatized.
The parts we cut off might be so-called “negative” emotions like pain, fear, or anger, but we can just as easily bury our joy, passion, vulnerability, sexuality, intellect, ambition, and creativity. We might also disconnect from our need for love and connection, or from our need for independence and self-expression.
Sometimes, we try to bury the unacceptable parts of ourselves using self-control and willpower. Other times, critical inner voices try to shame these parts into submission. Sometimes, the “unacceptable” parts are locked in our bodies, perhaps through clenching particular muscles, and by adopting a specific posture. But often this kind of disconnection occurs unconsciously — we are unaware of what we have lost.
Being cut off from parts of ourselves contributes to the underlying sense of loneliness that is inherent to trauma, because we are abandoning aspects of who we are. It also exacerbates the sense of danger that is built into a trauma-world, because we are not rooted in the fullness our own reality.
API: Shame is the third system that you say is intrinsic to a trauma-world. Can you expand on this?
Dr. Sieff: Shame is a visceral and pervasive feeling of being fundamentally flawed and inadequate as a human being. Shame is primarily relational: Although shame leaves us feeling absolutely alone, its roots lie in an implicit conviction that we are somehow unworthy of having meaningful relationships with other people.
Shame is often confused with guilt, but with guilt, we feel bad about things we have done. With shame, we feel bad about who we are.
Guilt is about our actions. Shame is about our being.
Shame is mediated by the emotional networks of the brain, so although shame is typically accompanied by self-critical thoughts like “I am stupid/useless/fat/pathetic,” it is ultimately lived as an embodied experience that resides deep beneath our awareness and sucks us into the psychological equivalent of a black hole.
Shame is a product of evolution, and it is experienced as a passing emotion in almost everybody. It exists to tell us that we are at risk of losing important social relationships, or that we might be thrown out of our group. However, if we’ve been traumatized, then shame becomes indelibly interwoven with our implicit sense of who we are, whereupon our identity becomes “shame-based.”
There are several routes to becoming shame-based:
- First, shame can originate outside of us — When we are made to feel inadequate by our family, caregivers, teachers, peers, culture, or socio-political environment, we absorb that shame and make it our own. In this case, being shamed constitutes the original painful and frightening experience around which our trauma-world is built.
- Second, human infants need sensitive and responsive nurturing from caregivers — When this need is not met, children develop an embodied and nonverbal sense of being inadequate. They also develop an embodied and nonverbal sense of inadequacy around their actual need for nurturing, itself — implicitly feeling that there must be something wrong with them for having the needs.
- Third, shame can originate inside us as a response to more overt traumatizing experiences — Painful and frightening experiences occur that have nothing to do with being shamed. However, we have evolved a need to understand why these things have happened to us, and for various reasons, we tend to believe that we are at fault. For example, children whose parents divorce commonly feel that if they had been “better,” their parents would have stayed together.
- Fourth, once we’ve entered a trauma-world, shame can be created in response to our own behavior — There are times when we know we are over-reacting. However, because we aren’t aware that our fear system is hyper-sensitive, we take our behavior as evidence of our own supposed inadequacy. In addition, when we bury parts of ourselves in order to make ourselves acceptable to others, we implicitly sense that we are being inauthentic, which in turn creates shame.
Irrespective of how our shame originates, once we’ve become shame-based, we can’t recognize shame for what it is. Thus, we see ourselves through a distorted lens. As a result, we are likely to experience ourselves as contemptible and feel a victim to our own believed inadequacy.
In this state, we get sucked into a downward spiral of shame. We can become even more desperate to obliterate the parts of ourselves that we believe make us inadequate, redoubling our efforts to shame those parts into submission. However, when we use shame against ourselves, we retraumatize ourselves. Then, instead of fostering change, we reinforce the status quo and fortify the walls of our trauma-world.
At the same time, we try to cajole ourselves into success, believing that if we can force ourselves to become more than we are — or ideally perfect — then the gnawing pain of being shame-based will abate. However, if we are shame-based, then no amount of success will be enough. No matter what we do, we are never enough.
Being shame-based doesn’t only poison our relationship with ourselves, it also poisons our relationships with others. When we are shame-based, we will be terrified that if others get to know us, they will see us as the inadequate person we believe ourselves to be, and in an unconscious attempt to prevent that from happening, we may put up barriers, push people away, and sabotage relationships. Alternatively, we may try to control others, hoping that we can prevent them from doing anything that might bring our shame to the surface.
We are generally not conscious of what we are doing, or indeed why we are doing it. However, we are left with a murky feeling that our relationships lack authenticity, trust, and intimacy. As a result, we feel increasingly isolated.
Also, because human beings are such a profoundly social species, when we don’t have meaningful relationships, we feel sub-human, and that, in turn, exacerbates our shame.
In short, shame creates more shame. Shame also generates isolation and fear. And shame reinforces the need to disconnect. Ultimately, shame keeps us locked in our trauma-worlds.
API: How can a person heal emotional trauma? What is the process?
Dr. Sieff: One of the challenges for healing is that although trauma-worlds are created in response to external events, once established, they form rigid and closed internal systems.
Locked inside these systems, our behavior sets us up to be retraumatized by other people. Additionally, the ways that we behave toward ourselves are invariably retraumatizing. Trauma-worlds are self-perpetuating.
Locked inside these systems, we also struggle to see trauma for what it is. That leaves us little choice but to focus on the visible symptoms and the chronic, deadening pain they create. These symptoms include the fear, disconnection, and shame that lie at the heart of a trauma-world — also depression, meaninglessness, addictions, self-harm, rage, and unexplained physical pain and ailments. Additionally, we are likely to struggle in our relationships and to sabotage things we care about.
Focusing on such symptoms, we — as individuals and as a society — put our resources into trying to alleviate them, perhaps through short-term therapy or psychotherapeutic drugs, or by pinning our hopes to something like success at work, a new romantic relationship, losing weight, or cosmetic surgery. This can give us temporary respite, but it won’t free us from the internal systems that were set up in the wake of the traumatizing experiences, so in time we fall back into our suffering.
Even when we can see beneath the symptoms to the underlying traumatizing experiences, we are unlikely to recognize the trauma-worlds in which we are living, so our first port of call is to blame whoever, or whatever, caused the original wounds and look for retribution.
That is a valuable first step and a necessary part of the process, for we do need to recognize what happened to us. We need to validate the experience and understand that it was not our fault. However, focusing on the traumatizing experience or on punishing the perpetrators is not enough by itself to bring deep healing, because that won’t change the embodied systems that form our trauma-worlds. It’s akin to being hit by a drunken driver and having our leg broken. Focusing on the accident and jailing the driver won’t heal our leg.
Healing trauma requires the courage to recognize that ultimately our lives are compromised not by the original traumatizing experiences themselves, but by the trauma-world that is created by our own minds and bodies as a response to those experiences. And we need to recognize this reality without blaming and judging ourselves — we need to understand that creating a trauma-world is what human beings do to survive.
At the same time, we have to take responsibility for our healing, and for moving out of our trauma-worlds.
API: Can you share on what you mean by “taking responsibility for our own healing”?
Dr. Sieff: Developing a cognitive awareness of the original traumatizing experiences, and of the systems created in their wake, is a good start to the process of taking responsibility for our own healing. But it is not enough.
To create lasting change, we have to enter into our emotional minds and bodies and slowly become aware of what we carry from the inside.
That means opening to the original traumatizing pain and fear, learning how to tolerate it, and integrating it into our sense of who we are. It is only when we find ways of relating to our buried pain and fear that our lives are no longer organized around the imperative to avoid anything which might trigger what we carry in our depths. However, this is an extremely challenging process: We need to do it slowly, taking one small step at a time.
Equally crucial is that we work with the fear, disconnection, and shame that form our trauma-worlds:
- First, we must enter into these systems and become conscious of how we feel in both our minds and bodies when they are active.
- Then, we have to challenge our shame, reconnect to the exiled parts of ourselves, and learn to live with our sensitized fear system.
- Finally, we need to develop new, and healthier, ways to protect ourselves.
It is hard, daunting, and arduous work. Our trauma-worlds were created to survive overwhelming pain and fear. When we try to transform them, we are besieged with the conviction that we will be annihilated. That conviction leaves us at risk of sabotaging the healing process. Thus, we need patience, perseverance, determination, and courage. It is also imperative that we have support and guidance from those who have been through the process themselves.
To heal trauma, we not only need an embodied consciousness of what we carry from our past, we also need new experiences. Real change happens in the present moment through lived experience.
This need for new experiences is one of the many reasons why we can’t heal trauma alone. Emotional trauma arises because something has gone awry in our relationships, so a healing relationship is crucially important if we are to learn how to connect to other people and to ourselves in healthier ways. Similarly, we need support if we are going to approach the unprocessed pain and fear that was once unbearable, and we also need guidance if we are to transform the fearfulness, disconnection, and shame that lie at the heart of our trauma-worlds.
A healing relationship can be provided by a therapist, counselor, teacher, social worker, spiritual guide, or healing group — the label doesn’t matter. What does matter is that whoever is accompanying us has worked deeply with his or her own trauma. Healing trauma is akin to learning to speak a language like Chinese: It is not enough that our teacher has a theoretical knowledge of the grammar and that she can recognize the characters when they are written on the page; rather she must speak the language herself.
API: What does it mean to be healed?
Dr. Sieff: When we embark on trying to heal trauma, we typically imagine that we will reach a place where our lives are free from the suffering that arises from our wounds, and where trauma no longer has any effect on our lives.
That is not what happens. We cannot change our past. Our trauma remains part of us. What can be changed is its impact. To achieve that, we have to find new and healthier ways of being with the pain and fear embedded in the traumatizing experiences, and just as importantly, we have to transform the trauma-world that developed around them.
It is a challenging process. It takes time. Many people, and indeed most public health services, look for an easier and faster route. But there is no easy route. To address trauma in a meaningful way, we need to commit ourselves to this challenge. And I believe it is vitally important that we make this commitment, not only to help ourselves, but also because when we carry unaddressed trauma, we have no choice but to relate to our children, family, neighbors, and colleagues in ways that are likely to result in them becoming traumatized.
In contrast, when we transform our trauma-worlds, we break that spiral and start relating to ourselves, other people, and the world around us in much healthier and more nurturing ways.
API: Thank you so much, Daniela, for your wise words and insight! Your knowledge surrounding shame and trauma is certain to change lives and has the potential to change the world.
Interview by Rita Brhel, API