Brain and body dimensions

Shame engages brain regions involved in self-focus, self and social evaluation and moral reasoning (dorsolateral, ventrolateral and dorsomedial prefrontal cortex, anterior insula, posterior cingulate, parahippocampal and sensorimotor cortex) (Fig. 1(a)). This pattern highlights the cognitive and emotional complexity of shame, and its strong focus on the self and perceived social failure. ^{Reference Bastin, Harrison, Davey, Moll and Whittle3} Described brain networks support both the adaptive function – regulating behaviour to avoid social devaluation, ^{Reference Sznycer1} and the excessive emotional burden.

Fig. 1 The dimensions and continuum of shame. (a) The multidimensional nature of shame across four interacting dimensions: brain and body, psychological, sociocultural and institutional. The left side illustrates neurophysiological pathways activated during shame and stress responses, highlighting predictive processing between cortical and limbic areas and peripheral systems via the autonomic and gut–brain axes. Shame’s psychological dimension involves self-conscious emotions, internalised stigma and unresolved trauma. Socioculturally, it is shaped by social norms, public scrutiny and collective narratives. Institutionally, shame is reinforced through blame cultures in systems that include healthcare, education and leadership. (b) A continuum of shame expressions, ranging from adaptive to maladaptive, along with strategies for intervention and repair. These evidence-based approaches include trauma-informed care, emotional literacy, accountable leadership and culturally responsive reframing. This integrative framework repositions shame – from a hidden burden to a target for systemic awareness and healing. PFC, prefrontal cortex; AI, anterior insula; PCC, posterior cingulate cortex; PHC, parahippocampal cortex; SMC, sensorimotor cortex; HPA, hypothalamic–pituitary–adrenal.

Shame and guilt partially share overlapping circuits, such as the medial prefrontal cortex, anterior insula and posterior cingulate cortex. However, shame engages regions including the dorsal medial prefrontal cortex and anterior insula more strongly, reflecting its emphasis on social threat and bodily self-awareness. ^{Reference Baez, García, Santamaría-García, Ibáñez, Sedeño and García2,Reference Bastin, Harrison, Davey, Moll and Whittle3} Guilt, in contrast, shows greater involvement of the ventromedial prefrontal cortex and subgenual anterior cingulate. Despite these subtle distinctions, the neural representation of shame and guilt is neither highly specific nor modular; instead, it is dynamic and shaped by individual, cultural and contextual factors.

Shame has distinct physiological effects across bodily systems (Fig. 1(a)). It activates the sympathetic nervous system, increasing heart rate, blood pressure and skin conductance. Intense or chronic shame may trigger a parasympathetic ‘freeze’ response, with reduced heart rate variability and emotional numbing. It is linked to elevated cortisol (via the hypothalamic–pituitary–adrenal axis), reflecting prolonged stress and reduced vagal tone, which impairs emotional regulation and social engagement. ^{Reference Baez, García, Santamaría-García, Ibáñez, Sedeño and García2,Reference Bastin, Harrison, Davey, Moll and Whittle3} Gastrointestinal symptoms such as nausea or stomach tightness point to gut–brain axis involvement. When persistent, shame may drive inflammation and metabolic dysregulation, contributing to depression, obesity and autoimmune conditions.

Psychological dimensions

Psychologically, shame involves intense feelings of worthlessness and a desire to hide or withdraw. Shame regulates behaviour via self-evaluation, fear of rejection, sensitivity to social comparison and negative self-beliefs. Shame often arises from internalised stress or trauma, particularly in early relationships that undermine confidence. Adverse childhood experiences such as abuse, neglect, emotional invalidation or bullying can lead to internalised shame. Shame is associated with secrecy and isolation, and can trigger explosive and angry outbursts and lead to risky behaviours. Shame is difficult to confront because it erodes interpersonal connections, ^{Reference Sznycer1} promoting maladaptive coping strategies including perfectionism and emotional and behaviour dysregulation. Not all shame is pathological. Normative shame can regulate social behaviour and moral learning, whereas pathological shame involves persistent self-devaluation, rigidity or trauma-based internalisation that generalises across contexts and impairs functioning.

Social, cultural, political and institutional dimensions

Sensitivity to shame varies across individuals, shaped by temperament, attachment history, early life experiences and cultural socialisation. Within organisations, rigid hierarchies and public evaluation can heighten shame reactivity; supportive leadership, confidential feedback and error-reporting systems focused on learning processes, growth of mindset-framing (‘skills are improvable’) and self-determination skills to support autonomy, competence, relatedness and motivation, rather than blame–shame situations, can buffer these effects. From an evolutionary perspective, shame probably emerged as a regulatory mechanism that reinforces social cohesion, shaping social behaviours and stimulating conformity to collective norms. ^{Reference Landers and Sznycer4} Experiencing shame following social transgressions discourages behaviours detrimental to group harmony, thus minimising conflict, avoiding social exclusion and enhancing group stability and trust. ^{Reference Landers and Sznycer4}

At a societal level, shame plays a role in maintaining social order, norms and morality. ^{Reference Schaumberg and Skowronek5} Societies often differ regarding the role of shame in their culture. In shame-oriented cultures there is a pronounced emphasis on collective conformity, moral standards and avoiding public disgrace. ^{Reference Schaumberg and Skowronek5} Conversely, in Western contexts, shame can emphasise individual responsibility, private moral accountability and an internalised conscience. Thus, shame not only guides individual behaviour but also reflects and reinforces broader cultural values. ^{Reference Matos, Galhardo, Moura-Ramos, Steindl, Bortolon and Hiramatsu6} Collectivist societies such as Japan and Singapore have reported higher levels of external shame. Individualistic cultures such as Australia and France have shown the pre-eminence of personal standards and internal evaluations. ^{Reference Matos, Galhardo, Moura-Ramos, Steindl, Bortolon and Hiramatsu6} Understanding cultural nuances is crucial for developing situated psychological assessments and interventions.

Politically, shame often enforces social conformity, stigmatises behaviours or groups and shapes collective sentiments. Shame has reinforced public accountability among political figures. However, recent shifts toward a ‘post-shame’ culture have eroded these norms. Countries frequently use ‘naming and shaming’ to address human rights violations. Domestically, shame can be weaponised to delegitimise opponents, fuel identity politics and deepen polarisation.

Shame can also operate at the intersection of multiple social identities, compounding the effects of stigma and systemic inequities. Individuals from marginalised groups – such as racial and ethnic minorities, lesbian, gay, bisexual, transgender and queer or questioning individuals, or women in male-dominated academic environments – may experience shame interpersonally and social exclusion. Across societies, shame is often invoked to preserve traditions or enforce role expectations – for instance, concealing mental illness to ‘protect’ family honour or sanctioning women who defy gender norms. Such practices can sustain group identity while perpetuating stigma and exclusion.

Leveraging shame for positive change at individual and societal levels

Understanding shame from sociocultural, institutional and neuropsychological perspectives offers opportunities for personal growth and social transformation (Fig. 1(b)). By recognising shame’s roots in brain processes such as social evaluation and emotional regulation, targeted interventions can reduce pathological shame and promote mental health, resilience and self-compassion. Culturally aware approaches can better address shame-related stigma. Reframing shame in public discourse (from stigmatising to fostering empathy and accountability) can drive prosocial behaviour and civic responsibility. Public health and education efforts that leverage shame constructively can enhance social cohesion and promote compassionate, equitable policies. Thus, an integrated approach can significantly enhance shame-related dynamics at individual and societal levels.

Shame is a powerful emotion rooted in secrecy, often making us feel damaged and unworthy. Its impact spans psychological, neurocognitive, sociocultural and institutional domains. Addressing shame requires naming and understanding it; tracing its roots in trauma, early experiences and societal norms. Rather than seeing it as a personal flaw, we must treat shame as a public health and relational issue, calling for systemic, empathic and culturally sensitive responses. Building shame competence in education, healthcare and leadership can foster safer spaces for learning, healing and growth.