How Therapists Can Help Clients Upend Shame and Stigma
Shame thrives in silence. For many women, deeply personal and painful experiences such as miscarriage, burnout, or illness are often met not with support, but with societal discomfort, platitudes, or even dismissal. As therapists, we’re uniquely positioned to disrupt this dynamic. But doing so requires intention, cultural awareness, and an active commitment to normalization.
Dr. Jessica Zucker, in conversation with Israa Nasir, shares 7 ways you can help clients move from internalized shame to empowered self-understanding.
1. Invite Storytelling as an Act of Reclamation
Clients often carry stories shaped by societal expectations, family myths, or medical gaslighting. Encouraging them to tell their stories fully, honestly, and without softening the edges can be a powerful first step toward healing. Storytelling helps clients reclaim their narrative from silence and shame and see their experiences within a larger context.
Clinical tip: Use narrative therapy techniques to help clients explore their stories, identify embedded beliefs, and rewrite internal scripts that equate suffering with personal failure.
2. Normalize the Collective, Not Just the Individual
When a client discloses a stigmatized experience, whether that’s a miscarriage, reproductive loss, burnout, or chronic illness, it’s important to frame it not as an anomaly, but as a common human experience. Shame isolates. Normalization connects.
Clinical tip: Offer psychoeducation that helps clients understand how common their experiences are. Use group therapy, bibliotherapy, or therapeutic disclosures (when appropriate) to foster connection and reduce isolation.
3. Explore the “Why” Behind Silence
Some clients may hesitate to talk about difficult experiences, even in therapy. Instead of pushing for disclosure, invite curiosity: Why is this hard to talk about? Is it privacy, cultural conditioning, fear of judgment, or unresolved shame?
Clinical tip: Gently guide clients to reflect on their reasons for staying quiet. This can reveal internalized stigma or inherited narratives that are ready to be challenged.
4. Name and Deconstruct Shame-Based Coping
Clients often blame themselves for things outside their control, especially in the face of loss. This self-blame can be a way to maintain the illusion of control. Recognizing this as a coping mechanism, rather than a flaw, is key.
Clinical tip: Help clients identify shame-driven thoughts and reframe them with compassion. Highlight the biological or circumstantial realities that challenge the myth of personal fault.
5. Model Emotionally Honest Support Language
Clients often report that even well-meaning friends and family make them feel worse with dismissive or minimizing comments. You can equip clients with the language to ask for the support they actually need and teach others by example.
Clinical tip: Work with clients to role-play or script assertive communication for moments when others invalidate their grief or pain. Model supportive language in session, reinforcing the value of presence over solutions.
6. Honor Cultural Context Without Reinforcing Limitations
Clients from collectivist or religious backgrounds may face added layers of shame, shaped by generational norms or expectations. While these frameworks can offer support, they can also reinforce silence or punishment for falling “out of line.”
Clinical tip: Explore how clients' cultural identities influence their emotional expression and coping strategies. Help them differentiate between inherited beliefs and their personal truth.
7. Stay Open to Ongoing Grief and Unresolved Pain
Healing is rarely linear. Clients may need to revisit the same pain over time, and therapists must resist the pressure (internal or external) to move on too quickly.
Clinical tip: Normalize the long tail of grief, especially in cases of invisible or disenfranchised loss. Create a space where clients can return to their pain without feeling like they’re “regressing.”
Therapists are not just healers. We are cultural disruptors. By giving our clients permission to feel, grieve, and speak the truth of their lives, we chip away at the systems that perpetuate shame. And in doing so, we help create a world where women's emotional realities are not just heard but also honored.
Based on patient stories, coupled with cutting-edge psychological research, Zucker fearlessly shares her insights into the shame and stigma that shroud so many women’s experiences and explores the lib
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Jessica Zucker, PhD, is a Los Angeles-based clinical psychologist specializing in reproductive and maternal mental health. Her writing has appeared in The New York Times, The Washington Post, New York Magazine, Vogue and Harvard Business Review, among other publications. She is the creator of the viral #IHadaMiscarriage campaign and has been featured on Good Morning America, The Today Show, CNN, and NPR. Dr. Zucker is the author of the award-winning book I Had a Miscarriage: A Memoir, a Movement.
(Author photo by Bonnie Tsang)
