title: Shame and the fear of feeling.
abstract: OBJECTIVE
  Toxic shame and the concomitant fear of feeling are core issues needing to be addressed during group therapy with adult survivors of childhood sexual abuse.
  
  
  OBJECTIVE
  To increase awareness of the toxic shame that survivors experience and to describe the impact of group therapy based on a family systems model.
  
  
  METHODS
  The authors' clinical experiences.
  
  
  CONCLUSIONS
  Symptom management, repatterning of cognitive distortions, and the improvement of self-care strategies are identified as crucial aspects of healing shame-based feelings and behaviors. Group treatment offers members the opportunity to cease reenacting family rules and roles that create toxic shame.
authors.affiliation: University of Akron, College of Nursing, OH, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Zupancic
authors.forename: M C
authors.initials: MC
authors.lastname: Kreidler
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D002675:Child, Preschool; D005190:Family / Q000523:psychology*; D005196:Family Therapy / Q000379:methods*; D005239:Fear; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D016294:Models, Nursing; D011568:Psychiatric Nursing / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods*; D012380:Role; D012648:Self Care / Q000379:methods / Q000523:psychology; D012752:Shame; D017741:Survivors / Q000523:psychology*