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Shame can be an emotion made of an impression of inferiority, of unworthiness, of lowering oneself in the opinion of others. It is then likely to be associated with a feeling of dishonor, humiliation, embarrassment felt by scruples of conscience, and fear of ridicule. This notion is not unlike that of guilt. If guilt and shame both concern a perceived or real moral transgression (regardless of any intention), guilt is externalized and focused on behavior, whereas shame concerns the internalization of this transgression. In chronic pain, shame and guilt can manifest themselves at the level of the disease, the person affected, and the loss of belonging to the social group, through the questioning of the person suffering from chronic pain, who is often challenged in his or her status and role(s). If ignored or not welcomed, these emotions can have a detrimental effect on the psychotherapeutic work. Shame should be welcomed and validated before going into a decentration process, among other things, by carrying out activities that are chosen for their potential to be a source of pleasure. It is then possible to "soothe" shame by abandoning a task that is too burdensome or by reorganizing its steps. The psychotherapeutic process tries to make it possible to accept a shorter, lighter activity aiming at behavioral (re)activation, and thus to decrease the feelings of failure and helplessness and to move out of the confinement of the complaint. This is the objective of cognitive-behavioral psychotherapeutic group work with patients suffering from chronic pain. [ABSTRACT FROM AUTHOR]

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