Part of working with clients as a mental health therapist is helping them understand the nature of guilt and shame. You cannot however discuss guilt and shame without discussing the nature of morality, ethics, virtue and vice. Some therapist do harm by counseling directees to ignore certain moral principles. Partly, this is because they do not feel comfortable themselves discussing such things. Yet, you still have the feelings of guilt and shame in the client that cannot simply be dismissed.
Human beings are moral agents. That is why G.K. Chesterton can say "Man is always something worse or something better than an animal; and a mere argument from animal perfection never touches him at all. Thus, in sex no animal is either chivalrous or obscene. And thus no animal invented anything so bad as drunkeness – or so good as drink.” We could ignore guilt and shame, repress these thoughts, but that does little to satisfy. Therapist should not only treat disorders and their symptoms but increase their clients' flourishing and freedom for responsible thinking, choosing, feeling, and relating with other people in virtuous ways (Ashley, 2003).
Guilt and shame most often comes up in therapy when a person becomes scrupulous. Scrupulosity is where people obsess over their thoughts and urges they have deemed morally abhorrent, which then becomes distressing to the person. Wikipedia notes that it is derived from the Latin word scrupulum, which means a sharp stone, implying a stabbing pain to the conscience.
Guilt and shame often feel the same because they both stir up feelings of liability and inadequacy. The difference is that guilt is an awareness of how our actions have affected others and correlates with remorse and a sense of responsibility; whereas, shame is an inward humiliation arising directly from the conscience.
Some will foolishly argue that guilt and shame do nothing but hold you back. "By feeling guilty, you are not in a positive, self-love, and acceptance mindset, and it is only holding yourself back" (Dani Dippro). I believe becoming more obstinate with a "guilt-free" conscience does nothing to aid mental health. In fact, it is a good sign you lack a very important trait, empathy, and is often the sign of a personality disorder.
Guilt and shame do have a way of tearing you down, especially if it becomes scrupulous, but it also has a positive duality to it. While guilt and shame may separate you from a positive mindset, it also moves you to a more objective positive mindset—a mindset based on reality. A serial killer might have a positive mindset, and self-love, but they are not mentally sane or psychologically whole.
Guilt and shame are an echo of our original calling to holiness and the good that we inherently long for. Although we are fallen, as Christians believe (though differing understandings of its nature), we maintain that the heritage of the human heart is deeper than the sinfulness inherited. Guilt and shame point us to this inner longing for the good, that original calling. You do no good to dismiss this longing. It would be much better to tap into it and make a change for the better.
Healthy guilt and shame is a good sign your conscience is working. It moves you to make the changes necessary for the good, points you towards meaningfulness, intimacy, and virtue. On the other hand, unhealthy guilt and shame result from irrational thinking and point towards meaninglessness, powerlessness, isolation, and self-pity.
It is good then to know when you should adequately feel guilt and shame over some wrongdoing and when you should dismiss it as scrupulous.
How Responsible Are We for Our Thoughts and Actions?
"There are three levels of practical wisdom or personal moral responsibility that a person has: responsibility for oneself, for one's committed relationships, and for the common good" (Vitz, Nordling, Titus, 2020, p. 427).
Our responsibility is connected to the limits of our knowledge and understanding; to our intentions and choices, and to our own power to do things (Vitz, et, al, 2020).
Further,
a) The intention must be good,
b) the action must be good, and
c) the circumstances (who's involved, how, when, and where the act takes place) must be good.
All three must be good for an action to be good. For instance, you may have good intentions, but the act itself be evil. Therefore the act is morally reprehensible. Moral philosophers call this consequentialism, and I use it here to talk about our current political climate. Scripturally, Paul tells us to “do no evil so that good may come” (Romans 3:8). If all three are met you have nothing to be guilty or shameful about.
If wrongdoing is committed, we have to look into whether you had full knowledge and complete consent. Is there an actual awareness and understanding of the foreseeable consequences? Was it a free act of the will? For instance, I had a client who thought things would be much better if her mother-in-law would just die. She obsessed over the thought, and it ate her up inside. She thought she was a horrible person for thinking this way. This is a classic case of scrupulosity. But she never entertained the idea. Nor did she ever plan out how she may aid in her demise. It was a passing thought. It was in her preconscious mind, and as soon as she was made aware of the thought, she willed it away.
Many things mitigate our volitional responsibility. "The cooperation of the will is needed to intend, consent, and choose fitting actions...Disordered affections and vices, which pursue disordered loves and only apparent goods, and extreme types of stress and fear can also dissipate the volitional focus needed for full responsibility" (Vitz, et, al, 2020 p. 486).
Lastly, I want to talk about formal and material cooperation. Formal cooperation in evil is when we are intentionally involved in the evil act that someone else is undertaking; affirming the end or means chosen by the other person; for example, the doctor who participates in the euthanasia of a mentally ill patient and all who help draw up and administer the drug. The doctor might be the one who gives the lethal dose, but all cooperating in the act would be equally guilty.
Involvement in material cooperation as opposed to formal cooperation is not intending or affirming the evil that the other person is doing, but being involved in some way that helps the person who does the immoral acts. For instance the drug manufacture who made the drug used for euthanasian and its employees may only be materially complicit and thus carry a lesser culpability, if nothing at all. Some material cooperation is licit, whereas others are not. We determine this by how immediate or mediate the material cooperation is.
Immediate cooperation is where you provide the material for the evil act, in which case you are guilty.
Mediate cooperation, you do not intend for the moral act to occur and you may or may not be complicit.
For mediate cooperation, you have two separate levels of connection, proximate and remote. Proximate contribution leads to, and is necessary for the evil act to occur. Remote contribution is remote material support, that is, not intimately connected to the evil and thus carries no culpability (for arguments sake, taxes that fund abortion or the death penalty would fit the principle of remote material support).
The double effect principle is used to determine when an action with two effects, one good and one evil, may still be chosen without culpability. It was defined by Thomas Aquinas in Summa Theologica (II-II, Qu. 64, Art.7) to show killing in self-defense is justified.
Four conditions should be met to determine the good and whether or not you are culpable.
1. The action must be morally good, or indifferent, as to object, motive and circumstances.
A good act requires the goodness of the object, of the end, and of the circumstances together. But there are some things in which are intrinsically evil such as killing of an innocent person (CCC 1755).
It is therefore an error to judge the morality of human acts by considering only the intention that inspires them or the circumstances (environment, social pressure, duress or emergency, etc.) which supply their context (CCC 1756).
2. The bad effect may only be tolerated, not directly willed.
An effect can be tolerated without being willed by its agent; for instance, a mother's exhaustion from tending her sick child. A bad effect is not imputable if it was not willed either as an end or as a means of an action, e.g., a death a person incurs in aiding someone in danger. For a bad effect to be imputable it must be foreseeable and the agent must have the possibility of avoiding it, as in the case of manslaughter caused by a drunken driver (CCC 1737).
3. The good effect must be caused at least as directly as the bad.
Again, an effect can be tolerated without being willed by its agent...A bad effect is not imputable if it was not willed either as an end or as a means of an action, For a bad effect to be imputable it must be foreseeable and the agent must have the possibility of avoiding it (CCC 1737).
4. The good effect must be proportionate to compensate for the bad effect.
There should be a sensible balance between the act and its consequences. It means we cannot tolerate bad effects that are not proportionate to the good effects that are expected from a certain action. There must be a very severe reason for the evil act to be tolerated. The good effect that is directly intended must be significantly more dire to attain than the accepted bad effect. This is not the same as consequentialism because it is considered in light of the other three conditions and not alone, all four conditions must be met.
If you have followed me this far, you must acknowledge that moral philosophy and ethics can be interesting, exciting and even applicable in the mental health field. The other option is you are a sucker for reading irrelevant dry moral philosophy, which is plausible. I am done here, but the following link will help describe the double effect principle, its criticisms, and its applicability more than I am willing to do here. If you suffer from scrupulosity it might be good to read back over all the conditions listed above. If you are a scoundrel, it might be good to read back over all the conditions again! Most importantly remember guilt and shame point to your inner longings for the ultimate goods. It is important to appeal and develop these longings for the happiness you long for. That is the essence of the positive psychology movement which focuses on your strengths, building up the good and flourishing as humanly as possible.
References:
Ashley, B.M (2013) Healing for freedom: A Christian Perspective on Personhood and Psychotherapy. Arlington, VA: The Institute of Psychological Sciences
VItz, P.C, Nordling, W.J, Nordling, Titus, C.S (2020) A catholic christian meta-model of the person: Integration with psychology & mental health practice Sterling, VA: Divine Mercy University
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