Shame and the fear of feeling

TOPIC. Toxic Shame and the concomitant fear of feeling are core issues need ing to be addressed during group therapy with adult survivors of childhood sexual abuse. PURPOSE. To increase awareness of the toxic shame that survivors experience and to describe the impact of group therapy based on a family systems mode l. SOURCE. 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 membe rs the opportunity to cease reenacting family rules and roles that create t oxic shame.