Bottle or Breast? Shame or Guilt, Either Way

Mummy wars still persist! One of the most intense battlegrounds has to do with infant feeding, where both breastfeeders and bottle feeders can feel let down and confronted. Infant feeding is often a moralized issue, with breastfeeding being tied to beliefs about “good mothering.” Despite these beliefs, breastfeeding rates are low across the globe and postnatal mental health issues in mothers are prevalent.

Many women do not achieve their breastfeeding goals, or alternatively some women decide not to breastfeed, which can cause women in both contexts to experience emotions like shame and guilt. Additionally, many women who do breastfeed feel uncomfortable feeding in public. As a result, women who breastfeed, bottle feed, and combination feed can experience self-conscious emotions for different reasons.

Shame and guilt are self-conscious emotions. They are very similar but also different. We experience both emotions when we think we have done something wrong. However, shame is more strongly related to body and image concerns. Shame is more damaging to how we view ourselves and is closely related to feelings of stigma and feeling unworthy. Stigma can also become internalized. This can happen when we become aware of others’ negative attitudes and then we believe them ourselves.

We conducted two studies to examine how shame and guilt relate to feelings of internalized stigma and breastfeeding behaviors. We also looked at how self-esteem, self-efficacy, and social support relate to feelings of stigma. In both studies, women with babies answered questions about their breastfeeding intentions, feelings of stigma, emotions experienced when feeding their babies, and other questions.

Where Shame and Guilt Diverged

The results highlighted some unique relationships for shame and guilt with stigma and infant feeding:

  • Women who breastfed and women who formula-fed experienced similar levels of shame. Thus, shame was experienced across feeding types.
  • Women who bottle-fed experienced more guilt, and in the second study they experienced more feelings of stigma.
  • Guilt, but not shame, was related to whether women had the desire to carry on breastfeeding, that is, from 3 months to 2 years. This suggests that women experience guilt when they have not reached their breastfeeding goals and had to switch to the bottle. Thus, women feel guilt when they think about how they haven’t fed their baby in the way they intended.  
  • Both shame and guilt were related to feeling more stigmatized for one’s feeding choice.
  • Lower self-esteem was related to experiencing more stigma because of underlying feelings of shame and guilt.
  • Lower parenting self-efficacy (i.e., feelings about general parenting competency) was related to higher stigma because of shame and guilt.
  • Lower breastfeeding self-efficacy, that is, feeling that you cannot achieve your feeding goals, was related to feelings of higher stigma because of experiencing guilt, not shame.

These results suggest that guilt is more closely tied to breastfeeding choices while shame impacts more global views of oneself, e.g., parenting as a whole. In sum, shame played a role in self-esteem and parenting self-efficacy versus guilt played a role in parenting and breastfeeding self-efficacy.

Researchers and the medical community must pay attention to ways to reduce feelings of shame and guilt in mothers, as both self-conscious emotions are related to feelings of stigma, self-esteem, and self-efficacy, regardless of infant feeding type. One way to reduce these negative feelings is to make sure that positive emotions are elicited through wider support networks, as it has been shown that positive emotions can override negative experiences. Another possible avenue is to make women feel positive in other areas of parenting to boost their self-views, and hopefully as a by-product have less stress and feel less pressure from others with regard to feeding choices.


For Further Reading

Russell, P. S., Birtel, M. D., Smith, D. M., Hart, K., & Newman, R. (2021). Infant feeding and internalized stigma: The role of guilt and shame. Journal of Applied Social Psychology. https://doi.org/10.1111/jasp.12810

Russell, P. S., Smith, D. M., Birtel, M. D., Hart, K. H., & Golding, S. E. (2021). The role of emotions and injunctive norms in breastfeeding: A systematic review and meta-analysis. Health Psychology Review. doi: 10.1080/17437199.2021.1893783
 

Sophie Russell is a Lecturer in Social Psychology at University of Surrey. She conducts research on moral emotions and how they impact our daily lives.

The Hurtful Consequences of Empathic Shame

When rape survivors tell people about their assault, they all too often face unhelpful and even hurtful reactions. Law enforcement may doubt them, healthcare workers may blame them, colleagues may shun them, and even close friends and family may avoid them. It’s difficult to overstate how devastating these reactions can be. Research suggests that negative reactions like these increase posttraumatic stress and depression, and hinder survivors’ recovery.

But why do people so frequently treat victims of sexual assault poorly?

My research suggests one powerful and surprising predictor—empathy.

Over the last decade empathy has become a buzzword. There are currently over 2000 books on Amazon.com with the word “empathy” in the title. Pundits, politicians, CEOs, and celebrities alike encourage people to be empathic, a trend that is evident in the many social media hashtags such as #empathymatters. While empathy-skeptics exist, research generally indicates that empathy is a psychological force of good in society because it normally increases helping behavior. However, whether empathy leads us to treat others well, or to treat them poorly, may depend on which emotion is evoked within us when we empathize.

Empathy can work in two different ways to trigger an emotional response. Sometimes we feel as others do. That is, we reflect the emotional state of another person in a mirror-like way. For example, if someone else feels ashamed, we will also feel ashamed. On the other hand, sometimes empathy leads us to feel for others, which is still an emotional response but not necessarily the same emotion the other person was feeling. For example, if my friend feels ashamed, I might feel concerned or angry at the person who made my friend feel that way.

There are a huge variety of emotions one might feel when a friend or acquaintance discloses that they have been assaulted, but here I will focus on anger and shame. I am focusing on these two emotions because previous research indicates that these emotions change how people respond to rape survivors. Anger is a motivating force for action; if we feel anger when our friend tells us they have been raped, we are more likely to stand up and do something about it. On the other hand, shame is a paralyzing emotion. If we feel shame, we are more likely to withdraw and distance ourselves from other people and the source of our shame. Shame may lead us to treat rape survivors poorly as we try to place physical and psychological distance between ourselves and the source of our shame.  In terms of rape disclosure, if people directly reflect the emotions of others they may be more likely to reflect a rape survivors’ feelings of shame, which is a very common emotion for survivors. Conversely, people who tend to feel different emotions may be more likely to feel anger on behalf of a rape survivor, and therefore be more likely to offer to help them.

In a recent research study, I attempted to predict how people would treat a hypothetical rape survivor. I did this by measuring people’s habitual empathic tendencies and what emotions they felt in response to a hypothetical rape disclosure.

I asked 282 American men and women to complete an online questionnaire called the Interpersonal Reactivity Index that measures empathic tendencies. I then asked these participants to read a date rape scenario involving a female victim called Kathy and report how they felt afterwards. Finally, I asked participants how much they blamed Kathy for her assault, how much they would distance themselves from her, and whether they would offer to help her.

Sadly, all too many participants indicated they would blame and distance themselves from Kathy. But—how people reacted could be predicted by their empathy and emotions.

Whether participants were likely to help Kathy was the easiest behavior to predict, with distancing intentions and blaming less so. People who reported tending to empathize by feeling different emotions were more likely to offer to help Kathy, and less likely to blame her or want to distance themselves from her. These helpful intentions were the result of feeling more anger and less shame. In contrast, people who said they empathize by reflecting other people’s emotions were more likely to treat Kathy poorly and less likely to offer her help. These hurtful intentions were the result of relatively more feelings of shame and less feelings of anger. It seems likely that participants’ feelings of shame reflected the shame they assumed Kathy felt. But it remains possible that participants may have felt ashamed for other reasons such as feeling ashamed on behalf of their gender (Kathy’s attacker was a man).

Nevertheless, if empathy arouses shame within us, it can paradoxically lead us to treat others poorly. Empathic shame is likely quite rare and may even be unique to disclosures of sexual assault. In another study I used the exact same method, but had participants read about a robbery rather than a sexual assault. In this experiment I did not find any evidence that participants felt ashamed. Even participants who said they tend to reflect other people’s emotions did not report shame. It appears that sexual assault may arouse a unique constellation of emotions and has a higher likelihood of triggering empathic shame.

It would be good if we could reduce the negative consequences of empathic shame for rape survivors in the real world by limiting people’s exposure to shame. Anti-sexual assault campaigns that draw attention to the shame or humiliation experienced by rape victims may do more harm than good. For instance, depicting survivors in poses of shame (such as with a hand over their face or looking away from the camera) might lead viewers to feel shame themselves and subsequently unintentionally react in a negative manner. To promote more compassionate treatment of survivors, societal movements such as the #MeToo movement may be particularly effective. The #MeToo movement may serve to lessen the shame surrounding sexual assault by visibly demonstrating that many women have survived such attacks and providing judgment-free solidarity for those who have.

Overall, having empathy for rape victims is only as beneficial as the emotion aroused and the actions one takes. A better understanding of how empathy might lead us to hurt rape survivors via empathic shame can hopefully help us to prevent these reactions in the future.


For Further Reading

Martingano, A. J. (2020). Helpful and hurtful empathy: How the interplay of empathy, shame, and anger predicts responses to hypothetical rape disclosures. Journal of Interpersonal Violence. https://doi.org/10.1177/0886260520922345
 

Alison Jane Martingano is a postdoctoral research fellow at the National Human Genome Research Institute, National Institutes of Health. Her research interests include empathy, communication, and the impact of emerging technologies on health.

 

Where Women Store Fat On Their Bodies Impacts Their Mental Health And Well-Being Outcomes

Obesity affects over 2 billion people globally. The CDC reported that the prevalence rate of obesity in the U.S. reached 42.4% in 2017-2018.

Body fat impacts individuals far beyond their physical health. Numerous research studies have linked body fat with reduced mental health and well-being.

Researchers have found that how others see you mediates the relationship between body fat and one’s self-esteem. In other words, an individual with a higher body fat percentage may still have a high self-esteem if they do not believe society perceives them as being unattractive. 

From an evolutionary perspective, researchers have found women’s fat location (waist-to-hip ratio or how weight is distributed across the waist, hips, and thighs) impacts perceptions of their attractiveness by men. While preferences vary across cultures, women who have waists that are narrower than their hips are typically perceived as being more attractive in the U.S.

Thus, it could be expected that women’s waist-to-hip ratio plays a role in self-esteem and other mental health outcomes. Michael Barlev from Arizona State University sought to better understand this relationship.

Barlev and colleagues presented their research findings at the 2020 SPSP Annual Convention. They found that fat location impacts perceptions of how society views an individual. Women with higher waist-to-hip ratios (having higher amounts of fat stored in the waist compared to the hips and thighs), were more likely to self-report lower perceived attractiveness. Through this relationship, Barlev found that fat amount and fat location have important effects on self-esteem.

Similarly, Barlev wanted to understand if waist-to-hip ratios also impacted other outcomes, such as weight-specific anxiety. The researchers found that respondents’ perception of fat discrimination was also dependent on where body fat was located. Through this relationship, fat amount and waist-to-hip ratios had implications for weight-specific anxiety.

The amount of fat did not seem to affect how the world perceives women who had low waist-to-hip ratios (less fat stored in the waist compared to the hips/thighs). Weight distributed in this way appears to buffer against the potential negative effects of the increased amount of fat. In other words, more fat will not necessarily impact how someone is viewed in terms of attractiveness, if it’s stored more in the hips and thighs, rather than around the waist.

Barlev and colleagues are working on a number of studies to better understand this phenomenon. Future research will benefit from examining more diverse populations with a wider variety of waist-to-hip ratios. Future research may also aim to better understand the role of stress in these models.

Ultimately, fat location is important in understanding outcomes for mental health and well-being outcomes in women. These findings have important implications for how interventions can address weight-related self-esteem and mental health issues.


Written by: Kristan Russell, PhD Candidate at the University of Nevada, Reno

Presentation: Fat Location, Beyond Fat Amount, Predicts Mental Health and Well-being in Women presented at The Psychology and Physiology of Fat: A Functional Perspective. 9:30am – 10:30am on February 29, 2020 .

Speakers: Michael Barlev (Arizona State University), Steven Neuberg (Arizona State University), and Jaimie Krems (Oklahoma State University)