‘Fierce compassion’ could be key to minimizing shame in HIV patients

Abigail Bachelder, M.P.H., Ph.D., associate psychiatry professor at Boston University Chobanian & Avedisian School of Medicine, says one of the most powerful ways to address shame is to approach patients with “fiercely compassionate” care that acknowledges how often they expect to be judged.

“I like to think of being kind of like fiercely compassionate and like explicitly so,” she explained in a recent Managed Healthcare Executive interview, noting that people may come into clinical encounters braced for judgment. This “anticipated stigma” means that even neutral expressions or comments can be misread as criticism and can deepen feelings of shame. By deliberately conveying compassion through words and body language, and by affirming what patients share and who they are, clinicians can counteract those expectations. As Bachelder notes, creating this kind of safe space may allow people to talk honestly about shame so that “it might not be as harmful.”

Bachelder and her colleagues recently published a study that examined the effects of HIV patients’ shame. The study, ‘Multi-modal measurement of shame in relation to perceived stress and avoidance coping in the context of recent HIV diagnosis,’ was published in the Journal of Health Psychology last month.