Understanding the importance of attachment in shame traumatic memory relation to depression: the impact of emotion regulation processes.

BACKGROUND: Early relationships are crucial to human brain maturation, well-being, affect regulation and self-other schema. Shame traumatic memories are related to psychopathology, and recent research has shown that the quality and type of attachment relationships may be crucial in shame traumatic memories in relation to psychopathology. The current study explores a mediator model of emotion regulation processes (rumination, thought suppression and dissociation) on the association between shame traumatic memory, with attachment figures and with others, and depressive symptoms. METHOD: Ninety subjects from the general community population completed the Shame Experiences Interview (SEI), assessing shame experiences from childhood and adolescence, and a battery of self-report scales measuring shame traumatic memory, rumination, thought suppression, dissociation and depression. RESULTS: Mediator analyses show that emotion regulation processes, such as brooding, thought suppression and dissociation, mediate the association between shame traumatic memory with others and depression. In contrast, shame traumatic memory with attachment figures has a direct effect on depression, not mediated by emotion regulation processes, with only brooding partially mediating this relation. CONCLUSION: The current findings shed light on the importance of attachment figures on the structuring of shame traumatic memories and on their impact on psychopathological symptoms, adding to recent neuroscience research and Gilbert's approach on shame and compassion. In addition, our results emphasize the relevance of addressing shame memories, mainly those that involve attachment figures, particularly when working with patients suffering from depressive symptoms and/or that find compassion difficult or scary. KEY PRACTITIONER MESSAGE: The quality of attachment relationships is important in how shame memories are structured and in their relation to psychopathology. The relationship between shame traumatic memory with attachment figures and depressive symptoms is not mediated by emotion regulation processes (rumination, thought suppression and dissociation). In contrast, these processes emerge as mediators on the association between shame traumatic memory with others and depression. For people suffering from depressive symptoms, having been shamed by an attachment figure may be a major block to develop self-compassion and receive compassion from others and may constitute an important obstacle to recovery. When working with patients suffering from depressive symptoms and/or that find compassion difficult or scary, it is important to target shame memories, especially those that involve attachment figures. In therapy with individuals with depressive symptoms and who reveal shame traumatic memories involving others, it may not only be pertinent to target these memories but also to evaluate and intervene on emotion regulation processes, particularly rumination, thought suppression and dissociation.