Shame is such a powerful emotion, and usually an unwelcome and unpleasant one. Shame implies something wrong has been done and that one should feel badly about him/her self. A person who is ashamed often feels on the "outside", marginalized, and outcast from the mainstream. One would not expect a person with illness to feel ashamed of his/her self. After all, most people do not wish to live with chronic illness nor does having an illness mean that something wrong has been done. At times, some people who live with chronic illness may feel guilty about things they may have done in their past, which may or may have not contributed to the illness (e.g. smoking, having a poor diet, taking drugs); however, guilt and shame are not the same emotion.

What can contribute to the feeling of shame when living with illness? Many things. It is logical to tell a loved one who lives with illness that s/he has absolutely nothing to be ashamed of...and most people would completely agree with this. Logically and externally there is nothing to be ashamed of. However, the person with the illness may experience it differently. A person with illness may tell you that they understand logically that there is nothing to be ashamed of, but that person may feel completely differently. That person may speak about the shame s/he feels when s/he cannot verbally express him/herself because his/her illness has affected his/her cognition and ability to retrieve words. Perhaps a person takes a medication that makes him/her very sleepy and this person frequently oversleeps and is late to events. Oftentimes, the person with the illness will not share that s/he is late because of the medication side effect. This person may feel ashamed but may also not want to appear as if s/he is making excuses, or may be ashamed of having the illness itself. A person may feel ashamed if s/he is covered in scars from multiple surgeries or has lost his/her hair as a result of chemotherapy. A person may feel ashamed of the weight loss or gain that has occurred due to the illness or the treatment of the illness. A person may feel ashamed because s/he is no longer the same person s/he used to be.

It is easy to say, "you have nothing to be ashamed of," and logically that is true, but there is a way to believe that without invalidating the feelings of a person living with illness. Maybe try to understand why s/he feels that way. Open up the conversation rather than shut it down with telling the person not to feel the way s/he feels. For a person who already may feel marginalized from the rest of the people around him/her, asking questions and trying to be curious about his/her experience is welcoming and inviting. In fact, this simple act may help the person feel less ashamed. Understanding is more powerful than people sometimes think.
Imagine saying, "I wish you did not feel ashamed. What makes you feel that way?" rather than "you shouldn't feel ashamed."

You are free to feel whatever you want. Whether a particular feeling serves you or not is a topic for another discussion. You do not have to be alone with your shame or marginalized. Find someone who is able to listen and who wants to understand. In addition to family and friends, there are always professionals who are trained to help you open up this space of understanding. Reach out for help if you need to.