Is Guilt or Shame Driving You? The Perspective of a Physician Coach on Why It Matters

Mar 2, 2023 | Coaching, Humanizing Medicine

Guilt has a purpose. It reminds me of my responsibility to be the best version of myself that I can be. Shame does not. It only serves to keep me bound up in negative thoughts about who I am—thoughts that block all possibility of being my best self.

The research psychologist Brené Brown put it this way:

Guilt is “holding something we’ve done or failed to do up against our values and feeling psychological discomfort.” Whereas shame is “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.”

I recently reflected on the difference between the two as I drove one morning last week to Dana Farber Cancer Institute—not as a patient, but to donate blood.

Here’s where the guilt factors in. The blood coursing through my veins is type O negative. It’s the type most in demand because it can be transfused into anyone, no matter their type. I’m the universal donor, and I’ve known this for years.

Do I regularly donate? No.

I tried twice and failed; once due to anemia and the second time due to a technical difficulty with the equipment halfway through.

The guilt has dogged me for years. Every time I saw a notice about a blood drive. Every time I talked about my first pregnancy and needing the Rhogam shot. Every time I was asked about my blood type.

Finally, this fall I decided to begin donating blood regularly.

As I drove over to the medical area in Boston last week for my second donation, I recognized that nagging in my brain for what it was: a healthy reminder of my desire to live by my values, one of which is to be of service to others.

Contrast this with the deep, paralyzing shame I felt when I experienced burnout and eventually left clinical practice. For at least 15 years I held that experience as evidence that I was flawed, that I “couldn’t hack it,” that I was unworthy of being visible anywhere in healthcare. I only talked about it under duress. I quietly worked in my home office as a writer.

It was my life coach, Anna, who helped me to reframe the experience and to own it as a sad reflection of the healthcare workplace and as a courageous act in stepping out into the unknown.

Being freed of that shame lets me apply to my current role as a coach the entirety of who I am: my life experience, emotional intelligence, personal character, values, and natural talent for listening and getting to the heart of things. I’m no longer shackled; it feels amazing.

Guilt aids you in your journey to being the best possible version of yourself. Shame stops you in your track. Which is directing your actions today?

If you’re not sure, ping me!


Diane W. Shannon


Diane Shannon is an award-winning writer, author, and coach. Since leaving practice as a primary care physician due to burnout, she has worked to support physicians in achieving their personal and professional goals and to highlight the changes needed to reduce burnout, improve career satisfaction, and protect the bidirectional healing power of the patient-physician relationship.

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