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DESCRIPTION: Humiliation has no ICD code and no clinical guidelines. How it differs from shame and hurt, why judgement from others affects self-esteem, and what research tells us about the consequences.

Humiliation: Psychology, how it differs from shame, and why it isn’t listed in any diagnostic manual

Almost everyone can recall a scene that still stings decades later: a classroom, a corridor, a dinner, a team meeting. It was rarely physically dangerous. That is why it does not appear as the first event in any trauma questionnaire, and what it left behind is easily dismissed as hypersensitivity. What was said remains etched in the memory: the faces in the room, one’s own clothes, the spot where one stood. The advice to finally let it go misses the point entirely.

Humiliation has no ICD code, no clinical guidelines and no specific treatment protocol. It is discussed under other names, usually as shame, trauma, depression or social anxiety. This shifts the focus. Shame is directed against one’s own self. Humiliation begins with a judgement by another, a perpetrator and, frequently, witnesses. It leaves behind a rage whose target often remains out of reach. Then it turns inwards and is mistaken for shame.

The memory that does not fade

In 1991, Donald C. Klein asked people what humiliation feels like. The answers were strikingly similar, right down to the choice of words: wiped out, helpless, bewildered, sick to the stomach, as if paralysed, full of rage. Those interviewed described being made to feel small, having been stabbed in the heart or struck in the pit of their stomach. They blushed, wanted to disappear, and could still recall the scene years later with a vividness that surprised even them.

This last point characterises the experience. Memories of humiliation retain details. They capture the tone of voice, the laughter, the position of the onlookers and the moment when a response became impossible. Outwardly, the scene is often unspectacular: a manager singles out an employee in front of the team. A teacher reads aloud a poorly written piece of work. Parents recount to guests what their child has done wrong again. A partner tells a story in a group setting that has no place there.

What these scenes have in common is that the belittlement strikes at an area through which a person defines themselves. It concerns intelligence, sexual dignity, professional competence, the body, background, motherhood, masculinity, illness or social identity. Add to this witnesses and a situation in which resistance would be futile, dangerous, or more humiliating than silence.

Shame and humiliation

The clinical distinction is clear, yet it is often overlooked. Shame is a judgement one passes on oneself. It can arise in an empty room. It can resurface decades after the triggering event because someone measures themselves against their own standards and believes they have fallen short.

Klein summed up the difference in a single sentence: people believe they deserve their shame; they do not believe they deserve their humiliation. Shame says: ‘There is something wrong with me.’ Humiliation says, initially: ‘Someone has belittled me.’

In 1987, Aaron Lazare described five elements of the experience: being visibly exposed, being made to feel small, being regarded as deficient, being subjected to ridicule, scorn or insult, and the need to hide one’s face or sink into the ground. Ricardo Torres and Raymond Bergner summarised the same structure for forensic practice: humiliation is a reduction in status, in public or in front of witnesses, without any effective means of defence.

Embarrassment alone is not sufficient. Anyone who breaches a rule of etiquette, forgets a name or says something awkward may feel embarrassed; the incident usually blows over. Humiliation attacks social standing and personal dignity. It determines who is on top in this situation, who remains at the bottom and who is allowed to watch.

Perpetrator, victim and witness

Klein’s model consists of three roles: the humiliator, the victim and the witness. The perpetrator inflicts the humiliation. The victim suffers it. The witness watches and confirms the scene’s social reality through laughter, silence, looking away, or mere presence.

The witness's role is easily overlooked. It transforms the act of humiliation into a social event. Those who watch escape the role of victim in that moment, while also realising how quickly their own standing can be lost. The fear of finding oneself in the same predicament can permanently shape subsequent behaviour: conformity, silence, alliances with those in power, avoidance of visibility and pre-emptive self-deprecation.

In 2023, Saulo Fernández and colleagues conducted an experiment to investigate the effect of an audience. The presence of a spectator intensified the experience of humiliation. It did not matter how well the spectator knew the person affected. The mere fact of being socially visible exacerbated the humiliation.

Humiliation and depression

In 2003, Kenneth Kendler and colleagues published one of the most important studies on the role of stressful life events in depression and generalised anxiety. They analysed 98,592 person-months of data from 7,322 adult twins in a population-based register. They assessed each life event separately for loss, humiliation, hopelessness, and danger.

Events involving humiliation or hopelessness were stronger predictors of the onset of a depressive episode than loss or danger without these characteristics. Events that belittled someone in a central role were particularly distressing. Those who focus solely on losses thereby overlook part of the history leading up to depressive episodes: by whom was someone belittled? Were they able to defend themselves? Was their professional, family or sexual self-identity under attack?

This study does not present humiliation as just one of many interchangeable sources of distress. It describes a characteristic of events that carries its own weight in the development of depression. The loss of a loved one can be deeply distressing. Public humiliation can also mark the onset of depression, even though, outwardly, no one has died, and there was no physical danger.

Humiliation in trauma

A study on complex post-traumatic stress disorder, published in 2024, examined humiliation, shame and guilt separately. The survey involved 449 people who had experienced domestic violence or sexual abuse; 77.11 per cent of the sample were women. The survey was conducted online and was self-selected. It does not allow conclusions about prevalence in the general population.

The findings relate to the relationships within this sample: none of the self-related emotions examined predicted simple post-traumatic stress disorder. Humiliation predicted the complex form, even after statistically accounting for shame and guilt. In the network analysis of both trauma types, humiliation occupied a central position.

Even after controlling for the shared variance with shame and guilt, a statistical association remains. Humiliation thus denotes a part of the experience that shame and guilt do not fully capture. This does not justify a new diagnosis. It calls for the question of degradation to be raised where long-term consequences of trauma, self-contempt, withdrawal and persistent anger converge.

The paradox of humiliation

Unfair treatment usually generates anger. Anyone who is convinced they have been treated unfairly keeps the judgement at arm’s length: the other person is mistaken, lying, abusing power or acting unfairly. Humiliation, however, contains the opposite. The affected person considers the devaluation undeserved yet continues to bear it, often for years.

Since 2015, Saulo Fernández and his colleagues have referred to this connection as the ‘humiliation paradox’. In 2025, José Antonio González-Puerto and Fernández presented three studies involving 1,098 Spanish participants, attributing the process to two separate factors: injustice and cruelty.

Injustice protects against internalisation. Those who perceive the treatment as unfair become angrier and are more likely to remain able to take action. Cruelty leads in the opposite direction. Those who experience the treatment as deliberate harm motivated by malice are more likely to accept the negative judgement, feel humiliated and become powerless. In an experiment involving 228 participants, researchers varied both assessments independently. Both main effects occurred in opposite directions; no interaction was observed.

In real-life situations, the two assessments often overlap. Cruel treatment is always also unjust. Injustice, on the other hand, can be objective, cold or bureaucratic without being experienced as cruelty. This gives rise to a mixed state of anger and self-deprecation. Thomas Scheff called this ‘humiliated anger’.

The authors draw a specific therapeutic conclusion: identifying the undeserved and unjust aspect of a treatment can weaken the internalisation that arises from experienced cruelty. The anger that is released then needs a place and a form where it does not work against one’s own self or uninvolved parties. The limitations of the studies remain apparent: no pre-registration, samples drawn from a Spanish open university, and imagined scenarios rather than actual experiences of humiliation.

Humiliated anger

In 1976, Helen Block Lewis described depressive patients who felt humiliated, quickly became angry and, at the same time, did not know who they were angry with. Klein placed this process at the centre of his theory of humiliation.

The anger has a real target. It may be a father, a teacher, a superior, a classmate or a spouse. Often, this person was more powerful, out of reach or too important for one’s own safety. The anger could not be expressed outwardly. It remains pent up and is later turned against the self. There it manifests as self-contempt, feelings of inferiority, depressive devaluation or shame.

This explains part of the clinical confusion. Shame becomes the final stage of a process that begins with devaluation by others. Work on addressing shame remains incomplete if it removes the perpetrator, the witnesses, the blocked resistance and the repressed anger from the picture.

Why no diagnostic manual?

Diagnostic systems classify conditions by symptom clusters, course, and level of impairment. This improves comparability between clinicians and prevents every distressing experience from becoming a distinct illness. Since the DSM-III of 1980, there has been a strong emphasis on this descriptive approach.

Humiliation does not fit well into this framework. It refers to an event and a social relationship, not a uniform group of symptoms. Its consequences can include depression, social anxiety, self-harm, post-traumatic symptoms, aggression, withdrawal, addiction or somatic complaints. A manual would have to decide which of these consequences are part of the condition and which have other causes. This distinction would be difficult to draw.

Added to this is the institutional aspect. Humiliation presupposes a perpetrator. A diagnosis bearing the word in its name would be cited in employment tribunals, school disputes, family law proceedings and complaints against public authorities. Post-traumatic stress disorder is one of the few major diagnoses whose definition presupposes an external event. Its inclusion in the manuals was itself politically contested. A diagnosis of humiliation would raise even more direct questions about responsibility, power and witnesses.

Measurement also remains limited. In 1999, Linda Hartling and Tracy Luchetta developed the Humiliation Inventory, comprising 32 statements and two scales. The internal consistency was good. However, the normative sample comprised 253 predominantly white students with an average age of 20.7 years; this is not a sufficient basis for a diagnostic classification in the manuals. Furthermore, questions remain about the instrument's availability and use.

In 2022, Luna Dolezal and Matthew Gibson proposed shame-sensitive care that goes beyond the trauma-sensitive approach. Institutions encounter shame and humiliation daily: in A&E departments, social services offices, schools, clinics, care homes, courts, and therapy settings. The term is often missing, yet the material remains.

The political history of humiliation

Historically, humiliation has been better explored than clinically. In *The Politics of Humiliation*, Ute Frevert traces 250 years of public shaming: the pillory, corporal punishment in child-rearing, military subjugation, colonial power, and the women who had their heads shaved in France after 1944. Her account reveals no straightforward progress. The modern era abolished the pillory but found new forms of public degradation.

Evelin Lindner established a distinct field of research with ‘Human Dignity and Humiliation Studies’. Her counter-concept is dignity. For her, recovery means regaining self-respect and no longer experiencing the social order as a confirmation of humiliation.

Avishai Margalit extended this framework to institutions. For him, a decent society is one whose institutions do not humiliate people. Justice alone is not enough to achieve this. Public authorities can distribute benefits correctly while simultaneously belittling applicants through incomprehensible procedures, public humiliation, mistrust, waiting rooms, language, and dependence on discretionary decisions.

A new term

Since 2025, the term ‘humiliation trauma’ has been circulating in the English-speaking world in therapy blogs, newsletters and texts on emotional abuse. The expression does not originate from a diagnostic manual. It arose from a need for words to describe experiences that only partially fit into existing categories.

This sequence is not unusual. Bullying, emotional neglect and stalking were initially terms used by those affected and in clinical practice. Research took them up later. Legal and medical classification followed even later, and never fully. In the case of humiliation, some research has long been available. Nevertheless, it has not yet entered standard clinical practice.

This does not lead to a new diagnosis. It leads to a more precise question. Anyone who, years later, still recalls the same incident should not only be asked about shame, trauma or depression. It is worth asking about the belittling: Who was there? Who was watching? What could not be said or done at the time? Which part of that external judgement lives on in one’s own self-assessment?

The most important points in brief

· Humiliation has no ICD code, clinical guidelines, or specific treatment protocol. It usually appears under the names of shame, trauma, depression or social anxiety.

· Shame is a judgement one makes about oneself. Humiliation begins with belittlement by others and presupposes a perpetrator; witnesses intensify the experience.

· Lazare described being visibly exposed, being made to feel small, being regarded as deficient, being attacked and wanting to disappear as hallmarks of humiliation.

· Klein’s triangle, comprising the perpetrator, the victim, and the witness, explains why social visibility exacerbates the process and why the witness's role can have a lasting impact.

· Kendler and colleagues demonstrated, using a sample of 7,322 twins, that life events involving humiliation or a sense of hopelessness were stronger predictors of the onset of depression than loss or danger without these characteristics.

· A 2024 study involving 449 victims of domestic violence and sexual abuse linked humiliation, coupled with feelings of shame and guilt, to complex post-traumatic stress disorder.

· The humiliation paradox consists of anger at injustice and the simultaneous internalisation of a devaluation experienced as cruel.

· Humiliated anger is directed at a real, often unattainable target. If it remains pent up, it can manifest as self-contempt and shame.

· Frevert describes the political history of public shaming. Lindner and Margalit present dignity as the antonym; for Margalit, it becomes the yardstick for institutions.

A personal note

This article marks the start of a book project on humiliation. Anyone wishing to read the subsequent instalments can subscribe to the Wikiblog’s newsletter. I will incorporate feedback on this text into the book.

Sources

· Dolezal, L., & Gibson, M. (2022). Beyond a trauma-informed approach and towards shame-sensitive practice. Humanities and Social Sciences Communications, 9, Article 214.

· Fernández, S., Saguy, T., Gaviria, E., Agudo, R., & Halperin, E. (2023). The role of witnesses in humiliation: Why does the presence of an audience facilitate humiliation among victims of devaluation? Personality and Social Psychology Bulletin, 49, 32–47.

· Frevert, U. (2017). The Politics of Humiliation: Theatres of Power and Powerlessness. Frankfurt am Main: S. Fischer.

· González-Puerto, J. A., & Fernández, S. (2025). The opposite roles of injustice and cruelty in the internalisation of devaluation: The humiliation paradox revisited—British Journal of Social Psychology, 64, e12823.

· Hartling, L. M., & Luchetta, T. (1999). Humiliation: Assessing the impact of derision, degradation, and debasement. Journal of Primary Prevention, 19, 259–278.

· Kendler, K. S., Hettema, J. M., Butera, F., Gardner, C. O., & Prescott, C. A. (2003). Life event dimensions of loss, humiliation, entrapment, and danger in the prediction of the onset of major depression and generalised anxiety. Archives of General Psychiatry, 60, 789–796.

· Klein, D. C. (1991). The humiliation dynamic: An overview. Journal of Primary Prevention, 12, 93–121.

· Lazare, A. (1987). Shame and humiliation in the medical encounter. Archives of Internal Medicine, 147, 1653–1658.

· Lewis, H. B. (1976). Psychic War in Men and Women. New York: New York University Press.

· Lindner, E. G. (2001). Humiliation: Trauma that has been overlooked. An analysis based on fieldwork in Germany, Rwanda/Burundi, and Somalia. Traumatology, 7(1), 43–68.

· Margalit, A. (1996). The Decent Society. Cambridge, MA: Harvard University Press.

· Torres, W. J., & Bergner, R. M. (2010). Humiliation: Its nature and consequences. Journal of the American Academy of Psychiatry and the Law, 38, 195–204.

· The centrality of humiliation in complex post-traumatic stress disorder. (2024). Journal of Trauma & Dissociation, 25(5).