http://bmj.com/cgi/content/full/324/7338/623

This is a useful and thoughtful editorial in the current BMJ, which
offers   'shame' as a possible reason why medics don't change their
practice.

"Indeed, it is arguable that shame is the universal dark side of
improvement. After all, improvement means that, however good your
performance has been, it is not as good as it could be. As such, the
experience of shame helps to explain why improvementwhich ought to be
a "no brainer"is generally such a slow and difficult process.2

What is it about shame that makes it so hard to deal with? Along with
embarrassment and guilt, shame is one of the emotions that motivate
moral behaviour. Current thinking suggests that shame is so
devastating because it goes right to the core of a person's identity,
making them feel exposed, inferior, degraded; it leads to avoidance,
to silence.3 The enormous power of shame is apparent in the adoption
of shaming by many human rights organisations as their principal
lever for social change4; on the flip side lies the obvious social
corrosiveness of "shameless" behaviour. "

I think this is helpful to us, as we regularly ponder why some
healthcare professionals and other colleagues seem unable to accept
that their misinformation about bf has such serious effects.  I don't
think shame is the only reason, BTW - but it could be one of them.

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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