A salesman started seeing psychotherapist Greg Struve, LAC, SEP, because he feared he was getting fired from his current position. The fear was legitimate: He’d been there for almost 18 months—the same time it’d take for him to get fired from previous jobs. Initially, when he’d start a new job, Struve’s client would work incredibly hard. After 6 months, however, he’d become terrified that his boss and coworkers didn’t like him and might even be trying to sabotage him. He’d start ruining these relationships and making major mistakes. And then, inevitably, he’d be fired.

Unconscious self-sabotage is a common symptom of shame, Struve said. “I’ve seen many clients with a long-standing pattern of making big mistakes at just the wrong time to prevent themselves from achieving something that they unconsciously don’t feel worthy of.”

Trauma therapist Britt Frank, LCSW, SEP, worked with a client who had profound shame about her sexual assault. “She told herself that she ‘should have fought back,’ and ‘should have tried to get away.’ [She] was sitting in a deep pool of depression as a result of the shame,” said Frank, who has a private practice in Kansas City.

Another client struggled with profound shame over her drug addiction. She felt shame (and guilt) for the pain she’d caused her family. And this shame would reignite a cycle of addiction and relapse.

Shame comes in all shapes and stripes. Shame can reside in everyday occurrences. In a conversation with our spouse. During a work meeting. During a class. At the gym. It manifests as people pleasing or chasing perfection.

However, what underlies different shame-filled situations is the same: The belief that we are unworthy. “Shame is a pervasive sense of ‘I am a mistake, and if people knew me they would reject me,’” said Frank, a certified somatic experiencing practitioner and an adjunct professor at the University of Kansas.

Shame is thinking: There is something fundamentally wrong with me. I am defective. I am damaged goods.

Shame is universal and has the same physiological sensations, Frank said: “a pit in the stomach, a feeling of weight on the shoulders, a red face, an inability to look people in the eye, and a desire to isolate and hide from the world.” Shame also triggers a state of survival physiology that spikes stress and shrinks our capacity to function, she said.

A lot of us create a “persona” to mask our shame, said Struve, who offers therapy sessions via online video at GregStruve.com, and serves as executive director of The Way Recovery, a Christ-based therapy clinic and IOP in Phoenix, Ariz. “We do what we can to project an image that will make us worthy of belonging in this world—making lots of money, becoming more attractive, being more religious, becoming an activist, trying to be famous… the list goes on.”

(According to Struve, “The way to decide if your motivation for wanting excellence is rooted in shame is simply to ask yourself: Do I believe that once I achieve this goal I’ll feel good enough? Is my goal to become excellent or to become worthy?”)

Shame stops us from being fully, authentically ourselves, because it convinces us that the true, at-the-core, us will just get rejected, he said. “For the primitive brain rejection equals death.” Shame isolates us, Frank said.

It’s also a vicious cycle. “When people feel shame, they turn to unhealthy coping behaviors to distract from the shame. These behaviors, once completed, end up producing even more shame, so the cycle continues.”

Even though it doesn’t feel like it, shame actually isn’t bad, Struve said. Shame has helped us survive for thousands of years. “A human being who was rejected from their tribe would find themselves at the mercy of the elements, predatory animals and, perhaps most dangerous, other people.”

The key is to work through your shame. While this is best done with a mental health professional, you can start with these suggestions:

Find an empathic person. According to Frank, “When people are locked in a shame spiral, the subcortical parts of the brain tend to take over, and logic and reason become difficult to access.” The part of the brain that’s wounded doesn’t think rationally. Which is why “to heal from shame, it is crucial to be connected in relationships to people who have the capacity to provide empathy.”

Create a collage. Struve suggested gathering a handful of magazines, and cutting out images that represent the parts of you that are hiding beneath your shame. Tape the cut-outs to a large piece of tag board, and hang it somewhere visible. “The reason this works so well is because your unconscious mind deals primarily in pictures, not in words. Simply noticing the collage on a daily basis allows it to go to work.”

Use compassionate self-talk. Frank and Struve both stressed the importance of using affirmations. Frank shared these examples: “I made a mistake, but I am still a good person. I am lovable and acceptable, and I can learn from my mistakes.” “I did not make good choices, but I am still worthy of love and acceptance, and I can make changes that can help enable better choices.” “I have the right to exist, even if I am not perfect.” She also suggested talking to ourselves like we would to a child.

Similarly, Struve talked about identifying limiting beliefs and regularly telling ourselves the opposite. To help you pinpoint limiting beliefs, look for patterns of difficulty in your life, he said. For instance, if you pick partners who cheat on you, your limiting belief might be: “I don’t deserve relationships with people who love me for me”; “all men/women cheat;” or “Sooner or later, I get betrayed.” So you’d tell yourself, “My life is filled with women/men who love and respect me and who behave honorably in relationships.” (You also might make a list of your ideal partner’s traits, he said.)

Use your senses. “Experiencing sensations can stimulate the parasympathetic nervous system, which is responsible for producing calmness and a sense of overall well-being,” Frank said. For instance, smell essential oils, listen to music and take a walk in nature, she said. What other ways can you appeal to your senses?

Forgive yourself. Self-forgiveness is speaking to ourselves with kindness and practicing self-acceptance. Which means accepting ourselves exactly as we are, and loving ourselves enough to keep growing, Frank said. If we’ve hurt someone, it also means “making amends, taking ownership over our mistakes, and doing our best to repair what we can.”

Shame is painful, and it can feel permanent. Thankfully, it isn’t. Again, you can work through it (on your own or with a therapist).

Struve’s client ended up changing his ways after doing somatic experiencing around his belief that his father didn’t want him as a child. “His difficulties at work subsided and he was able to focus on his performance and get it back on track.”

Frank’s client who struggled with her sexual assault started making peace with her body, particularly after understanding that the “freeze” response is one way our bodies keep us alive. Her client who struggled with addiction found healing through understanding the dynamics of addiction, receiving acceptance from her peers, starting to forgive herself and changing her shame-soaked self-talk.

No matter how deep or severe your shame, you can be free of it.