Compared with the more easily conceptualized emotions of anxiety, guilt, and depression, shame, for complex and far-reaching reasons, has been bypassed in our theorizing. The result of this oversight is a failure to integrate aspects of our understanding of affect and defense in severe character pathology, especially its interpersonal manifestations. The ne­ glect of shame and the difficulty conceptualizing it have resulted in models that lend themselves better to more mechanically derived notions based on guilt, ones that give us an incomplete and misleading view of the patient in intimate personal relationships.