Where shame meets psychological safety: reflections from our latest Shame and VetMed gathering

The session opened with two questions for the room.

First: what behaviours has veterinary medicine traditionally rewarded? The answers came quickly. Always being right. Always having an answer. Perfectionism. Responsibility verging on martyrdom. Being always on, pushing through, self-sacrifice. Technical skill, calm in a crisis, positivity, resilience.

Second: what behaviours are valued in a psychologically safe culture? Speaking up even when it's uncomfortable. Curiosity, openness, trust. Vulnerability. Admitting mistakes. Showing emotion. Bringing ideas to the table without being made to feel stupid. Failing, and learning from it.

Not everything on these lists is in opposition. Compassion and empathy appeared on both. But many were in clear tension. If we're meant to be independent, how do we ask for help? If we're meant to be strong and in control, how do we show that we aren't, some of the time? And what happens to us when we fall short?

That tension sits right at the heart of professional identity, and it's where shame does a lot of its work.

One of the most important points raised was that shame is experienced internally. A team might be entirely accepting of a mistake, and we can still be unable to accept it ourselves. A psychologically safe environment doesn't switch shame off. What it does is set the stage for the idea that none of us are all-knowing, and that we will all get things wrong.

In many ways, shame and psychological safety pull in opposite directions. Shame is rooted in judgement; psychological safety asks us to suspend it. Shame tends to produce withdrawal, concealment, silence and defensiveness, while psychological safety encourages the opposite.

But shame isn't simply the enemy. At its core, it's a pro-social emotion. It exists to keep us connected, nudging us to behave in ways that mean we won't be rejected by the group. Civility, and even compassion, can be seen as expressions of that same drive towards connection.

So the aim isn't to eliminate shame. It's to understand that it has two faces.

The session drew on three perspectives on psychological safety:

Amy Edmondson's widely used definition describes an environment where people can speak up without fear of embarrassment or humiliation, both close relatives of shame, and where interpersonal fear is low.

Carl Rogers, the psychotherapist credited with first using the term, saw psychological safety as the absence of external evaluation, where another person is seen as having unconditional worth. How that translates into a busy workplace is an open question, but it's a useful direction of travel.

Timothy R. Clark's four stages model places inclusion at the foundation: being accepted simply because we're human and act with good intent.

This led to a working hypothesis we'd love to see explored further: perhaps psychologically safe environments are those where the disconnecting forms of shame are minimised, while the pro-social forms are managed wisely.

We also looked at what gets in the way in our professions: a culture of stoicism and invulnerability, perfectionism, fear of failure, judgement and complaints. Power gradients and hierarchy, which can be seen as a systemic manifestation of shame. Incivility, which can trigger shame and, in turn, make us lash out (the Compass of Shame offers a helpful map of those reactions). Differing communication needs and preferences, particularly within neurodiverse teams. High demands with low resources. And stigma around burnout, trauma and mental health.

In breakout rooms, a few themes kept returning.

Leaders need psychological safety too. Leadership can be a lonely place. Leaders are often taught how to create safety for their teams, yet have nowhere safe to be human themselves. Some described a kind of anticipatory shame: the fear that if they try something new and it goes wrong, their team will pay the price. Those in the middle of larger organisations can feel pulled between the needs of their team and the demands from above. And when change arrives as a one-size-fits-all template, it can create frustration rather than safety, and quietly raise the question, “am I doing this wrong?”

Modelling matters. One leader described sharing their own clinical errors with the team, naming how awful it felt, and then asking together how to put it right. That kind of modelling sets the tone far more than any policy.

Belonging changes how shame lands. When we feel we belong, a moment of shame is less likely to feel like a threat to our place in the group. When we feel othered, whether through ethnicity, neurodivergence, disability or anything else, the risks stack up. A social misstep and a clinical mistake can both become sources of shame, and our internal narrative may already be primed to go there, often shaped by experiences from childhood.

Basic needs come first. Being hungry, exhausted or dehydrated makes it much harder to meet a difficult moment without making shameful meaning of it. Neurodivergent colleagues may override those signals more easily, so supportive structures help everyone.

Safe spaces work. Research on the second victim phenomenon shared in the room suggested that what people most want after an adverse event is someone they trust to talk to, and somewhere safe to simply be alone with their thoughts. One practice described a regular surgical huddle that gradually became a place where people could also say how they were really doing, and other services have since adopted it. Not everyone will want that with their own colleagues, so cross-practice spaces could fill the gap.

Learning to sit with discomfort. Several people reflected on how early we learn black-and-white, right-or-wrong thinking, long before vet school. Learning to welcome discomfort, rather than rushing to escape it, may be one of the most useful skills we can build, individually and as a profession.

We're a growing, international community, and this is very much a shared space. Keep an eye out for further discussions and reflections.

And if any of this resonated, you're not alone. That, perhaps, is the most important thing shame tries to convince us otherwise of.

If you are struggling right now, Vetlife Helpline is available to the veterinary community in the UK and Ireland, 24 hours a day, 365 days a year, on 0303 040 2551 (UK) and 1800 145 145 (Ireland).