Shame is a powerful emotion that often prevents people from seeking help or acknowledging their problems. In this presentation, shame will be discussed in the context of psychosis and how it often emerges when people encounter stigma or social judgment, experience confusion and loss of control over their mind, or feel that their sense of self was harmed or negatively affected by their psychotic experiences. Special attention will also be given to the relationship between paranoia and shame and the distinction between internal and external shame. The presenter will describe the importance of shame-sensitive care and how to address the impact of shame on the psychotherapeutic process and how to build the metacognitive capacity to withstand shame and talk about painful and disorganizing experiences.