I just think we view this topic from very different perspectives. As I've said, some people experience shame from negative comparisons, but others are not particularly sensitive to such cultural messages and are not unduly influenced by them, either by nature or self-awareness. While I'm sure most have experienced shame at some point in their lives, I view that as a healthy experience. But for someone to be in the grip of continued experiences of shame is unhealthy. I don't think a self-aware T would have any difficulty understanding and appropriately responding to any shame a client feels, regardless of where it originates. But the responsibility ultimately rests with the client to be willing to examine the internal source of continued shame experiences, otherwise empathic acceptance will never be internalized--and the person will continue to be subject to external negative messages.