Explore how individuals are affected by guilt, shame, and self-forgiveness in abortion healing, and learn practical ways providers can help clients move toward compassion, community, and freedom.
OVERVIEW
What does freedom look like for someone who feels stuck in guilt, shame, or the struggle to forgive themselves?
For many people seeking support after abortion, the past is not simply something that happened. It can become something they continue to carry: in their thoughts, relationships, self-worth, faith, choices, and ability to receive care. A person may replay what happened, repeat harsh words spoken by others, or believe that one decision has permanently defined who they are.
In this Abortion Healing Provider webinar, Michele Mazelin, Communications Manager for Support After Abortion, spoke with Kelly Burgess, a licensed professional counselor whose clinical work includes trauma recovery, addiction, codependency, and emotionally manipulative relationships. Kelly brought a practical, trauma-informed perspective to one of the most common and complicated themes Support After Abortion hears from clients: guilt, shame, and what can be the long road toward self-forgiveness in abortion healing.
Michele opened by naming the webinar’s theme: freedom. Support After Abortion often hears from people who feel stuck — stuck in guilt, stuck in shame, and stuck in a loop they cannot seem to break. After looking back at nearly 2,000 client records, Support After Abortion found that nearly one-third of clients talked about guilt, shame, or both.
That reality framed the conversation: What happens when someone is stuck in guilt and shame, and what helps them break free enough to move toward self-forgiveness in abortion healing?
Unlike a presentation-style webinar, this session unfolded as a conversation. Michele and Kelly explored the clinical difference between guilt and shame, how shame shows up in clients, why self-forgiveness can feel impossible, what helps when someone is too stuck to offer themselves compassion, how providers can support clients from both religious and secular perspectives, and when a client may need referral to a licensed counselor.
Throughout the webinar, one message remained central: freedom does not mean the past disappears. It means the person is no longer controlled by their past, guilt, or shame.
THE BASICS: FREEDOM, GUILT & SHAME AFTER ABORTION
Michele began by asking Kelly to define guilt and shame, as they are different experiences.
Kelly offered a simple clinical frame:
“Guilt says ‘I did a bad thing.’ Shame says ‘I am a bad person.’”
Guilt is usually connected to a behavior, choice, or action. In many cases, Kelly explained, guilt can be healthy. It may mean a person has acted outside their values, and it can motivate accountability, repair, or different choices in the future.
Shame is different because it attacks identity. It turns “I did something I regret” into “I am a failure,” “I am bad,” or “There is something wrong with me.”
That difference matters in abortion healing work. Guilt can name an action and open the door to growth. Shame tends to make people hide, numb, punish themselves, isolate, or believe they are beyond help.
WHAT DOES SHAME LOOK LIKE IN CLIENTS AFTER ABORTION?
Michele then invited participants into the conversation by asking what shame often looks like in their clients.
Karin Barbito, Healing Support Specialist for Support After Abortion, shared that this is a large question because there are probably as many answers as there are people struggling with shame. Still, she named several phrases she has heard clients speak over themselves:
“There’s something wrong with me.”
“I’m a failure.”
“I should have known better.”
“I don’t want to be a burden.”
“I’m evil.”
Karin noted that those kinds of statements are attached to identity. They are not only about what someone did; they are conclusions the person is making about who they are.
She also named some of the unhealthy choices and behaviors shame can lead to. She mentioned substance use or numbing, including cutting or other ways people try to numb emotional pain. She also named giving up on positive steps because the person cannot convince themselves they are better than they feel they are, as well as codependency, perfectionism, unhealthy caregiving patterns, and isolation.
Karin added one more example from her own experience after abortion: intentionally punishing herself.
The chat responses mirrored what Karin described. Participants named shame as embarrassment, disgust, worthlessness, “everyone is better than me,” self-harm, addiction, constant comparisons, brokenness, unworthiness, “I hate myself,” being unable to look someone in the eye, “I did this to myself,” not feeling worthy, avoiding the fact, self-loathing, self-destructive behavior, deep sorrow, regret, blame, thinking less of self, and hoping no one will ever find out.
Kelly said those examples matched what she sees clinically. She added one phrase she has heard repeatedly:
“If people knew me, if people knew what I did, they would leave.”
For Kelly, that reflects the feeling that no one can know the “big, bad secret,” because if they knew who the person really was, they would not want to be around them anymore.
That belief captures the isolating power of shame. Shame not only makes someone feel bad about the past, it can convince them they have to hide in order to stay loved.
SELF-FORGIVENESS AFTER ABORTION
Michele then asked Kelly how self-forgiveness ties into guilt and shame, and what it looks like in clients.
Kelly described self-forgiveness as “often the bridge between guilt and healing.”
Healthy guilt says, “I wish I would have done something differently.” Self-forgiveness allows a person to acknowledge the reality of what happened without becoming trapped in it.
When shame is present, self-forgiveness becomes harder because the person can no longer evaluate only the action. They are judging themselves as a person.
Kelly named one important misconception: many clients believe self-forgiveness in abortion healing means saying that what happened was okay. Kelly clarified that it does not.
Self-forgiveness is not rewriting history. It is not pretending something didn’t matter, minimizing pain, or sugarcoating what happened. Instead, Kelly explained, self-forgiveness means acknowledging what happened honestly while also recognizing that human beings are more than what they have done — even more than the thing they believe is the worst thing they have done.
When Michele asked what changes when someone begins moving toward self-forgiveness, Kelly said they begin talking about actions rather than identity. The experience is no longer who they are. It is something that happened, something they did, or something they regret — but it is not the whole of them.
CHAT FEEDBACK: SELF-FORGIVENESS AFTER ABORTION
Michele invited attendees to share whether the conversation about self-forgiveness resonated with them and what they had observed with clients or experienced themselves.
Angel shared that after her abortion experience, she could not even fathom what self-forgiveness looked like. She described struggling with low self-worth and feeling that she did not deserve to be forgiven. It took time for her to begin the road to healing because she couldn’t separate what she did from who she was. It felt “all one and the same,” and she internalized it deeply.
Angel said she has seen the same thing in clients. Many cannot initially separate what they did from who they are. Many feel unworthy of forgiveness or ashamed for people to know who they truly are, and the thought of someone knowing about their decision to have an abortion can bring up complex emotions and feelings.
The chat reflected similar themes. One participant shared that “as she learned to forgive herself, she learned to give herself grace.” Another described a “lightness in the person’s countenance” when someone begins to move toward self-forgiveness. Another wrote, “I could not self forgive until I could speak out loud that which caused me to feel the shame.”
Angel also wrote in the chat, “There is a level of freedom when you can say it out loud. It’s not easy, but it does help.”
Another said, “it took accepting love from God to be able” to forgive herself.
Michele noted that Support After Abortion also sees clients who struggle with self-forgiveness from a secular view and said they would talk about that later in the webinar.
She also named rumination and replaying as common barriers that make self-forgiveness difficult. Another participant shared about “being able to receive forgiveness but still not being able to share the story out loud, not wanting anyone to know.”
One participant reflected on loving and accepting yourself for making the best decision you could at the time, while still carrying trauma and hurt and seeing the need to heal.
Karin added a phrase in the chat that resonated with many participants:
“Our secrets keep us sick.”
Another participant shared a turning point: “I had a friend tell me before I can begin to forgive myself, I need to forgive the girl who had the abortion. That was my moment.”
Together, the chat made clear that self-forgiveness in abortion healing is not simply a concept. For many clients and providers, it touches the deepest questions of identity, belonging, faith, secrecy, and worries about whether a person can be loved after their story is known.
SELF-FORGIVENESS IN ABORTION HEALING TIPS: WHAT WOULD YOU SAY TO… & COMMUNITY
Michele then asked Kelly to explain one of her go-to questions for clients who say, “I can’t forgive myself”:
“What would you say to a friend if they came to you with this same story?”
Kelly explained that when people are trapped in shame, their perspective can become narrow. This question urges them to look outside of that tunnel vision.
If a best friend came to them with the exact same story, with all the background details, what would they say?
Kelly said people often respond with grace and patience they cannot show themselves. They might say, “You were going through a lot,” or “That was such a difficult situation,” or “Of course it was hard.”
That exercise can help shift perspective.
But Kelly also cautioned that this technique does not work for everyone. If the person is not able to shift their perspective cognitively, they need community. They need someone else to show them grace.
Kelly named a central truth about shame:
“Shame lives in darkness.”
When someone shares their experience with someone else and is received with compassion, it can help them experience the shame less.
If a client cannot move from compassion for someone else to compassion for themselves, Kelly suggested making the question smaller. Providers might ask:
What would a therapist say to you?
What would a mentor say to you?
If the client is religious, what would your priest or preacher say to you?
The goal is to help the person identify a safe person they might be able to share their story with.
That was one of the major threads of the webinar: self-forgiveness in abortion healing is deeply personal, but it often doesn’t happen in isolation. Sometimes people need to borrow the compassion of another person before they can begin to offer it to themselves.
SELF-FORGIVENESS IN ABORTION HEALING TIPS: STOPPING THE SPIRAL
Michele then asked Kelly about a “medium step” for clients who cannot move from negative thoughts about themselves directly into positive thoughts.
Kelly said she found this especially relevant in her work with veterans. Many struggled to move from incredibly negative self-talk to positive self-talk. They could not make that jump.
In those cases, the first movement may be from negative to neutral.
Instead of expecting a client to replace self-hatred with self-love immediately, Kelly focuses on helping them catch the negative self-talk spiral and stop it. If a client can develop the skill of stopping the spiral, they may eventually be able to add positive messaging. But first, they can build the habit of stopping the spiral.
Kelly later gave several examples of tools for shame spirals.
One is identifying a phrase the person can hold onto when the spiral begins. For example:
“I’m not doing this today.”
The goal is to catch the spiral, name it, and interrupt it.
Kelly also described externalization. The person can take the thought they are having and name it, or even give their brain a name. Kelly gave the example of naming her brain Sarah. If she were having a bad thought spiral, she might say, “Sarah, I can’t do this with you right now.”
Kelly acknowledged that it may sound silly, but said that “neurologically, it actually changes the place in the brain, so it can help you externalize the thought and create space.”
For providers, this is a helpful reminder that clients may not be ready for affirming language right away. Sometimes the first sign of movement is not “I love myself.” It may be, “I am not going to keep feeding this thought today.”
SELF-FORGIVENESS IN ABORTION HEALING TIPS: RELIGIOUS & SECULAR CONSIDERATIONS
Because Kelly works in both secular and religious spaces, Michele asked her to speak to both.
For clients whose belief systems include divine forgiveness, Michele named two patterns. Some clients are afraid that God cannot forgive them, so they cannot forgive themselves. Others say they believe God forgives them, but they still cannot forgive themselves.
Kelly said the first group can be invited to explore whether their beliefs about forgiveness are consistent with what their faith teaches.
What does your faith teach?
If they use the Bible, what does the Bible say about forgiveness?
Where are the examples of forgiveness in the Bible?
For clients who say, “God has forgiven me, but I can’t forgive myself,” Kelly asks:
If God can forgive you, why are you holding yourself to a higher standard than He is?
Kelly clarified that this is not meant as a “mean challenge,” but as a way to help the client reflect.
Michele also asked Kelly to talk about something she had once mentioned that she asks clients: “what’s the evidence?” In religious contexts, Kelly said that might mean going back to the Bible and asking: What is the evidence of God forgiving people in the Bible? What is the evidence that He is not forgiving you?
For Catholic clients, Kelly said she may use the saints as examples, noting that some saints had “colorful pasts” and reconnected with their faith.
The point is to use examples from the client’s specific faith walk to help them see what they may not be paying attention to.
Michele connected Kelly’s ability to “enter into what their faith is and then help them within the construct of their own belief systems” to Support After Abortion’s emphasis on meeting people where they are.
Michele then asked about people whose belief systems do not include divine forgiveness. She gave the example of a Buddhist client who wished she could go to confession like Catholics, but her faith did not include external forgiveness. Michele also named clients who do not believe there is anyone besides themselves who exists to forgive them, and they cannot forgive themselves.
Kelly returned again to community, “I’m going to sound like a broken record…but honestly, community is the answer.”
She said religion often brings a sense of “other” through God. If divine forgiveness is not part of the client’s belief system, Kelly said they can experience an “other” through community.
If it is not God showing someone compassion, Kelly would look for community members to show them compassion. She would encourage the person to seek out someone with a shared experience or a support group, so they can see they are not the only one who has experienced this and can receive compassion from those people.
Michele noted that this is part of why support groups work for many people. She also connected it to Support After Abortion resources such as Keys to Hope and Healing, Finding Solid Ground, and video stories, where people find reading or hearing someone else’s story can help them feel less alone.
The thread running through both religious and secular examples was the same: providers meet the client where they are. They help the client find a way to receive compassion that fits their own beliefs, language, and community.
SELF-FORGIVENESS IN ABORTION HEALING TIP: WHEN OTHERS ARE INVOLVED
Michele then brought in a question from the chat:
What if it is hard to forgive yourself because you were not the one who made the decision?
In this situation posed by an attendee, doctors had influenced the decision, and the person still found it hard to forgive herself.
Kelly said that kind of circumstance requires processing the whole situation. As difficult as it may be, the client may need to move toward some kind of forgiveness for the doctors who influenced the decision, because forgiveness is ultimately for the person forgiving, not necessarily for the other person.
Kelly said that would be the first piece before moving on to self-forgiveness, because the person would need to process the whole situation in full.
Michele said Support After Abortion hears similar themes when the influencing person is a doctor, boyfriend, parent, or someone else. Although the webinar focused on guilt, shame, and self-forgiveness, she acknowledged that forgiveness of others may also factor into getting to self-forgiveness. For some clients, she said, that may even include forgiveness of God with questions such as, “Why did you let this happen?”
Sometimes self-forgiveness is not only about the client’s own decision. It is also about pressure, influence, betrayal, authority, fear, and the pain of what other people did or failed to do.
PRACTICAL TIPS FOR PROVIDERS: HOW TO HELP CLIENTS NAVIGATE GUILT, SHAME, & FORGIVENESS IN ABORTION HEALING
Michele then shifted into practical tools providers can use when helping clients navigate guilt, shame, and self-forgiveness in abortion healing.
Because Kelly works from a cognitive behavioral therapy framework, Michele asked which CBT tools Kelly reaches for most when working with clients dealing with shame and self-forgiveness.
Kelly named the “what would you tell a friend?” exercise discussed earlier in the webinar as one common CBT tool.
Another tool is helping clients identify the belief, or what Kelly called the shame message. A shame message might be:
“I am not enough.”
“I’m unlovable.”
“I’m awful.”
Once the shame message is identified, Kelly helps clients challenge the evidence for it.
She may ask:
“What’s the evidence for that?”
“What’s the evidence that you’re unlovable?”
“What’s the evidence that you’re terrible?”
Kelly said clients often start with the thing they did. In this case, that might be, “I got an abortion.” Then Kelly keeps asking, “Okay, what else? A terrible person? There must be a list, right?” Usually, she said, there is not much there besides the one thing they are struggling with.
Then Kelly asks for the evidence against it:
“What’s the evidence that you’re not unlovable?”
“What’s the evidence that you’re not a bad person?”
If clients struggle to identify evidence themselves, Kelly may ask what someone safe who knows them well would say about their character, such as their mom, best friend, or another healthy person in their life.
Michele also asked about journaling from a clinical perspective. Kelly said clients usually either really hate journaling or really love it. For clients who like journaling, especially within a CBT framework, Kelly asks them to identify the bad thoughts about themselves and then play the evidence game on paper.
She said it can be powerful to see written out, because usually the evidence that someone is not a bad person is much longer than their evidence that they are.
Across these tools, the central movement is the same: help the client move from identity condemnation toward honest, specific reflection. It’s not ignoring the past. Providers are helping clients examine the past without letting one action become the definition of the whole person.
CHAT FEEDBACK: TOOLS & APPROACHES FOR SELF-FORGIVENESS AFTER ABORTION
Michele then invited providers to share tools or approaches they have found helpful with clients or themselves in working on self-forgiveness.
Karin shared several practical exercises, and later named a summary process that resonated with participants: Acknowledge → Feel → Repair → Learn → Release.
Kelly said that matches how the process can come out clinically in practice. She also noted that “feel” can be its own process because many people struggle to identify exactly how they are feeling.
Karin named the importance of evaluating whether the person is judging an action or making a conclusion about identity. This connects back to the difference between guilt and shame.
Second, she shared an exercise about telling the story with context, not excuses. She named a middle path between minimizing what happened and condemning oneself. She offered questions such as:
What choices did I make?
What pressures, fears, or limitations was I under?
Karin noted that context can explain behavior without erasing accountability.
Third, she shared a multiple-perspective writing exercise. The person can write as their current self, write as the version of themselves who made the decision they regret, and write as a wise, compassionate observer who cares about both of those people.
Karin also named a powerful question that stood out to her:
“What am I afraid would happen if I forgave myself?”
A client may fear that if they forgive themselves, they will become careless, stop being accountable, believe people they hurt deserve their lifelong guilt. Or they may think that if they suffer enough, they will somehow balance the scales. Karin noted that “those beliefs are worth examining because self-punishment does not necessarily make someone more ethical.”
Participants added other tools in the chat, including letters to self, diagramming the context and influencers, Scripture, journaling, writing prayers, memorizing Scripture, gratitude lists, feelings wheels, art, painting, performing music, and helping clients understand they are not responsible for circumstances outside their control.
One participant shared an analogy for stopping spiraling thoughts: “not letting the bird make a nest and lay eggs in your brain. Shoo the bird away.”
Another participant shared a visual activity using rice paper. Clients write down their pain, shame, guilt, or the person they need to forgive, then place the paper in water and watch it dissolve. Another participant said she had done something similar by nailing paper to a wooden cross, lighting the paper, and then being told not to pick up anything she had written down again.
This section showed the value of provider community as well as client community. The chat became a space where providers exchanged tools, images, questions, and practices that may help clients move from shame toward release.
ACTIVITIES FOR GUILT, SHAME, & FORGIVENESS AFTER ABORTION
Michele then connected the conversation to Support After Abortion’s Activity Guide for Facilitators, which includes sections on guilt, shame, and self-forgiveness.
One activity is a guilt and shame sorting exercise. Participants name the messages they tell themselves and begin to notice whether those messages are rooted in guilt, shame, or something else.
Kelly also described a shame card activity she uses with clients.
In the shame card activity, clients receive a note card and are asked to write down their shame messages. Kelly said providers may need to give examples of shame messages, such as “I’m unlovable” or “I’m unworthy.”
Then clients sit with the card in front of them for until the end of the group session. This externalizes the shame message. It is not only living inside the person anymore; it is something they can see and sit with visually.
Kelly said she often teaches about shame in tandem with this activity, including the difference between guilt and shame and what it looks like to heal shame.
At the end of the session, she asks clients what they want to do with the card:
Do they need to hold onto it?
Do they need to rip it up?
Do they need to stomp on it?
What do they need to do with those messages to help them heal and move forward?
Kelly said the most common response is tearing it up.
Michele also named the self-forgiveness mirror activity from the Activity Guide for Facilitators, where a person practices speaking words of affirmation to themselves.
Kelly said the affirmation mirror can work well for some clients, but not for everyone. Some people respond to it, and others do not.
For clients who do not connect with affirmation practices, Kelly often focuses on behavioral activation, including an exercise she described as treating yourself like you are worthy.
She asks clients to consider how a person who believes they are worthy would treat themselves. That person might prioritize rest, eat regularly, try to be in community with friends, and do enjoyable things.
The behavioral activation piece is choosing to do those things even when the person may not want to or may not believe they deserve it.
That can be a helpful bridge, Kelly said, for clients who are not ready to believe compassionate words about themselves. Sometimes the next step is not feeling worthy. Sometimes the next step is practicing one action that treats the body, the person, or the day as worthy of care.
Michele also reminded providers of Support After Abortion’s Nature-Based Healing Resource, written directly to clients. It includes 25 outdoor activities with reflections organized by emotion, including some for shame, guilt, and forgiveness and can give clients something to do on their own between sessions.
CO-REGULATION: LETTING CLIENTS “BORROW YOUR NERVOUS SYSTEM”
Michele then connected the conversation to recent Support After Abortion webinars about nervous systems and co-regulation.
Learn More:
👉 The Body Remembers: Practical Somatic Tools for Abortion Healing Work
👉 Being a Safe Space: The Science of Compassion
She asked Kelly to explain something Kelly had said in their earlier conversation: that sometimes she lets clients “borrow her nervous system” and “take up space.”
Kelly explained that when a client walks into her office, they may be dysregulated depending on what is going on with them. It is her job to be calm and set the pace of the room.
Kelly named limbic resonance, explaining that humans naturally feed off each other and each other’s energy. Letting clients “borrow my nervous system,” she said means, “I make the very hard decision to stay calm and not get amped up with them, so they can pace themselves.”
Kelly also described letting people take up her space as her “gift” in therapy. It is how she supports people. In that space, clients can do what they need to do. “They can be listened to or met with compassion. I give them my space.”
For providers, this reinforced that support is not only about the words used. A calm, steady presence can help create the space where a client is able to slow down, speak, and be met with compassion.
That matters especially when shame has taught a client to hide. A provider’s steadiness can become part of the first evidence that the client’s story can be spoken and received with care.
SELF-CARE FOR ABORTION HEALING PROVIDERS WHO SUPPORT OTHERS: DURING & AFTER HEAVY SESSIONS
Michele then asked Kelly about provider self-care during and after heavy sessions.
Many providers listening, Michele noted, may carry their own stories. Those stories may not be related to abortion; they may include other unresolved grief. Providers sit with clients who carry heavy stories too. Michele commented that she was sure Kelly has also had to balance caring for clients while maintaining her own regulation and well-being.
Michele asked what Kelly does in the moment, during a session, when a client shares something that affects her personally.
Kelly said it can be hard to identify exactly what was triggered during the session. “In session is not necessarily the time to sit and fully identify it,” she said. Instead, Kelly tries to notice what is happening internally. Is she starting to feel anxious? Are symptoms of anxiety showing up?
Then she uses grounding tools that help her regulate. For Kelly, that may mean focusing on the air coming in and out of her nose. That brief meditative practice helps her regulate for a minute, then she refocuses on the client by reminding herself, “This is their time, not mine.”
After the session, Kelly tries to identify what came up. If she can identify what was activated and why it gave her those feelings, she can “work on it so countertransference is not an issue in the future.” She usually takes that to her own therapist.
Michele then asked what Kelly does after a tough session.
Kelly said she works in an office building without windows, which she calls her cave. If a session is particularly difficult, she drinks ice water because it helps her “be in the room.” If she has time, she goes outside. She said she needs to “go touch grass,” feel the sun on her face, and “be somewhere other than where the difficult session happened” so she can breathe and reground herself.
Michele invited attendees to share what they do to take care of themselves during or after a heavy session.
Nyles shared that journaling has helped him as he tends to carry other people’s emotions and let them linger with him. One phrase he writes in his journal is:
“Do not make their story yours.”
Nyles said providers “can care for someone and want better for them without taking on that person’s weight.” He also said people may have their own key words or places that help them separate themselves. “I like to make my place a bat cave,” he said.
Providers shared in the chat many self-care practices they find helpful: getting outside, breathing fresh air, debriefing with fellow workers, journaling, reading Scripture, consulting a professional colleague, staying attuned to breathing and body cues, walking, prayer, stretching, yoga, food, social interaction, getting in nature, Christian music, and “dirt therapy.”
One participant who works by a lake shared that if time allows, she goes outside, stands by the water, and imagines “tossing clients’ issues into the water.”
Michele also spoke directly to solo practitioners who may not have coworkers. She named the importance of building community among other abortion healing providers and mentioned Support After Abortion’s coaching program, led by Karin, as one place where providers can debrief after hard sessions so they do not have to carry the work home alone.
This section echoed one of the webinar’s strongest provider-facing messages: caring for clients does not mean absorbing their stories as your own. Providers can hold space, lend calm, and stay present without carrying what does not belong to them.
Q&A
Q: WHAT CAN WE DO FOR A CLIENT WHO CAN’T FORGIVE THEMSELVES BECAUSE OF OTHERS SHAMING THEM?
A: The first question asked what providers can do for a client who cannot forgive themselves because of other people shaming them. Sometimes the client is stuck replaying harsh words someone said to them, or people still in their life, such as a parent or partner, continue saying shame-filled things.
Kelly said the first thing she does is help the client distinguish between what happened and what other people are saying.
She asks:
What are the facts?
What are other people saying?
Whose voice is saying this to you right now?
Is this accurate?
Is it helpful?
Does this sound like a healthy response?
Those questions help clients begin to separate the facts of what happened from the voices and messages other people have attached to it.
That distinction can be powerful because shame often speaks in borrowed voices. A client may be replaying a parent’s words, a partner’s accusation, a provider’s comment, or a cultural message and experiencing it as truth about themselves. Kelly’s questions help create space between the person, the event, and the shame message.
Q: WHEN SHOULD WE REFER A CLIENT OUT?
A: Michele then asked Kelly to describe situations or circumstances where a non-clinical provider should refer a client out because they may benefit from working with a licensed counselor.
Kelly said referral is important when there is any indication that the issue is becoming more severe.
Examples she named included persistent depression; suicidal ideation or intent; significant trauma symptoms such as dissociation, dreams, or not being able to handle going out in public; severe anxiety; substance misuse co-occurring with shame; self-harm behaviors; eating disorder behaviors; or shame that significantly impacts daily life.
This guidance helps non-clinical providers recognize when abortion healing support may need to be paired with licensed clinical care.
Q: WHAT DO YOU DO WHEN A CLIENT SEEMS TO HAVE DONE EVERYTHING?
A: Michele then asked what to do when a client seems to have done everything — healing programs, therapy, prayer or confession if that is part of their belief system — and is still stuck.
Kelly said she gets curious before assuming something is not working.
“Sometimes clients are still trying to earn forgiveness instead of receiving it. They may be waiting to feel different before acting differently, waiting for some magical thing to happen and wash over them…instead of doing the hard work of changing that feeling themselves.”
Kelly also said, “clients can get stuck thinking the provider is the thing that will save them. A therapist is a tool, but I can’t do it. They have to put the work in.”
She said that’s when she starts “getting curious and asking questions to see how actively they are participating in that healing themselves.”
When Michele asked what Kelly discovers when she asks those curious questions, Kelly said some clients become what she calls “the warm body” in therapy. They show up and think showing up is enough, without digging in and doing the work themselves.
Others get stuck believing that because they still have painful thoughts, they are not making progress. They think healing would mean the painful thoughts are gone.
Kelly said she lovingly reminds clients that painful thoughts are not the marker of healing. The marker is how they respond to the painful thoughts.
For providers, this is a helpful distinction. Healing may not always mean a painful thought never returns. Sometimes growth looks like recognizing the thought, responding differently, practicing a tool, or choosing a new action instead of returning to the old shame spiral.
Q: HOW DO YOU HELP CLIENT EXAMINE THEIR PAST ACTIONS THEY’RE STUCK ON?
A: Michele then read a question about how to help clients examine past actions where they are stuck and move forward toward forgiveness, healing, and flourishing. The question named the tension of living in the present while still being called to examine the past.
Kelly said she would again ask the client to identify the actions instead of characteristics.
That focus matters because it leads the client to look at what happened and what they did, rather than turning the past into who they are as a person.
When they do the hard work—like when she gives a CBT exercise, the client has to do the practice outside of therapy. “If you don’t go home and use it, it’s not going to do anything,” she said.
This returned the conversation to the webinar’s core distinction. Examining the past can be useful when it helps a client name actions, pressures, choices, and context. It becomes harmful when it morphs into identity condemnation.
Q: WHAT CAN WE DO FOR A CLIENT WHO CAN’T FORGIVE THEMSELVES BECAUSE OF OTHERS SHAMING THEM? PT. 2
A: Michele returned to the second part of the earlier question about clients who are still being shamed by others—especially when people in their lives are continuing to say toxic things and keep the client’s shame active.
She recalled two analogies Kelly had shared in their earlier conversation: Trying to heal while toxic people continue to throw shame at you is like trying not to get wet while continuing to walk in the rain. It also is like brushing your teeth while eating Oreos.
Kelly named clearly what the focus needs to become: boundaries.
Setting boundaries may look different depending on the client’s circumstances. Some clients may live with the person shaming them and may not be able to leave immediately. Kelly mentioned in particular young people in situations where the toxic person is their parent, and they had no choice but to live in the same home. In those cases, providers can help the client consider whatever level of boundary is possible in their current life.
CLOSING
Michele closed by thanking Kelly for sharing her time and expertise and thanking attendees for their participation. The chat, she noted, added richness to the conversation.
She returned to the webinar’s core theme: freedom.
Freedom for clients does not mean the absence of the past. It means they are no longer controlled by their past, guilt, or shame. It means they can move toward self-forgiveness.
Providers were also reminded that their work matters. “The work that you do, holding space, lending your calm, staying presence,” Michele said, “that’s a key part of how they get there.”
FINAL TAKEAWAY
This webinar showed that guilt, shame, and struggling with self-forgiveness are often words clients use to describe feeling stuck after abortion. And they are often the hidden forces shaping how clients see themselves, if they feel safe enough to tell their stories, and whether or not they believe healing is possible.
Kelly’s distinction between guilt and shame offered providers a practical starting point. Guilt can name an action and open the door to accountability, repair, and growth. Shame attacks identity and often keeps people hidden, isolated, and convinced they are beyond compassion.
Self-forgiveness in abortion healing, then, is not about minimizing what happened or pretending pain does not matter. It is about helping a person tell the truth without letting one experience become the whole truth about who they are.
The conversation also showed that freedom is not always reached through one tool, one program, one prayer, or one conversation. Some clients need cognitive tools to challenge shame messages. Some need community to receive compassion when they cannot offer it to themselves. Some need to examine forgiveness through their faith tradition. Others need a secular space where shared stories and compassionate witnesses help them feel less alone. Some need clinical care. Many need time.
For providers, the invitation is to remain curious and steady. Listen for whether a client is naming an action or condemning an identity. Notice whose voice is speaking inside the shame. Offer tools, but do not force them. Encourage community, but honor readiness. Know when to refer out. And remember that your calm, grounded presence may be part of what helps a client begin to believe their story can be held.
In the end, freedom means guilt and shame no longer get to control the person’s life, identity, or capacity to receive care. It means a client can begin to say: this happened, this mattered, but it is not who I am. I am worthy.
© Support After Abortion
LINKS
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© Support After Abortion