I agree with your post about when there are no spectator shame can’t bloom. In some case the client may feel that because of experiencing psychological and behavioral problem or symptoms of mental illness and that are a source of stigma. And sometimes the client may also feel shame of unsuccessful attempts (often over a period of years) to resolve such problems. And telling their story to the counselor or therapist face to face could be shameful, and that is why the couch effect could minimize that problem.
Nice seeing you in this course, Ava and looking forward to reading your informative post.