Shame is an unpleasant and powerful feeling that occurs during the social exposure of your own shortcomings. It’s connected with a sudden drop in self-esteem because of a negative evaluation of the self. Shame restrains, isolates, lessens and limits. It starts because of a developmental mistake in an early dyadic relationship with the first important object. It is a reaction to rejection, or to real or imaginary danger of losing that object. Complications during the self structuring lead to lasting narcissistic sensitivity and a tendency to shame. Shame hurts more than guilt because the whole self is subjected to a negative assessment, not just inadequate behavior. It is one of the main narcissistic affects. It exists in either open or hidden form. Narcissistic patients often suffer from overwhelming, conscious or unconscious chronic shame. With the domination of shame, we often find a disorder of the self in the clinical picture of narcissistic people. Shame is an affect that suggests that self is endangered so change and consolidation are needed. Due to intolerance to feeling of shame in these patients, it carries the risk of several complications, of which suicide is the worst. In psychoanalytic therapies unconscious shame must be made conscious so it can be analysed, worked on, and then used in therapy as a motivational and a driving tool. Except for its negative sides, shame has an important protective and warning function, as well as an evolutionary and an upbringing role. It helps with the adjustment to external and internal reality conditions, and also strengthens personal boundaries.