此篇論文研究以恥感情緒作為創作手法的七位重要畫家庫爾培、馬內、克林姆、羅特列克、畢卡索、馬格利特、以及培根，分析此一時期現象之因，其發展形式為何，探討恥感圖像的延續脈絡與終極目標，以及對繪畫藝術史進程有何獨特意義。對照特定創作圖像的恥感意識之源，與畫家人格與作品之社會回饋，了解畫家所開創之藝術性影響。筆者以分析理論基礎、視覺與美學理論、畫家專述三大部份的文獻資料，探索畫家重大生命事件與社會氛圍，以研究西洋近現代繪畫史中獨特的發展時期，發現恥感圖像，為畫家逃避現實的另類語法，恥感情緒於畫面的舒展，深深地影響了西方近現代繪畫，並成為當代廣為接受的形式。 此外，恥感圖像的意義遠遠超越現今世人的理解，它構成一種藝術家用以昇華羞恥、執筆表達複雜人生的特殊圖型語言。然而恥感圖像所顯現之恥感，並非真實之恥感，一如圖像並非即為真實，而是現實的再次呈現，以至於重複的再現。恥感圖像或非純然為描繪淫穢下流的現實存有，而是體現了諸如想像、壓抑、慾望、與顛倒夢想的奇異幻境與情色妄念。然而，足以確信的是：任何一種源自於恥感情緒的圖像，所見皆為人類意識所創生，並以獨立渠徑，或其它相互關聯的方式，在獨特的繪畫美學中顯現其存在，成為文化與藝術史中砂磧涓滴的一部分。 / This thesis studies the shame emotions as an important creative technique used by seven famous artists: Gustave Courbet, Édouard Manet, Gustav Klimt, Henri Raymond de Toulouse-Lautrec, Pablo Picasso, René François Ghislain Magritte, and Francis Bacon. The researcher aims to analyze the origin of this phenomenon in this period and the form of development of the shame images. The researcher also discusses the extensile sequence and ultimate goal of the shame images, and the special meanings to the process of the history of painting. By comparing the sources of the shame feelings of the specific creative images, realizing the social feedback of painters’ personalities and their works, the researcher tries to understand artistic effects created by the artists. Moreover, the researcher explores the artists’ important life events and the social atmosphere as the theoretical basis to learn the visual and aesthetic theories, painters’ documents, and this unique period of history of western modern art. And find that the shame image is the alternative linguist for artists to escape. Using the shame emotions to compose the picture had been influencing the western modern painting deeply, and becomes a popular art form contemporary. Furthermore, inner part of the shame images had deeper and more fascinating meanings and associations than we now realize. They made up a language of pattern used by artists to convey ideas about complex human life by the path of the sublimation of ashamed. The shame images show us the shame not the shame itself. Images are not the things shown but are representation thereof: re-representation. What shame images represent may otherwise not exist in the indecent reality and may instead be confined to the realm of imagination, depress, desire, dream, or sexual fantasy. And yet, of course, any image from the shame emotion exists as an object within the aesthetic of painting that it in one way or another engage, what we see is the product of human consciousness, itself part and parcel of culture and history of art.

The background to this thesis is the dramatic increase of the long-term sickness absence that took place in Sweden from the late 1990s. There was also a shift in the diagnostic pattern with rising mental diagnoses. The overall purpose was to describe and try to understand the process leading to long-term sickness absence from the perspective of the sickness absentees, in order to get a better knowledge base for preventive and rehabilitative actions. The thesis comprises four studies (I-IV). Research methods have been both qualitative and quantitative. In study I data from individual interviews with 32 persons on long-term sick leave due to burnout was analyzed using a grounded theory approach. In study II the study population comprised of 2064 employed sick-listed persons, a sub sample derived from the 2002 national Swedish survey on health, working conditions, life situation and sick-listing. It was analyzed if persons with burnout had higher probability of having experienced the steps in the burnout staircase compared to other diagnostic groups in accordance with the previously suggested hypothesis of "the burnout staircase". Study III comprised of 2521 employed persons, a sub sample derived from the same national survey as in study II. It was analyzed if psychosocial work environment and conflicts and losses in private life independently or in combination were more strongly associated to sickness absence with mental diagnoses as compared to a healthy population. In study IV individual interviews with 25 professional rehabilitation actors and 14 unemployed sick-listed persons were conducted. Data were analyzed according to grounded theory method. The process that led to sicknes absence can be described as an emotional deprivation process, illustrated as a flight of stairs (the burnout staircase) describing a sequence of steps toward sickness absence (I). In accordance with the tested hypothesis persons with burnout to a noticeable higher extent reported expereince of being in the different steps in the burnout staircase compared to sickness absentees with other diagnoses. The model seemed to be valid also for persons with other mental diagnoses (II). Reorganization and conflicts at work as well as adding adverse private life events were associated with increased risk for sickness absence with mental diagnosis (III). Three significant factors behind the weak co-operation between local social insurance and employment agencies were identified: indistinct regulation of co-operation, shifting political goals over time and conflicting goals between agencies (IV). In this thesis it has been suggested that the course of events preceding sickness absence might be understood as a process of emotional deprivation, where the individual is gradually emptied of the life-giving emotional energy revealed in joy, commitment, and empathy. This life-giving force finds its nourishment in safe and secure social relations with others and in a social structure that promotes this type of social relations. The profound changes in the Swedish labour market during the 1990s influenced not just the psychosocial work climate but also the rehabilitation efforts for unemployed sick-listed persons. When the political goal of reducing the unemployment level came to the forefront the indistinct regulation and the conflicting goals in addition were factors that impaired co-ordinated rehabilitation. In this process also the physicians were involved. A labour market problem was turned into a medical problem.