This master thesis in music therapy is a qualitative hermeneutic-phenomenological single case study on how shame is expressed and processed in a course of music therapy with a young suicidal man with Asperger’s syndrome. The presented data is a narrative based on the music therapist’s notation of the course of therapy and transcription of video recordings. A modified thematic coding analysis was carried out with an additional analysis of the musical improvisations in the sessions. The analysis and interpretation data show the following results: The patient shows shame in his appearance, in his expressions and unfolding about himself, and in his musical expression on the piano. Altogether, his signs of shame indicate a deeply shameful self-understanding and a chronic state of shame. Relational traumatic experiences and mis-attunement to the patient’s experience of shame has led to him not to be able to trust in acknowledgment from other people and to have negative expectations to his possibilities of establishing new and healthy relationships. Nevertheless, his experience of shame involves a need for acceptance and acknowledgement. Therefore, the patient exposes himself to the music therapist verbally and through music. In the beginning of the music therapy course, the music therapist experiences shame in her countertransference, often in projective identification of the shame of the patient. By verbally, non-verbally and musically holding and tuning in to his experience and expression of shame, and later becoming aware of her own shame, the music therapist facilitates a therapeutic environment in which the patient begins to develop trust in his relation to her. This is essential for the processing of the shame of the patient. In the end of the music therapy course, signs in the appearance, verbal expressions, and musical expression of the patient indicates that shame has been processed. That is, the patient still experiences shame, but now in a less invasive way and often in association to expressions of pride and self-acknowledgement. Finally, the patient seems to be processing his shameful self-understanding into an understanding of himself as a person who can establish a healthy relationship with the music therapist and shows openness to receive her care and acknowledgement. The fact that he still struggles to process her acknowledgement of him, illustrates the difficulty and tardiness in processing shame in therapy. The findings of the thesis document the feasibility of music therapy for processing chronic states of shame.