Archive for February, 2011

Shame: Impact in Addiction, Treatment and Recovery


I want to share about a great continuing education course for counselors provided by Hazelden Treatment Center (Newberg, OR) I attended last month regarding shame and its impact on addiction, treatment and recovery.


The beginning is simple.  What is shame and how is it different from guilt?  Shame is about who I am and guilt is about something I’ve done.  There are many degrees of guilt but no degree of shame.  If I am feeling shame, I believe that I am bad, period.  Some symptoms of shame are a feeling of chronic emptiness, a belief that “I am not enough,” and that my mistakes equal a sense of worthlessness, isolation, and lots of defenses raised so no one can get inside and judge me.  The defenses that cover shame include things like anger, apathy, lack of trust of others and self, perfectionism, controlling behavior, blaming others and arrogance (fear of being vulnerable or found out).


So how does shame impact addiction?  It’s part of the downward spiral of addiction.  The more shame I have, the more I use to feel better.  The more I use to feel better, the more shame I have.  Shame is also a “relapse normalizer.”  “Of course I relapsed, I’m just a bad person.”


Since shame has such a role in addiction, how do we combat it?  The whole goal of treatment is to move people from shame to guilt and the best way for that to happen is in groups of other people who struggle.  If I see you and I know that you are an addict and not “bad,” and you are being accountable for your actions maybe there is hope for me.  In fact, according to our presenter who has worked for years with addicts in treatment “the group, itself, is the most therapeutic entity.”  Other treatments that are helpful include affirmations, reframing, thinking journals, work on changing the inner critique, art and education about relapse prevention.


So how do I recover from shame?  Sometimes trauma is at the root of our shame and in order to recover fully the trauma must be addressed.  It is estimated that 80% of women with addiction have suffered some kind of trauma.  That’s a lot of trauma.  EMDR therapy has been found to be very helpful in resolving trauma and is being used more often in treatment centers.  Empathy, courage, compassion and connection experienced in daily life can lead to recovery from the shame and addiction spiral.


When clients ask me why they should attend AA or Al-Anon, I say that those groups can do things I cannot.  AA and Al-Anon are shame busters of the highest degree.


Have you thought about trying a meeting?


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