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?


An Interview with Gloria Sandford

Posted by Tanya Ruckstuhl-Valenti in clincial social workpsychotherapy on January 5, 2011 http://seattletherapist.wordpress.com/

By Tanya Ruckstuhl-Valenti LICSW, MSW

Gloria Sandford MA, LMHC

This week I interviewed Gloria Sandford, a bright, intuitive and warm-hearted therapist specializing in addictions and co-dependency.

If you are a therapist interested in learning more about community treatment of addictions within the scope of mental health, Gloria and I will be co facilitating “Becoming Twelve Step Savvy for Therapists” in the spring.

If you are searching for a therapist who has addictions expertise, you can find Gloria on line at http://www.CreativeRecoverySolutions.com or email her at Gloria@CreativeRecoverySolutions.com or call her at 206 303-8506

What do you see as the intersections as well as the separations between addictions and mental health issues?

Addictions are a mental health issue.  Within addictions brain chemistry, thought patterns, behavioral patterns and family dynamics each play a role as in other mental health disorders.  Although overlap occurs, when viewed as a whole, addictions have a unique formation of symptoms requiring a unique response in treatment.

What do you wish the public knew about addictions?

Compassion 1stBoundaries 2nd, Judgment Never.  Nothing happens in recovery work without compassion.  Boundaries come immediately after.  Addictions are a boundary-less disease/situation/form.  And without boundaries, treatment, friends and family will become overpowered and ineffective.

What boundaries do you recommend for family members of addicts?

Find out what really hits you as “not okay” and set a boundary for yourself, for what will work for you.  Not what they need to do, but what you need to do.  Eventually, our boundaries will lead us to healthier boundaries, but at first we will cave, so it has to come from inside: where am I presently?  What needs to be okay to me?

What advice would you give to someone who has a loved one that they suspect is addicted?

Communicate!  Communicate your concerns with unemotional language and without judgment and you’ll have the best chance of being heard.

What would you say to someone who says, “I tried a 12 step meeting once and it was boring/stupid/etc…”?

That is normal.  It takes most people a number of tries to find a fit in 12-Step.  Why?  Because the big “D” of denial takes some time to conquer.

Anything else?

Recovery takes time and there is no perfect way to achieve it.  There are no formulas only paths unique to each individual.  It is a journey toward health and one that I feel very privileged to walk along side.

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