Shame

A frequent topic that arises in recovery is that of shame. It is often met with dread when brought up in the group setting, yet the need to unburden from it is palpable. The most frequent question I have gotten is “How do I get rid of shame?”

First, I make sure that people understand what shame is. The simplest explanation I heard in the rooms is guilt is feeling bad about WHAT you DID, shame is feeling bad about WHO you ARE.

Second, shame can be experienced by all members of the family and loved ones, not just the person who is using the subtance. There is such a stigma surrounding the disease of addiction that shame can feel contagious. The family member or loved one frequently thinks/feels – I am responsible for the addiction or caused the person to use. The person using often thinks/feels – I am the root of everyone’s problems.

Authors Shadley and Harvery discuss how shame is often characterized as a negative emotion, but one that encourages social responsibility, a guiding force that is essential to our well-being and how we contribute to the greater good (Baldwin, ed., 2013). Kohlberg described it as a tool that propels us to a higher level of moral development, which immediately makes me think of Maslow’s self-actualization process.

Encouraging those in recovery to separate what they did from who they are is essential to making progress physically, mentally, emotionally and spiritually. I often ask my patients – would you have done those things if you were sober/not under the influence?

It is at this point that I emphasize psychoeducation about the disease and how it hijacks the brain, removing a person’s ability to use their pre-frontal cortex (decision-making/impulse control part) so that they are operating from the limbic system (survival part). When we are in flight or fight mode under the control of the limbic system, we are focused on solving the immediate need. In this case – obtaining the drink or the drug – at any cost because it is as essential as eating, drinking, sleeping.

The 12 step programs emphasize cataloging what happened in active addiction/alcoholism and to make amends under the guidance of a sponsor. This is how to effectively eradicate guilt. Shadley and Harvery go one step further and suggest the way to reduce shame is to practice acceptance of self despite the mistakes, character defects and failures.

Acceptance is one of the tenets of recovery as seen in the Serenity Prayer. It is also part of any type of growth – awareness, acceptance and action. Many of us can identify the problem, jump right to the solution and wonder – Why can’t I fix/change this? I know what’s wrong!

It is because we have not truly accepted the problem.

So the answer to how do I get rid of shame? Acceptance.

It is not lost on me that one of my favorite passages from the AA literature in the Big Book of Alcoholics Anonymous is about acceptance – it all comes full circle.

The Self of the Addiction Counselor by Meri L. Shadley and Colleen Jo Harvey from The Use of Self in Therapy 3rd Edition by Michele Baldwin, Ed., 2013.