Barriers to Recovery: Shame

He was the kind of kid who didn’t back down from a confrontation. But this day, as he sat in my office with his head in his hands, he never met my gaze. Instead, he recounted an earlier event when he took medication from a sick relative to get high. He didn’t look at me once.

On another day, in another place, a politician known for not needing a microphone in crowds spoke in hushed tones about his addiction. Barely a whisper escaped his lips, “How did this happen to me? No one can find out about this.”

One of the greatest barriers to recovery for those struggling with substance use disorder (SUD) is shame. Shame is partly the result of stigma (more on this in another post). Where stigma is the voice of the masses, shame is the voice of one. It comes from our self-script –- what we say to ourselves about ourselves. See if you can recognize some of these phrases:

“You’re an idiot! How could you do that?” “You’re weak!” “You’re pathetic!” “Get it together!” “You’re an embarrassment!”

There is a minefield between the time we realize our substance use has gotten out of control (insight) and when we’re ready to access services and develop a plan of recovery.

The in-between ground is strewn with barriers to recovery, cognitive distortions and societal beliefs that slow a person’s progress from insight to services. Recovery from SUD is hard enough as it is. No one benefits from delaying or complicating matters once a person is ready to seek help.

Shame is a massive barrier to recovery. The voice of shame tells us we are Broken. Worthless. Incompetent. Weak. Shame speaks in generalities about personal worth. Most damaging of all, shame encourages concealment. Guilt, on the other hand, speaks to specific past acts that have recourse for repair.[1] The two concepts may appear related, but they’re not the same. Shame hides. Guilt confronts. Shame freezes. Guilt moves. Shame inhibits recovery. Guilt assists recovery.

So many former clients have told me that it was shame that kept them from reaching out for help, sometimes months or even years after they realized they had a maladaptive relationship with substances. That’s because shame creates a type of cycle that goes like this: The person uses a substance to alleviate emotional pain. The relief is temporary. The original pain returns, now with the addition of shame, which deepens the pain. Then, the substance becomes even more attractive.

Researchers have been able to actually measure shame in individuals.[2] The findings likely won’t surprise you. For many, the presence of shame significantly predates the beginning of their substance use. So shame was already on board, a universal self-rejection of the whole person before the first substance was ever used.

So if shame (in part) causes SUD, and then shame perpetuates SUD, we need to find a way to break this barrier down.

Eliminating shame is no small task, but it can begin with challenging our cognitive distortions. We speak to ourselves in our own voice and tend to just accept what we tell ourselves as fact. We can interrupt that cycle by writing down the self-messages we say to ourselves. Take out a sheet of paper and write the words “I am” on each line, for ten lines down. Then, fill in the blanks with phrases you often use to criticize yourself.

Next, take each statement and find supporting evidence for it. I said evidence, right? We’re looking for facts here, not opinions. Lastly, show this list to an objective person and ask for feedback. A therapist would come in handy right about now. In challenging our self-perceptions, we can alter them and bring them more in line with reality. We can come to terms with the adaptive guilt about specific acts and begin to discard the maladaptive shame that keeps us stagnant and hidden in the darkness. This is a great place to begin your inner work.

Here’s your second task in eliminating shame: Shame works best and is the loudest when it’s hidden and alone. But the good news is that shame is malleable. [3] That is, shame is more of a thermostat that we can control and less of a thermometer. One of the best ways to control shame is to do the opposite of what it asks you to do. Shame asks you to hide –- to hide your head in your hands and whisper. Okay, bear with me because this is about to get a little uncomfortable: we have some pretty good evidence that shame lessens the more you tell your story. Even the ugly bits. Especially the ugly bits.

If you’ve ever been to a speaker meeting in AA or NA (Alcoholics Anonymous or Narcotics Anonymous), you’ve seen this in action. Speakers stand in front of the group and tell their stories, warts and all. Watch them do it. It’s not a whisper. As it turns out, shame’s biggest tool is the lie that your whole person will be rejected for what you have done. When you tell your story and notice that you are not rejected (in fact, you are accepted), shame’s hold on you begins to weaken. You’re getting data that contradicts what shame has been telling you all these years. You are not worthless. You are not a failure. You are not weak. You are, in fact, lovable. You are strong. If you can find this truth about yourself, you can move closer to a liberating recovery.

Of the two figures mentioned at the beginning of this post, only one made it to the other side, breaking the cycle of addiction and self-loathing. And it wasn’t the one who was the smartest, had the most resources, or had the most “going for him.” It was the one who tore his house down to the studs and found a person he actually liked. It was the one who pushed through and told his story over and over again. It was the one who finally learned how to be kind to himself.

If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialists can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

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About the Author: Larry Vaughan is a native of Kentucky and is the COO of Human Development Company and Counseling Associates. He is also a licensed counselor who enjoys working with adolescent and adult populations.

Photo by Tima Miroshnichenko: https://www.pexels.com/photo/grayscale-photo-of-support-group-having-a-discussion-5711167/

[1] Dearing, R. L., Stuewig, J., & Tangney, J. P. (2005). On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use. Addictive behaviors, 30(7), 1392-1404.

[2] Rizvi, S.L. Development and Preliminary Validation of a New Measure to Assess Shame: The Shame Inventory. J Psychopathol Behav Assess 32, 438–447 (2010).

[3] Snoek, A., McGeer, V., Brandenburg, D., & Kennett, J. (2021). Managing shame and guilt in addiction: A pathway to recovery. Addictive behaviors, 120, 106954.

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