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Shame can play a powerful role in shaping human behaviors and relationships, and thanks to researchers like Brené Brown, we now know more about the psychology of shame and how it works than ever before. But what is shame’s role in recovery from addiction and substance use disorders, and how might awareness of its influence and steps to address it improve treatment outcomes?
We reached out to Adis Padron for insights into these questions. As the program director of FHE Health’s Compass and Empower programs for men (Compass) and women (Empower), Padron has expertise working with people in recovery from substance use disorders and dual diagnoses. She also has been a licensed mental health counselor since 2015. Padron specializes in therapies like cognitive-behavioral therapy and motivational interviewing, which offer tools for addressing and overcoming shame. Her answers below shed light on the importance of addressing shame in recovery and ways to do so.
Understanding Shame
What Is Shame?
“Shame is an unpleasant emotion that comes with negative self-evaluation,” Padron said. She noted shame’s close association with guilt and that the two “go hand in hand in recovery.”
The Differences Between Shame and Guilt
Padron was careful not to draw easy lines of separation between shame and guilt when describing their differences:
Shame and guilt really go hand in hand in recovery. Shame is the self-evaluation of not being morally correct. Guilt is another emotion and the understanding that “I did something wrong.” Guilt is the self-conscious emotion regarding your own actions. When people are using, they think about all the bad or regrettable things that they did, and this guilt can turn into shame.
Mental, Emotional, and Physiological Characteristics of Shame
What are the mental, emotional, physiological characteristics of shame?
“Physiologically, when we talk about how the body reacts to shame, the sensations tend to come and go, and people often develop patterns to deal with the symptoms of shame,” Padron said. “People may become overly aggressive or emotional or at times have extreme anxiety or depression.”
At the mental and emotional level, shame can be the “gut-wrenching feeling that you can’t really get past certain emotions; and “you may put yourself in a mental jail where you tell yourself you can’t get past a certain event because of the shame and guilt associated with it.”
Padron added that shame dynamics can vary with the person, their specific situation, and the origins of shame.
The Origins of Shame
Where does shame come from?
Padron was quick to emphasize the role of early childhood experiences. She talked about how shame can develop in the interplay between “nature” and “nurture: “Are we born with preconceived notions because of our genetic material, or do we develop certain shame-based patterns with nurture? I think it can be a combination.”
Padron gave the example of how many of us as children learn emotions based on the feedback that we receive from our parents:
If you’re playing Monopoly as a child and throw all the pieces — and then your parents give you feedback that when we’re angry we don’t throw things — you learn to associate anger with throwing things. If you’re happy and giggling, and your parents say that they can tell you’re happy, you correlate happiness with laughter.
In other words, “we build our ability to identify emotions based on how they manifest in our daily life.” And these experiences can vary greatly between individuals: “You can interview just a couple people and discover that being happy or upset looks different, based on their upbringing and what they learned from their parents.”
A similar dynamic helps to describe the evolution of shame in one’s family of origin, Padron said:
Our parents push their understandings of shame onto us with messages like “we don’t wear short skirts” or “boys don’t cry” — so that over time those messages can manifest as feelings of shame about one’s body or about expressions of emotion.
Cultural and Societal Influences
Shame also has cultural and societal origins.
“Your culture has a lot to do with it,” Padron said. “I’m Cuban, so that environment is very different than what someone in Iowa grows up with. A person’s culture may send the
message that miniskirts are inappropriate or that it’s shameful for a man to cry.”
People in recovery may also absorb shame from societal influences.
“We’ve come a long way in understanding that substance use is a disorder, but there still is a lot of shame attached to it because of the label of ‘drug addict,’” Padron said.
Once again, a person’s community — their societal context — can mediate their experience of shame:
If you’re in a sober community that understands the struggles of an addict, it can be very open and destigmatizing; but if you’re in the middle of nowhere without a sober support group, you may be more vulnerable to that shame and stigmatization. Your community and environment can either make or break you.
Types of Shame
What types of shame are most common in recovery?
“Toxic” shame is common in recovery and the highest level of shame, according to Padron. She described it as “self-sabotage, isolation, and a false sense of control – in recovery, you know how to fail, so toxic shame says, ‘I’m going to do everything I need to do that.’”
A person’s level of shame will depend on factors like its intensity, whether it manifests as a “fight or flight” stress response, and whether “you’re able to move past it.”
The Impact of Shame on Recovery
Why is it important to address shame in overcoming addiction? The answer to that question has everything to do with the impact of shame on recovery — and particularly its effects on mental health and behavioral patterns.
Padron described that impact this way:
If you continue to self-sabotage and self-isolate because of shame, that makes it difficult to challenge those old behaviors and implement new ones. It really prevents you from being able to understand that you’re feeling anxious or sad and from implementing new coping tools like talking to a therapist or going for a walk.
Shame can become a mental prison. Say someone notices that I’m a little off. Then I start to self-isolate because of negative self-talk. If you don’t have good awareness about the negative self-talk and/or a supportive community that calls you when they don’t see you, you’ll self-isolate more. Those shame-based thoughts and behaviors can quickly lead to relapse.
Psychological Effects
“Shame needs to be addressed because it’s a weight that prevents you from moving forward,” Padron continued. Some of her clients have been “so ashamed of what they did to others in active addiction that they don’t share it in therapy.” After they leave treatment, those same guilt-and-shame-ridden thoughts about past actions continue to keep them from moving forward in their recovery, Padron said.
“On the other hand, understanding the things that we did in our past — that they don’t have to continue to define who we are — that lets you take control of your own narrative,” Padron said.
Overcoming Shame in Recovery
What tools and strategies can help individuals overcome shame? Padron mentioned several and described how they help.
Therapy
“People sometimes think of therapy only as a crisis measure, but therapy can be about helping to make your day better. It helps you develop self-compassion and address those things you’re not proud of, but that don’t have to determine who you are moving forward. Therapy can give you tools for defeating negative self-talk and help you find strategies to understand your feelings and associated behaviors.
Many of us can get stuck not seeing the positivity, but words have a lot of power, so being able to talk ourselves off the edge and acknowledge “I did a lot of things in the past but that’s not me anymore” — just changing some minimal things can have a long-term effect. Therapy can help there.
Therapy is also about becoming more mindful of the situation we’re in and the changes we want to implement. If I want to accomplish x, y, and z, a therapist can help us develop goals for that.”
Inpatient Group Therapies
Same-sex therapy groups that help individuals feel safe to share and get feedback from their peers about experiences like sexual trauma provide great opportunities to address shame and find healing, Padron said.
Practicing Self-Compassion
“This is everything in life, in terms of giving yourself grace. Some of us may mess up more than others, of course, but self-compassion is the understanding that we’re not meant to be perfect and can learn from our mistakes. We will have good days and bad days. The whole goal is to keep pushing through. With addiction, we have no notion regarding how to be nice to ourselves, so it’s okay to have the full spectrum of emotions. Self-compassion is understanding that I know I’ve done bad but deserve better.”
Practicing Mindfulness
“This is about being present to our thoughts, emotions, and behaviors, so that we can begin to understand why we’re reacting this way and feeling this way. In active addiction, you’re shutting everything down with substances and only thinking about the next hit. Mindfulness is about becoming more aware of mind, body, and soul and the need for self-compassion.”
Conclusion
Can you fully overcome shame? A good therapist and/or effective inpatient treatment program will help you “manage your shame,” Padron said. “There are certain traumas and aspects of who we are from childhood that we won’t be able to completely erase, so we must learn to live with it.”
Here Padron used the analogy of a rock in one’s pocket:
If you carry a rock in your pocket, the first couple of days, you’ll feel the weight; but with time you learn to live with the rock in the pocket so that it doesn’t’ prevent you from moving forward. Some painful things are just there at the surface level, and we won’t leave everything behind; but these things don’t have to prevent us from being the person we want to be.
Are you struggling with drugs and alcohol? Reach out anytime. We’re here 24/7.
