Shame and Substance Abuse
One of the more difficult aspects that those afflicted with a substance use disorder experience is the feeling of shame associated with their process.
The shame an addicted person feels can come from many sources. The fact of the matter is that while substance abuse is a serious widespread issue in the world today, the addicted population only makes up about ten percent of the populace. Due to this fact, there is a stigma surrounding the disease of addiction. As a whole, we are heading in the right direction as it pertains to how we approach the issue of substance abuse, we still have a way to go. For many of us growing up we experienced the Reagan Era approach to drugs (“Just Say No”) or the D.A.R.E programs provided by local law enforcement. Films depicted drug dealers and addicts as the lower dredges of society. Terms like “loser” and “junkie” were thrown around at those struggling in their addiction. The humanity of the disease was overlooked or rather it was misunderstood due to negative societal aspects of addiction.
It is a fact that the cost of substance abuse is tens if not hundreds of billions of dollars in the United States alone. Lost revenue from employees missing work, state and government funded healthcare costs rising due to emergency room visits and the need for first responders, theft and violence. The ripple effects of substance use disorders touch many aspects of our daily lives that many may not fully grasp. Due to these negative aspects of drug and alcohol abuse, there is a stigma surrounding the addicted person. Before a person becomes addicted, they may view those who abuse substances in a negative life. I can say form my personal experience I looked down on those who struggled, until one day I was in their shoes. The realization and fear I had a drug problem caused me shame. I was ashamed I could not use my own will to stop despite knowing what my actions were causing in my personal and professional life. Shame kept me from asking for help. Shame kept me out in active addiction longer.
Shame is different from guilt. While at first glance the two words are very similar, they are actually very different. Guilt and shame are not the same. Guilt is what we feel when we perform an act that goes against our own values. For example, when we steal, we feel guilt due to the fact we know it is wrong but performed the act regardless. Shame is different as it is a belief that something we did or some aspect of ourselves is fundamentally flawed or wrong. Shame is a firmly held belief we have imposed upon ourselves that determines our unworthiness as a person. While guilt can be a nagging feeling and cause us distress, we can have a positive learning experience from it. Shame on the other hand, is an intensely painful feeling and lessens our self-worth.
The stigma of addiction casts a dark shroud over those afflicted. This shroud is an enveloping shadow filled with shame. This shadow of shame makes the addicted person feel like they need to hide their problem and thus prevents them from seeking treatment for their affliction. The feelings of low self-worth and feelings that they are pathetic and weak can plague an addict. It can become a lie that the addict begins to believe. The lie then becomes a self-defeating prophecy. A person with a substance use disorder can begin to think things like, “I’m just no good”, “I deserve this” or “I’d be better off dead”. They hold onto their pain and it becomes all they know.
Shame can also hurt somebody after a relapse. A person who achieves substantial lengths of sobriety that relapses can be kept from getting the appropriate level of care due to the shame of “losing the clean time” and needed to start over. This negative thinking blinds them to the truths. The truth is they may have lost a count of days but everything they put together during their experience sober is not lost. They still maintain that knowledge in recovery. However, it is not easy for those who experience this to acknowledge. In the moment, they are gripped in feelings of self-doubt, fear, depression and anxiety.
Intense feelings of shame can even give a person meaning. It becomes an identity of sorts. The pain begins to define them. If they do not have the pain, then who are they? The pain and feelings they experience happened for a reason, didn’t they? The pain derived from the shame they feel can even feel like a tool or survival skill they use to tell the story of who they are. Without the hurt they no longer have a sense of self. To tell them they do not need to hurt anymore shatters their narrative of who they are.
So how do we break this cycle? How do we alleviate the shame many addicts feel? How can we let those suffering from the disease of addiction know that it is okay to ask for help and receive it? How can we convince a person we mean it when we say “you matter, and we care” when the entirety of who they are says otherwise? The easy answer is to shatter the stigma. We can take steps towards this goal, but this is the long game and cannot be done overnight. So how can we remove the shame?
If you or a loved one is struggling with seeking help in their addiction it is important to develop an awareness. When we accept the shame is holding us back, we can begin to move past it. It is not easy. Sometimes it takes professional help to get over this hurdle. Therapy to overcome these feelings work towards shifting a person’s thinking from the issues that drive the feelings of low esteem and unworthiness. If somebody with substance abuse issues believes they are unworthy of a better life, then it is difficult for them to do little more than continue to seek out their drug of choice. By working towards changing the narrative the process can begin. This can be accomplished rather successfully through the use of Cognitive Behavioral Therapy (CBT). CBT aims to change distorted thinking and form new and healthy thought patterns. By retraining the ways that you think and perceive things you will be able to create a new narrative for yourself.
