Feelings of shame and guilt are often reported by people suffering from substance dependence and addiction. [1] Depending on how these emotions are managed, they can either be beneficial or undermining for addiction recovery. [1]
What are shame and guilt? Understanding the difference
Shame and guilt are both self-critical emotions, and although they have much in common, there are differences between the two. [2] Guilt generally occurs due to a negative action that has caused actual or perceived harm, whereas shame is related to a perception that you are flawed, either in the eyes of others or yourself. [3] As a result, guilt is considered a more social emotion, relating to an individual’s concern about the effect of their behavior on others, but shame is a more self-centred emotion. [1]
For example, if someone misses work due to substance use, they might have thoughts of guilt along the lines of ‘I feel bad for inconveniencing others’; whereas thoughts of shame could include ‘I’m unreliable, I’m not fit to do my job’. [1]
How shame and guilt influence recovery
Those who experience shame with substance use can get locked in a ‘shame addiction cycle’, whereby the individual uses substances to escape feelings of shame, which is paradoxically caused by substance use. [4] However, shame and guilt can be used to aid addiction recovery. Researchers generally suggest that guilt can help to overcome addiction, but shame less so, and therefore target treatments towards guilt and to decrease shame. [1]
However, a new study suggests that both shame and guilt can be equally beneficial or destructive to addiction treatment, depending on how these emotions are managed. [1] Feelings of guilt can inherently lead to a motivation to change, which can be harnessed during addiction recovery. [1] However, researchers also argue that shame can be important in addiction recovery by promoting attempts to redeem oneself. [1]
It has been theorized that shame and guilt can be grouped as either ‘retributive self-blame’, which is destructive to addiction recovery, and ‘scaffolding self-reproach’, which is constructive. [1] Self-blame is generally associated with wallowing in negative emotions, fixating on negative actions and a dysfunctional past, and actively engaging in self-destructive behaviour. [1] On the contrary, a scaffolding self-reproach involves looking to the future with self-compassion, envisioning a different self without addiction, shame, and guilt. [1]
Self-compassion as a pathway to managing emotions
The transition from destructive self-blame to constructive self-compassion is key to a successful addiction recovery. Rather than treating oneself with harsh criticism and blame for past and current behaviors, self-compassion involves acknowledging that imperfection is part of life and something that can be learned from.
This shift in mindset from more negative to more positive emotions helps to stop the shame-addiction cycle. For individuals in recovery, this means recognizing that setbacks and mistakes don't define them as a person, helping them to focus on a positive future without substances.
Evidence-based strategies for managing shame in recovery
Several different strategies are effective in helping individuals manage shame during addiction recovery. Cognitive Behavioral Therapy (CBT) has demonstrated its effectiveness in treating a range of substance use disorders (SUDs). [5] It helps people identify and challenge shame-based thought patterns, replacing them with more balanced perspectives. For instance, instead of thinking 'I'm a terrible person who can't be trusted', CBT might help someone reframe this as 'I made mistakes in the past, but I'm actively working to make better choices now'.
Acceptance and Commitment Therapy (ACT) is particularly effective in shame intervention. [6] ACT takes a different approach to CBT, encouraging individuals to accept difficult emotions like shame, but understanding these emotions shouldn’t prevent individuals from moving forward with their lives. [7] By using acceptance and mindfulness techniques, ACT teaches people to observe these emotions but without letting these feelings dictate their ongoing behavior.
Additionally, group therapy and peer support programs, such as meetings like Alcoholics Anonymous and Narcotics Anonymous, can also be effective for managing shame. They provide opportunities to share experiences in a supportive environment. Hearing others express similar feelings can reduce isolation and normalize the recovery experience and associated emotions. Openly discussing shame in a non-judgmental space can help to significantly reduce its intensity.
Supporting loved ones who feel shame
If you have a friend or family member who is struggling with shame from substance use, it’s important to support them as best as possible. Having an understanding that addiction is a chronic condition with associated neurobiological changes, and not simply a moral failing, can help you to respond with compassion rather than blame.Â
Try to have open and honest conversations with them, but refrain from using any judgmental language or behaviors, as this could further exacerbate their shame and potentially trigger a relapse. Active listening is also important, so that the individual feels listened to and understood, helping them not to feel isolated with these complex emotions.Â
Support can also be provided in lots of practical ways, like finding local support groups and taking the individual to these meetings, or researching local clinics and treatment options. Supporting someone through addiction recovery can be emotionally taxing, so make sure you’re also taking care of your own well-being.
Long-term resilience and relapse prevention
Building resilience against shame requires ongoing practice and support. Shame may resurface periodically throughout recovery, so being able to recognize and manage this is important. Developing healthy coping mechanisms, such as regular exercise, mindfulness, or journaling, for managing shame when it arises, is essential for relapse prevention.
Alongside this, keeping track of milestones, no matter how small, helps counteract shame's tendency to focus on failures. Continuing to engage with therapy, support groups, and having regular contact with healthcare professionals all play a role in long-term relapse prevention.Â
