1. Shame, Guilt and Addiction Susanah Stone, LCSW, MAC, CAADC, ICCDP-D msfyzabad@aol.com

2. Objectives  Training Objectives: Understand the difference between shame and guilt. Understand the impact of shame and guilt in addiction and recovery. Utilizing strategies to assist individuals in the recovery process.

3. Understanding Shame

4.  One of the most powerful and destructive emotions humans experience.  A feeling of humiliation, disgrace, embarrassment. Something is wrong with me.  Basic feeling of inferiority. “I am bad”.  Comes from negative messages we may have received as children from family of origin and even from one culture. Can create shame-based thinking as an adult.

5. Understanding Shame  Self-blame, linked to low self-esteem.  Sense of failure before the eyes of someone. (How I perceive how other see me or how I see myself.)  Shame is broader than just our identity. It has to do with our relationships.

6. Symptom of Shame Shame springs from the lie that normal condition for human being is perfection & absence of problems. Belief of that lie makes one feel uniquely flawed and worthless than other people in the world.  Physiological Symptoms Nausea - Panicky feelings- Poor eye contact- Body minimizing posture- Low energy.  Cognitive Symptoms Demeaning, self-labeling- Guiltiness proneness – Personalization – All or nothing thinking, Perfectionism.  Relational Symptoms Rescuing, or “needing to be needed”- Trust problem -tolerating disrespect & abuse –fear of criticism/anger.

7. Understanding Guilt

8.  Guilt is an acute awareness of having done wrong, accompanied by feelings of regret.  A violation of standards.  Feeling or responsibility or remorse for some offense, crime, wrong (whether real or imagined ).  Creates an uncomfortable feeling about ones behavior.  “ I did something wrong or bad. I acted careless.”

9. Features of Guilt  Guilt is a feeling of responsibility for bad events, ( whether that feeling of responsibility is realistic or not.)  Failure of doing, which is a direct result of one behavior and choice.  Based on values, morals and standards.  Blaming self for past actions.

10. Distinction between Guilt & Shame  Guilt: I did something wrong or bad,” I did something dumb,” “I acted careless,” etc. Emphasis is on behavior  Shame: “Something is wrong with me - I am worthless, dumb can’t do anything right,” “I am bad,” etc. Emphasis is on self

11. Distinction between Guilt & Shame  Guilt is an experience of not meeting your own values.  Shame is an experience of not meeting the values of other people.  Guilt may be private or public, but shame is always public.

12. Distinction between Guilt & Shame  Shame about a behavior is less harmful- the person can usually decide to change the behavior to conform to the group’s values.  Shame about the entire person is much more difficult, because how can a person change who they are?  “You should be ashamed of what you did,” can be remedied.  “You should be ashamed of yourself” requires more intensive work.

13. Can Guilt and Shame co-exist?  Guilt and shame often exist together.  Guilt and shame are negative emotions. When you are addicted to crack, you feel guilty for falling into this trap. To support your addiction, you sell yourself for sex or steal and you feel shame, because you know you have done something demeaning. You are still addicted and continue to feel guilt over it. Guilt and shame exist together and are for the addict feels indistinguishable.

14. Addiction  Addiction is a pathological relationship to any mood altering experience that results in ongoing, recurring life damaging negative consequences. (John Bradshaw)  A physiological and psychological dependency.  More than the drug use.  Lack of boundaries.  Lifestyle for the addict.  Cover-up for flawed feelings.

15. Impact of Shame and Guilt in Addiction  Active addicts engage in behaviors that go against their core values and beliefs.  This is gradual over time and not all at once.  As drinking, drug use and other addictive behavior patterns escalate they find themselves repeating crossing one line to the other, to the point what they’ve become is utterly unrecognizable, even to themselves. (The Recovering Value of Guilt, Shame and Remorse. December 9, 2013. Early Recovery )

16. Impact of Shame and Guilt in Addiction  Guilt and shame happens each time addict violates his/her own value.  The addict then responds to these negative emotions the only way he or she knows how - with more of the addictive activity.  This thereby creating even deeper feelings of guilt, shame.  This constant progression of emotional discomfort followed by addictive behavior followed by emotional discomfort defines the addictive cycle.  Over time, these negative feelings become internalized and cause the addict to view himself or herself as bad, unworthy, and unlovable.

17. Impact of Shame and Guilt in Addiction  Eventually this negative self-talk becomes an integral part of the addict’s personality and thought process.  Here you begin to see life damaging consequences.  Guilt and shame that both drive and result from addiction, makes these negative consequences begin to feel both unavoidable and deserved.

18. Impact of Shame and Guilt in Addiction  The addict begins to think that he/she is the problem and their addiction is evidence of this fact.

19. Recovery work Shame Resolution work  Addiction is a trauma. Addiction and shame goes together.

20. Recovery Work  Addressing trauma issues through use of Trauma-Informed treatment.  Evidenced-based models  Source-Focused Trauma Counseling ( Dr. Denice Colson of Trauma Education & Consultation Services)

21. Recovery Work  The process requires exploring the traumas in the addicts lives.  Examine the messages the traumas have instilled in the individuals.  Treating the underlying causal factors  Understand the unseen factors that created the addiction.  These are often based in trauma or chronic stress. (Copyright H. Gay Otis, PhD, MHC, 2013)

22. Recovery Work  Teaching how to safely deal with your feelings.  Promote Positive- Self-Beliefs replacing Negative Self-Talks.  Help client distinguish difference between shame and guilt.  Emotion Regulation (self-care)

23. Recovery Work 12 - Step Program Spiritual Connectedness  The steps allows:  The ability to SURRENDER. Addiction is a form of control. Give up control.  Step 1- Powerlessness

24. Recovery Work  Ability to SOCIALIZE. Get out of isolation, hiding, pretending, join a group, get a sponsor.  Step 2 and 3  Ability to SELF-DISCLOSE. Need to talk about how bad you feel, the terrible things you have done.  Step 3, 4, 5

25. Recovery Work  Learn about FAMILY SYSTEM. If you were a leader, you learn to follow, stop giving orders, becoming vulnerable with feelings.  Step 4  Ability to learn SELF-TALK. Learn to stop feeling shame about the trauma in life. Address the pain. Affirmations.  Steps 4, 5, 6, 7, 8

26. Recovery work  Ability to LOVE SELF. Loving yourself is a choice not a feeling. Learn to ask for what you want.  Steps 6, 7, 8, 9  Ability to practice SPIRITUALITY. Learning to deal with silence. Spiritual awakening. Meditation. Healing the shame.  Steps 1 through 12.

27. 12- steps Step 1 -Powerlessness Step 2 -Power Greater than Step 3 - Turning Our will Over Step 4 - Moral Inventory Step 5 - Admitting Step 6 - Character Defects Step 7 - Asking removal of shortcomings Step 8 - Making list to Amends Step 9 - Make amends Step 10 – Daily Personal inventory Step 11- Pray and meditation. Step 12 – Carry message through spiritual awakening.