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How Does Guilt and Shame Impact Relapse?

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by Steve Wright, LPC

As a substance abuse counselor and now a supervisor of counselors treating both substance abuse and mental illness, I hear about many different reasons clients relapse back into drinking and using drugs. Triggers that pull someone back into the life of abuse and addiction are as varied and numerous as there are people. However, the most common reason I see is an inability to cope with painful emotions.

At the top of that list is guilt and shame. When people cannot face something they have done or something they blame themselves for, they will try to avoid feeling those feelings.

This is natural for nearly all human beings. To keep from feeling pain we try many different ways to avoid emotions. We might throw ourselves into work, or push those emotional thoughts to the back of our minds. Some, unable to deal with difficult thoughts and emotions turn inward and isolate themselves. Others try to pretend everything is fine, while still others escape from their difficult reality through the use of media or other distractions. For the former alcoholic or substance abuser, the use of alcohol and/or drugs was a very effective way to stop feeling pain. It can become their “go to” coping device.

We all have to step back at times from thoughts and emotions that overwhelm us. Many coping mechanisms are benign and do not leave us any worse off; unless, of course, we don’t eventually come back to the real problem and deal with it effectively. For the former alcoholic or substance abuser who uses as a way to cope with his or her emotions, a devastating and potentially lethal cycle of addiction can begin all over again.

For a large number of individuals who struggle with addictions, guilt and shame are already issues they face. Some because of past issues from childhood; some because of the knowledge that they have manipulated and hurt the people that care about them in order to maintain their addiction.

Good substance abuse treatment includes teaching men and women how to deal with these painful emotions. That education should also include the understanding that an addiction is something that controls them. A person need to learn acceptance of the past as something that cannot change and how to have hope for the future. Another aspect of good recovery education includes techniques that can be used to help someone go through those painful emotions instead of trying to avoid them.

Here is a list of good coping skills that have helped many substance dependent individuals keep from falling back into abuse and addiction:

  • Journaling: get into the habit of externalizing your thoughts and emotions in written form. Go back and read those entries and see those thoughts and emotions more objectively.
  • Learn to take time to breathe deeply and slowly at times of high stress or when emotions become overwhelming.
  • TALK TO SOMEONE! 12-step programs encourage the adoption of a sponsor for everyone struggling with addiction for a reason. Dealing with this alone can be too difficult. Would you get into the ring with a heavy weight boxing champion alone? Substance dependent individuals already know that their addiction is more powerful than they are. Don’t fight the fight alone!
  • Get counseling: having someone to help address more serious life issues is important.
  • Pray: Whatever your religious belief, prayer can be an important part of dealing with guilt and shame.
  • Write a new script for yourself. We often play old tapes over and over in our minds; recordings of negative thoughts based on voices from our past or more recent voices, even our own. There is tremendous power in verbalizing new, more positive thoughts about ourselves.

Let me end with a story. A former client of mine, John (not his real name), was addicted to cocaine and alcohol. He shared his story with me, one that kept him from progressing in recovery. As a young boy he was playing with matches in his upstairs bedroom. His younger sister was with him at the time when the unthinkable happened – fire. Not knowing what to do he hid under the bed as did his little sister.

The fire department arrived and was able to rescue him, but his sister died of smoke inhalation. He stated to me that he remembered seeing them lift her lifeless body from under the bed.

The tragedy of being responsible for his sister’s death haunted him, compounded by the fact that his father blamed him for her death and took out his anger on him through physical abuse throughout the rest of his childhood. No one ever spoke to him about it.

Unable to deal with his guilt and shame and tired of the physical abuse, he left home early and began to make his own way in life. Early on he found that drinking and using drugs helped dull the pain of these powerful feelings. He could forget his sense of guilt and shame for a while. But, of course, the development of addictions began to make it all worse. Fortunately, he wound up in treatment.

Through counseling he learned how to stop the negative thoughts of guilt and shame. He was able to accept that, although his sister died in an accident he caused, it was an accident. He realized he was too young to know any better and that his father’s anger was misplaced. He was able to see that he was wrong to project his adult mind into his little boy body to say, “I should have know better.” He realized that he was not old enough then to know better.

The result of learning to cope with guilt and shame effectively allowed him to come to a more realistic acceptance of himself and his addiction and give him the ability to live in recovery. He found healing and freedom. Perhaps you can, too.