Being Ashamed of Drinking Prompts Relapse, Not Recovery

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Embarrassment over an excessive-drinking session doesn’t necessarily lead to more sobriety.

In a study of alcoholics and relapse rates, researchers found that the more shame-ridden a drinker looked when talking about drinking — interpreted through body language like hunched shoulders — the more likely he or she was to relapse and the more drinks he or she downed during that relapse.

Researchers, led by Jess Tracy of the University of British Columbia, studied 105 people who had been in recovery from alcoholism for six months or less, recruited from Alcoholics Anonymous (AA) meetings in Vancouver.

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In the first session, participants filled out several questionnaires about their health and personality. Then they were videotaped as they discussed the last time they embarrassed themselves while drinking or otherwise felt shame about an alcoholic experience. Afterward, they rated how shameful and guilty they felt about the incident.

Four months later, participants returned to discuss their recovery and their current health. The authors found that displays of physical shame in the first 10 seconds of the video (coded by a system involving body language) were strongly correlated with relapse rates. For every 1-point increase on the nonverbal-shame scale, participants consumed an additional 11 drinks — and people with a moderate amount of shame drank on average 20 drinks more than those who displayed no shame-related behavior.

“The extent to which they showed shame behaviors when talking about the last time they drank quite strongly predicts whether they will relapse within about four months,” Tracy says.

The results add to a body of literature suggesting that widely used shaming and humiliating methods of treating alcohol and other drug problems — such as those seen on shows like Celebrity Rehab — are not only ineffective but also may be counterproductive.

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For example, a review of the research on the use of humiliating, confrontational tactics, which attempt to induce shame, found that none of the studies done in four decades supported this approach. In one study included in the analysis, the more the counselor confronted the client with past mistakes or other shaming information about his problem, the more the client drank.

Similarly, some studies in which drunk drivers face those they have hurt or the families of those they have killed find that being confronted with this intensely shameful experience increases recidivism, although this negative effect may depend on the offender’s age and gender and on the way the panel is handled.

“There’s that sense out there that shame is good,” says Tracy. But the new study, which will be published in Clinical Psychological Science, contradicts that. It also shows that greater shame was linked with worse health overall, not just increased drinking.

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Why doesn’t shame change or deter addictive behavior? Shame is not only an effect of addiction but also can be a key reason why some people turn to drink or other drugs in the first place. Research suggests that people who feel particularly high levels of shame are at increased risk not just for addictions but also for other conditions that can worsen addictions, like depression.

“If you are prone to shame, it’s incredibly painful and is one of the worst emotions to experience,” Tracy says. “People hate it. And one way to [escape it] is to drink because it helps you get out of your head.”

That can set up a vicious cycle: if you drink to escape shame and then embarrass yourself while drinking, you wind up with even more reasons to drink — and to be ashamed of yourself. “It just goes on and on,” Tracy says.

Shame, however, shouldn’t be confused with guilt. While the two emotions often occur together, they are distinct and have different effects on motivation. Shame is the sense that you are a bad person, while guilt is remorse over bad behavior. “Guilt is much better,” says Tracy, noting that unlike shame, having a sense of guilt when you do wrong tends to be associated with good mental health rather disease.

“When you feel shame, you feel that who you are as person [is] bad and there’s nowhere to go with that, there’s no solution,” explains Tracy. “With guilt, you did a bad thing, but you can fix it.”

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To help overcome shame, those who are depressed and people with addictions are often taught to essentially “hate the sin, not the sinner.” They are encouraged to take responsibility for their actions but to avoid seeing themselves as having a fundamentally bad character. Instead, they’re helped to interpret what happened as bad behavior that they can choose to avoid in the future and for which they can make amends. By reducing shame, they can then reduce the pain that is likely to lead to relapse and perpetuation of the vicious drinking cycle.

Not only can understanding this connection help alcoholics to recover, but identifying those who are more embarrassed by their drinking may help counselors focus on people at high risk of relapse, who may need extra help in overcoming their addiction. That could help make treatment more effective.

2 comments
thefreedomtorecover.com
thefreedomtorecover.com

The organization most guilty of invoking guilt and shame over slips is that of Alcoholics Anonymous. If say, after 6 months of sobriety you have a slip, you are supposed to admit your weakness and defeat and confess your misdeed in front of the entire group. You are then expected to participate in the demoralizing practice of going up to the front of the room to reclaim a "white chip" which indicates that you have failed and must start over. It's as if those 6 months meant nothing. That is a horrible message to send. Those 6 months, 6 days or however long you were successful are NOT meaningless.

Another practice that is particularly negative, in my opinion, is the ritual of declaring that you are an alcoholic every time you raise your hand to speak. I'll never forget the first meeting I went to when during the introductions at the beginning of the meeting, the person next to me uttered; "Frank, grateful recovering alcoholic for 35 years!"

A red flag immediately went off in my head. I thought to myself, if this guy hasn't had a drink in 35 years, why does he still consider himself an alcoholic? That's crazy! The goal should be to become recovered and move on with your life. The problem is that in AA there is NO EXIT plan. The idea is that you are a "recovering" alcoholic that must maintain his or her sobriety "one day at a time" for eternity.

The messages of powerlessness in their Step one is also shame and guilt provoking. Then the suggestion of surrender in their step 3 "Made a decision to turn (SURRENDER) our WILL and LIVES over to the care of God as we understood him" This is nothing more than faith healing. How do you think you are going to feel if you slip after having taken that step? Now, not only have you failed yourself, you've let God down.

Finally there are the "stories" that people share during the meetings. They are basically recaps full of the horrible things that one did while they were abusing alcohol. How does this in any way help and not bring about more feelings of self-loathing and guilt. The pat answer given is that we need to hear these stories so that we don't forget where we came from. Really? I haven't had a drink in close to 4 years and I can still very clearly remember the DUI, the failed marriage, lost jobs, loss of respect from my children, etc...... I don't need to go to meetings every day or every week in order to "remember". I killed a lot of brain cells but not that many. I don't drink so therefore I don't label myself as an alcoholic anymore. Do I have the potential to once again become one? You betcha! But until when and if I do, I'm just a man that used to have a dependency issue, overcame it, and moved on in his life.

Overcoming drug/alcohol dependencies should be about self-empowerment and becoming RECOVERED, not guilt and a lifetime spent RECOVERING.



kfonow
kfonow

I am in total agreement - have thought long and hard about this guilt/shame combo that has been festering in me for a very long time - I am gradually learning to forgive myself and to allow myself feelings of self-worth.  AA has been the catalyst.  With the AA program and by the Grace of God, I have been able to make the changes in my thinking and employ the resources in my life (on a regular basis) that have enabled me to start to like myself and really live and enjoy life as it was meant to be.   I could go on and on...................... I am anxious to read the book.  Thanks.  Karen