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.
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.
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.
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.”
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.