The Shame of Addiction: Refuse to Own it
The conjunction of two events — the celebration of September’s National Recovery Month, and the publication of Brené Brown’s latest book, “Rising Strong” —has many of the people who work in addiction medicine thinking about the stigma of shame. National Recovery Month traditionally marks a time when people in recovery are encouraged to deny their past issues with shame and take pride in their stories of recovery. Brené Brown reminds us that the shame of addiction can only affect us if we don’t take ownership of our recovery … our story. Brown spends her days working as a research professor at the University of Houston’s Graduate College of Social Work. She has also studied and written extensively about the human behaviors inherent in addiction, including vulnerability and a debilitating sense of shame and guilt.
Her work is practically de rigueur for anyone who is working on recovery or helping others achieve their own recovery. She is one of those people, like Melody Beattie, who writes for a beaten-down population that does not often claim its champions. She reminds us that we can embrace recovery and own the shame of addiction, and that doing so can be our finest hour of courage and freedom. Shame can come at people suffering from addiction like a missile launched with a two-pronged attack. The first attack causes an instinctive gut reaction based on the horrible experiences that they have lived with over time. They think they must be bad or those things wouldn’t happen to them. The second prong may be a reproach of their failure to make positive choices, and if it comes from the people they love then it hurts all the worse.
The American Society of Addiction Medicine tells us that up to 60 percent of all intimate partner violence (IPV) co-occurs with substance use disorder. We learn that up to 90 percent of all people who abuse alcohol or drugs experience IPV, report sexual, physical, or emotional abuse during their childhoods, or suffer from memories of a specific traumatic event. The memories of those events result in feelings of vulnerability and shame. As imperfect adults, we cannot sort out that we did not cause those events to be perpetrated upon us. We blame ourselves for incurring the abuse of our parents, spouses, or others in our lives. There is even a chicken-and-egg aspect to the shame of addiction: Many people first feel shame over abuse and then medicate it by using drugs, and others first experience the addiction and then progress to the shame.
Such was the case with the grandfather of Dr. Nora Volkow, director of the National Institute of Drug Abuse. Like Brown and Beattie, she has sent distinct and calming messages to those who struggle with recovery, and recently she talked about her grandfather’s addiction to alcohol. As Volkow’s mother neared the end of her life, she admitted to Volkow that her grandfather had not really died of a heart attack, as she had been told, but in fact killed himself because he was ashamed that he could not control his addiction. But that loss of free will, Volkow then explains, is the very nature of the disease. It is not a reason for shame.
So how can we combat shame? Brown teaches us that shame is eradicated by the ability to talk about it with an empathetic, trustworthy person who will hold our vulnerability in a safe place. As the frontrunners in the battle against addiction, substance abuse professionals must elicit from clients their stories of shame and help them realize that being vulnerable and owning their story can change their lives. They can then step out from the imprisonment brought on by shame to the freedom that comes with courage. They now get to write the ending to their own story!