In Addiction and Recovery, Guilt Heals While Shame Poisons

Most people don’t see much difference between guilt and shame, and both are perceived as emotions to avoid. They can be experienced after doing something harmful or embarrassing. However, for those in treatment for substance use disorder, there are significant differences between guilt and shame.

Guilt heals, and feelings of guilt are a sign of a healthy recovery. Guilt allows healing by allowing ownership and empowerment. Guilt is connected to behaviors, and behaviors can be changed. Shame is poison to recovery. In fact, shame is one of our worst enemies, and ending the stigma and shame of addiction is at the core of everything we do at Caron.

Feeling bad is a necessary part of the human experience. Its unrealistic to think that we should all be happy all the time – life doesn’t work that way. Families at Caron Florida are sometimes surprised that we want patients to talk in their therapy sessions about all the pain, the hurt, and the guilt and shame. Shouldn’t they be focused on the future? Shouldn’t we be helping them to find the positive? The answer is simple: If a person doesn’t deal with their past and their present honestly, confronting the reality of their situation, then they can’t move forward effectively. They must know where they are before they can plan what they want to achieve.

Here we come to the core difference between guilt and shame.

When someone inherently understands that their action or behavior was inappropriate or hurtful to others, that’s guilt. Guilt is a necessary part of the adult process of evaluating our behavior. Without guilt, whether due to alcohol or another type of addiction, we don’t have any reason to change those behaviors. Yet, it’s also important to identify what really is or isn’t our responsibility. Therapeutic guidance can serve to increase appropriate guilt, which positively confirms an individual’s ability to grow and adapt into healthy relationships. An increase in guilt, combined with an increasing responsibility for adult behaviors, causes a reduction in shame. Guilt induction causes shame reduction.

Shame, on the other hand, convinces us that we ourselves are bad. Not, “I did bad things,” but, “I’m a bad person.” Shame leads to feelings of worthlessness and helplessness, that the problem is a fundamental character flaw that we are powerless to change. Nothing could be further from the truth, because we do have the power to change.

The Healing Power of Guilt

In treatment, we’ve learned that the more someone accepts their guilt -- which is about behaviors -- the less shame they carry. If we can get someone talking about their behaviors, we can decrease their feelings of shame. And we increase their sense of empowerment which creates the openness for an increase in genuine self esteem.

This tends to be a very uncomfortable process, both for the patient and for the family. There is a temptation for family members to jump in and protect their loved ones from feeling this pain. Their natural parenting instincts kick in. What if the guilt their loved one is experiencing becomes too much for them and they start using again?

It’s not an irrational fear. This speaks to the need for a supportive and safe treatment environment in which to do this type of work. Under those circumstances, a family can understand intellectually that their loved one has support and that the family doesn’t have to take on the responsibility.

Still, we counsel families to step back. If they allow their loved one to take responsibility for their guilt, this empowers their loved one to make changes. They build genuine self-esteem, because they’ve made positive changes.

As adults, most of us have self-esteem because we have overcome difficulties. We don’t feel self-esteem because we got out of bed in the morning. We feel it because we made it to work on time for an important meeting when traffic was difficult, perhaps by getting up early or taking the back roads, all while making sure the kids got to school on time. Addiction is no different. Only by allowing someone to work through their difficulties themselves do we give them a chance to grow.

The Healing Role of the Family

Families play an essential part in the healing process. The patient is the family, and the family is the patient. If the family is not involved in the process of getting well, then that newly sober person who has learned all these new tools and strategies for approaching the world differently will find themselves thrown back in with family members who haven’t been a part of that process and don’t have any of those same tools.

This is not a confrontational process; it is an honest process. It can, however, feel very uncomfortable if family members have developed the habit of shielding their loved ones from reality. We simply ask the families to be honest with their loved one about how their behavior is affecting them and what the experience has been like. Family members don’t need to say anything other than the truth.

Guilt and shame are powerful emotions, but one emotion can become the motivation for real change, while the other leads to feelings of helplessness and worthlessness. Getting people to understand the difference between guilt and shame -- confronting their guilt and letting go of their shame -- often forms the foundation for many of the interventions we do with patients and families.