Many people who struggle with addiction feel a lot of guilt and shame over their use. A new study published in PLOS One suggests that independent of depression, this shame and guilt can be significant barriers to reducing drug use, which has considerations for recovery.
Substance use is a significant and widespread health issue that can have many adverse effects for people who suffer from it. Due to their prevalence, it is increasingly important to understand why they develop and what mechanisms can help or hinder recovery. Shame and guilt are common emotions felt by people struggling with addiction.
They are often spoken about together but are distinct and separate emotions. Shame is often described as a negative judgment of oneself and is associated with avoidance, while guilt can be described as a negative evaluation of one’s own behavior and is associated with apologetic responses. Previous research has shown that shame is associated with substance use while studies on guilt have been inconsistent.
Researcher Abilgail W. Batchelder and her colleagues utilized a sample of 110 sexual minority HIV positive men living in the San Francisco area who have been confirmed as using methamphetamines. The study design was a randomized controlled trial. Subjects completed an assessment and then were reassessed at 3, 6, 12, and 15 months. Participants completed measures on demographics, health status, substance use, negative self-conscious emotion, positive emotion, and depressive symptoms.
Results imply relationships between negative self-conscious emotions, shame and guilt, and substance abuse. As guilt level changes, substance use level changes accordingly in a bidirectional relationship. Additionally, more shame may lead to slower cessation of substance use. These relationships existed even when depression was controlled for, implying that these self-conscious concepts themselves can have serious implications for substance use. This research could be helpful in understanding barriers to recovery for substance use.
“These innovative results are the first we are aware of to identify bidirectional relationships between negative self-conscious emotions and substance use, including differential relationships by type of substance use,” the researchers said. “While we did not find evidence to support all of our hypotheses, our findings indicated that high levels of shame may delay the pace of stimulant use reduction and that as guilt decreases or increases stimulant use correspondingly decreases or increases, respectively.”
This research sought to better conceptualize shame and guilt in regard to addiction. Though it made great progress, it is not without limitations. One such limitation is that the sample size was small, which can influence results. Additionally, they used a very narrow population, making it difficult to know if the results would generalize to other sufferers of substance abuse.
“While additional work is needed to enhance our understanding of the nuanced relationships between substance use and negative self-conscious emotions to more effectively intervene and ultimately reduce substance use, these results provide compelling novel insights into the complex relationships between substance use and behaviorally influential negative self-conscious emotions,” the researchers concluded.
The study, “The shame spiral of addiction: Negative self-conscious emotion and substance use“, was authored by Abigail W. Batchelder, Tiffany R. Glynn, Judith T. Moskowitz, Torsten B. Neilands, Samantha Dilworth, Sara L. Rodriguez, and Adam W. Carrico.
