Continued guilt, shame, and internalised stigma correlated to alcohol and other drug use

Well, hello and good morning, afternoon, and evening readers. I truly hope you’re swimming in the pleasantries of life rather than keeping your head above water in the unpleasant swamp. HOPE = Hold On Pain Ends. And there’s generally a learning or personal growth that comes after the storm of every painful experience, even if it’s simply greater empathy and compassion for others.

Today’s the day to learn or remember the fallacies of the human mind. I am not as smart as I look, haha. Have you heard of heuristics before? In cognitive psychology, a heuristic is a mental “shortcut” that allows people to solve problems and make judgments quickly and efficiently. They can be very helpful in many situations, but they can also lead to cognitive biases, errors in thinking, and even perhaps without the mental shortcut, our thinking is often filled to the brim with cognitive distortions, assumptions and fallacies (faults). Awareness raising is probably the first step to identify our own cognitive traps and also identify them in others. Cognitive errors are natural – we all have them. Below are some cognitive distortions/errors to be aware of when we reflect on our interactions with people, during personal reflection, and when making meaningful decisions or judgements.

• ALL-OR-NOTHING THINKING (aka. POLARISED THINKING, SPLITTING, and BLACK-AND-WHITE THINKING: is extreme thinking i.e., the error in a person’s thinking to bring together the dichotomy of both positive and negative qualities of the self and others into a cohesive, realistic whole. It is a common defense mechanism. Before you think “I must have really shitty thinking because I do this ALL the time”, give yourself a break. If you’re thinking in black and white, you probably internalised this from social media, television and movies, your family of origin and the broader society. Be mindful of using extreme, dichotomist terms, such as “failure”, “success”, “best”, “worst”, “freezing”, “boiling”, “everything”, and “nothing”. If you think “I’m a terrible person”, that is bullshit and inaccurate. You may have behaved terribly for a period of time towards yourself, to someone else, or towards some “thing”, but we cannot discount all the NON-terrible qualities about you. We must THINK in DIALECTICS i.e., the ability to view issues from multiple perspectives with reason and wisdom or in other words being able to have two contradictory viewpoints, where a greater truth emerges from their interplay. The truth is, if you think you’re a terrible person, there’s also virtuous person in there too.

• OVERGENERALISTION: The words “always”, “every” and “never” come into play here, and you have an unshakable “rule” or “conviction” about yourself, something, or someone, based on one or two incidences. Overgeneralising is “a cognitive distortion in which an individual views a single event as an invariable RULE, so that, for example, failure at accomplishing one task will predict an endless pattern of defeat in all tasks.” Coming into the present moment and being specific can be helpful if you are someone who overgeneralises. You may also want to ask yourself if what your saying is the really the truth. Is it really accurate or correct. There’s an assumption that because something has happened once or a few times that it’s like going to happen every time. Remember, the words “always”, “every”, and “never” frequently appear in this cognitive “trap”. I encourage you to look at the big picture and ask yourself if what you’re saying or thinking is accurate. Overgeneralisations tend to be vague and board statements e.g., “I always get every red light”. Perhaps this is part of our evolutionary negativity bias. We tend to notice the so-called “bad” and overlook the so-called “good”. If you find yourself using overgeneralisations that suggest a future prediction (e.g., “I’ll never get a partner) … use some humour – you may have big balls but neither one of them are crystal – VEEP. If there is some truth to unusually frequent and specific situations that are making your life unpleasant, validate them, talk to someone, and brainstorm some solutions. We humans have plenty of blind spots that others can see sometimes.

• MENTAL FILTER: is considered to be the opposite to OVERGENERALISATION the mental filter takes one small event and focuses on it exclusively, filtering out anything else that’s relevant. Filtering out the positive and focusing on the negative can have a detrimental impact on your mental well-being. Filtering out the so-called “negative” can also make one a bit hubris (excessive pride or self-confidence), arrogant, vain and conceited – and then you’re just a stone’s throw away from narcissism.

• PERSONALISATION AND BLAME: Personalization and blame is a cognitive distortion whereby you entirely blame yourself, or someone else, for a situation that in reality involved many factors that were out of your control. I think this is a symptom of our wounded ego, or simply just the ego. As human’s we are egocentric, like children, and we often think that circumstances in our environment are solely because of our influence. For example, your friend isn’t behaving like they usually do, so it must be because you have done something.

Again, personalisation is an egocentric error in cognition. “Of course it has to do with me”, we think. It makes sense that we personalise things. We are the star of our own show, our own narrative. If you personalise something, it means we’ve directly influenced it – we are the primary cause. This may elicit internal pain, shame or guilt, so what’s the pay-off? Personalisation is a cognitive error that offers us the illusion of control e.g., “If we caused it then we will learn how to not cause it again, and maybe even undo what we have caused”. If you think about it, personalising something is something children do. Remember, there are infinite variables in any situation to take full credit of the outcome. That being said, it is responsible and mature to reflect objectively on the influence of our behaviour and what we can learn about our shortcomings.

Blame deserves it’s own blog post but in short, it can be defined as a defence mechanism to protect the self from feeling some unwanted emotion or thinking something unacceptable in relation to the “self”. Blaming provides a way of devaluing others, an the pay-off or reinforcement the blamer receives is a sense of superiority. It protects our ego from feeling responsible for something, and protects us from feeling guilt or shame. Perfectionists are very good at blaming others, and themselves. Even if you genuinely think faulting someone or something is valid, remember that no one is perfect. Recognise that you are human and others are fallible humans. As they say in recovery, “there is a bit of bad in the best of us and a bit of good in the worst of us“. We may have internalised from society and culture that we couldn’t make mistakes (because we receive “punishment” for making mistakes) but we must move beyond that now. As adults, we need to get real. Validate your experience because it may be very disappointing when we don’t meet others or our own expectations. We must nurture and care for the wounded child. Lets attend and befriend to our shortcomings and accept we are not superhuman. Learn to expect you will make mistakes. Failure is kind of an illusion, isn’t it? Or maybe a social construct? “Failure” is really learning – replace ‘failure’ with the word ‘feedback’. Would a cat or dog blame them self for a “mistake”? In the minds of animals, there’s no such concept as failure or a mistake.

Here’s a link to website “simplypsychology” that discusses a theory called Attribution Theory, an idea about how people explain the causes of behaviour and events: Attribution Theory – Situational vs Dispositional | Simply Psychology

Abstract

Addiction is a complex, multifaceted phenomenon that has been described variously as a disease, disorder, syndrome, obsessive-compulsive behaviour, learned behaviour, or spiritual malady. Modern scientific understanding emphasises addiction as a chronic brain disorder shaped by neurobiological changes, learning, and social context. This article examines each conceptualisation and presents an integrated definition that aligns with current neuroscience, psychological, and public health evidence.

Conceptualising Addiction: Labels and Their Accuracy

No single label fully captures addiction’s complexity; each highlights certain truths while overlooking others.

Disease

From a medical perspective, disease is the closest match. Addiction involves persistent neurobiological changes in reward, stress, and self-control circuits, increases relapse risk over years, and shows substantial genetic vulnerability (~50–60%) (NIDA, 2018; Heilig et al., 2021). Treatments improve outcomes but rarely “cure” the condition. This framing is used by the American Society of Addiction Medicine (ASAM), NIDA, WHO ICD-11, and DSM-5-TR (as “Substance Use Disorder”) (NIDA, 2018).

Disorder

Disorder is also scientifically accurate and slightly less medicalised. DSM-5’s “Substance Use Disorder” captures behavioural, psychological, and biological criteria and recognises functioning and harm rather than framing addiction strictly as a lifelong disease (Heather, n.d.; Heilig et al., 2021).

Syndrome

Addiction may be described as a syndrome because it is a cluster of symptoms with behavioural and physiological manifestations, without a single causative factor. However, the term is too generic for practical use outside clinical texts (Blithikioti et al., 2025).

Obsessive and Compulsive Learned Behaviour

Addiction involves learning, habit formation, and compulsion through reinforcement of rewarding behaviours (Hyman, 2005; Hausotter, 2013). Yet describing it solely as learned behaviour ignores genetic predisposition, neuroadaptation, withdrawal, and social factors.

Spiritual Malady

Some mutual-aid traditions characterise addiction as a spiritual malady. While this may be meaningful for individuals, it is not scientifically explanatory: addiction can be adequately explained via biological, psychological, and social mechanisms (Lewis, 2017).

Modern Integrative Definition

The most accurate contemporary description of addiction is:
“A chronic, relapsing disorder of brain circuits involved in reward, stress, and self-control, shaped by learning, environment, and social context”.

This definition encompasses:

• Disease/disorder: medical accuracy
• Learned behaviour and compulsion: neuroscience and behavioural accuracy
• Social determinants: public health relevance
• Flexibility for personal or spiritual interpretations

In short, addiction is best understood as a bio-psycho-social condition that is treatable and sometimes reversible, rather than a deterministic, lifelong curse.

Neurobiology: Why Addiction Is Considered a Brain Disorder

Repeated substance use alters structural and functional brain circuits involved in reward, stress, motivation, memory, and self-control (Nwonu et al., 2022; NIDA, 2018). These changes can persist long after use stops, explaining why addiction is more than a matter of “bad habits” or weak will (NIDA, 2025).

Chronicity and Relapse

Addiction is often chronic and relapsing. Even after long periods of abstinence, cues and stressors can trigger relapse (Meurk et al., 2014; SAMHSA, 2023). Key regions implicated include the basal ganglia (habit formation), extended amygdala (stress), and prefrontal cortex (decision-making) (Kirby et al., 2024). Nevertheless, many individuals achieve stable remission, highlighting heterogeneity in clinical outcomes (Heilig et al., 2021).

Learning, Memory, and Habit Formation

Addiction exploits neural mechanisms of learning and memory: rewarding behaviours are repeated and consolidated into habits, with cues triggering compulsive responses even when the substance’s reward diminishes (Hausotter, 2013; Lewis, 2017). This intertwines biological disorder and learned behaviour.

Critiques and Limitations

Some scientists caution that framing addiction strictly as a brain disease is simplistic:

• Brain changes may resemble those from other motivated behaviours (Lewis, 2017).
• Many recover without formal treatment (Heilig et al., 2021).
• Social, environmental, and psychological factors are crucial to understanding addiction (Blithikioti et al., 2025).

Thus, while the disease model is powerful, it does not fully represent addiction’s heterogeneity or socio-psychological dimensions.

Implications for Treatment

Addiction is treatable, not simply curable. Interventions combining pharmacological and behavioural approaches, alongside social support, can foster long-term recovery (Liu & Li, 2018; Heilig et al., 2021). Like other chronic conditions, management — rather than elimination — is often the realistic goal (NIDA, 2018). Neural circuits can gradually readjust, particularly when environmental and personal factors support recovery.

Conclusion

Addiction is a learned, compulsive brain disorder with chronic potential, shaped by neurobiological, psychological, social, and environmental factors. Recognising addiction as both a disorder and a behavioural learning condition avoids extremes: it is neither an unchangeable fate nor merely a moral failing. This integrated perspective supports nuanced understanding, compassionate care, and effective treatment strategies.

References

Blithikioti, C., Fried, E. I., Albanese, E., Field, M., & Cristea, I. A. (2025). Reevaluating the brain disease model of addiction. The Lancet Psychiatry, 12(6), 469–474. https://doi.org/10.1016/S2215-0366(25)00060-4

Hausotter, W. (2013). Neuroscience and understanding addiction. Addiction Technology Transfer Center (ATTC) Network. https://attcnetwork.org/neuroscience-and-understanding-addiction

Heather, N. (n.d.). What’s wrong with the brain disease model of addiction (BDMA)? Addiction Theory Network. https://addictiontheorynetwork.org/brain-disease-model-of-addiction

Heilig, M., MacKillop, J., Martinez, D., Rehm, J., Leggio, L., & Vanderschuren, L. J. M. J. (2021). Addiction as a brain disease revised: Why it still matters, and the need for consilience. Neuropsychopharmacology, 46(10), 1715–1723. https://doi.org/10.1038/s41386-020-00950-y

Hyman, S. E. (2005). Addiction: A disease of learning and memory. The American Journal of Psychiatry, 162(8), 1414–1422. https://doi.org/10.1176/appi.ajp.162.8.1414

Kirby, E. D., Glenn, M. J., Sandstrom, N. J., & Williams, C. L. (2024). Neurobiology of addiction (Section 14.5). In Introduction to Behavioral Neuroscience. OpenStax. https://socialsci.libretexts.org/…/14.05:_Neurobiology_of_Addiction

Leshner, A. I. (1997). Addiction is a brain disease, and it matters. Science, 278(5335), 45–47. https://doi.org/10.1126/science.278.5335.45

Lewis, M. (2017). Addiction and the brain: Development, not disease. Neuroethics, 10(1), 7–18. https://doi.org/10.1007/s12152-016-9293-4

Liu, J. F., & Li, J. X. (2018). Drug addiction: A curable mental disorder? Acta Pharmacologica Sinica, 39(12), 1823–1829. https://doi.org/10.1038/s41401-018-0180-x

Meurk, C., Carter, A., Partridge, B., Lucke, J., & Hall, W. (2014). How is acceptance of the brain disease model of addiction related to Australians’ attitudes towards addicted individuals and treatments for addiction? BMC Psychiatry, 14, 373. https://doi.org/10.1186/s12888-014-0373-x

National Institute on Drug Abuse. (2018). Drugs, brains, and behavior: The science of addiction (Rev. ed.). https://irp.nida.nih.gov/…/NIDA_DrugsBrainsAddiction

Nwonu, C. N. S., Nwonu, P. C., & Ude, R. A. (2022). Neurobiological underpinnings in drug addiction. West African Journal of Medicine, 39(6), 874–884. https://pubmed.ncbi.nlm.nih.gov/36063103

Substance Abuse and Mental Health Services Administration. (2023). What is substance use disorder? U.S. Department of Health and Human Services. https://www.samhsa.gov/substance-use/what-is-sud

When to Fake It Till You Make It (and When You Shouldn’t)

Faking it for the right reasons can change you for the better. Here’s why.

Posted Jun 27, 2016By Amy Morin

One day, a client came to see me because she felt socially awkward. She knew that her inability to make small talk was holding her back both personally and professionally. As a shy person, she hated going to networking events. But making connections was vital to her career.I asked, “What do you usually do when you go to a networking event?” She said, “I stand awkwardly off to the side and wait to see if anyone will come talk to me.” I asked her, “What would you do differently if you felt confident?” and she said, “I’d initiate conversation and introduce myself to people.”

Right then and there, she discovered the solution to her problem: If she wanted to feel more confident, she had to act more confident. That wasn’t quite what she wanted to hear. She’d hoped for a solution that would immediately make her feel more confident. But the key to becoming more comfortable in social situations is practice.Her instinct was to wait until she felt more confident, but that confidence wasn’t going to magically appear out of thin air—especially if she was standing around by herself. However, if she started talking to people like a confident person, she’d have an opportunity to experience successful social interactions, and each of these would boost her confidence.

Acting “As If”

Acting “as if” is a common prescription in psychotherapy. It’s based on the idea that if you behave like the person you want to become, you’ll become like this in reality:

1. If you want to feel happier, do what happy people do—smile.

2. If you want to get more work done, act as if you are a productive person.

3. If you want to have more friends, behave like a friendly person.

4. If you want to improve your relationship, practice being a good partner.Too often we hesitate to spring into action. Instead, we wait until everything feels just right or until we think we’re ready. But research shows that changing your behavior first can change the way you think and feel.

The Biggest Mistake Most People Make

Faking it until you make it only works when you correctly identify something within yourself that’s holding you back. Behaving like the person you want to become is about changing the way you feel and the way you think.If your motives are to prove your worth to other people, however, your efforts won’t be successful, and research shows that this approach actually backfires. A study published in the Journal of Consumer Research found that people who tried to prove their worth to others were more likely to dwell on their shortcomings. Ambitious professionals who wore luxury clothing in an effort to appear successful, and MBA students who wore Rolex watches to increase their self-worth just ended up feeling like bigger failures. Even worse, their attempts to project an image of success impaired their self-control. They struggled to resist temptation when they tried to prove that they were successful. Putting so much effort into faking it used up their mental resources and interfered with their ability to make good choices.

How to “Fake It” the Right Way

Acting “as if” doesn’t mean being phony or inauthentic. It’s about changing your behavior first and trusting the feelings will follow. As long as your motivation is in the right place, faking it until you make it can effectively make your goals become reality. Just make sure you’re interested in changing yourself on the inside, not simply trying to change other people’s perceptions of you.