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

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

Despite significant advancements in political and health initiatives by governments and non-governmental organisations, shame, stigma, and internalized stigma continue to profoundly impact millions of lives worldwide. These negative perceptions and self-judgments can lead to feelings of worthlessness, self-blame, and social withdrawal, which in turn hinder access to services and participation in treatment.

Shame and stigma are particularly prevalent among individuals with substance use disorders, mental health conditions, and those experiencing psychosis. For instance, internalised stigma can lead to low self-esteem, depression, and hopelessness, which significantly impede recovery and emotional well-being. Even with the implementation of cognitive therapy and other supportive measures, the battle against internalised stigma remains ongoing in a similar fashion to intergenerational trauma, as though it has been built into human DNA.

Political and health initiatives have attempted to be instrumental in addressing these issues. For example, the Australian Government Department of Health and Aged Care has launched numerous programs aimed at improving health outcomes and reducing stigma. These initiatives focus on health promotion, early intervention, and disease prevention, aiming to create supportive environments for those affected by stigma.

However, the persistence of shame and stigma highlights the need for continued efforts to combat these issues especially in the workplace and within individual families. Addressing stigma therapeutically, promoting empathy and non-judgmental attitudes, and supporting individuals to view themselves beyond their conditions are crucial steps in mitigating the negative impacts of stigma.

Helping someone with a substance use disorder (SUD) while protecting yourself and your family involves a delicate balance of support and self-care. Here are some steps you can take:

1. Educate Yourself

Understanding SUD and its effects can help you make informed decisions and provide better support. Reliable sources include medical professionals, reputable websites, and support groups.

2. Set Boundaries

Establish clear boundaries to protect your well-being. This might include rules about substance use in the home, financial support, and personal interactions. Boundaries help prevent enabling behaviours and reduce stress.

3. Practice Self-Care

Taking care of yourself is crucial. Engage in activities that bring you joy and relaxation, such as exercise, hobbies, or spending time with friends. Self-care helps you maintain your mental and emotional health.

4. Seek Support

Join support groups like Al-Anon or seek therapy to process your emotions and develop coping strategies. Connecting with others who are going through similar experiences can provide invaluable support and understanding.

5. Encourage Professional Help

Encourage your loved one to seek professional help, such as counselling, therapy, or medical treatment. Treatment programs often include individual, group, or family therapy sessions, which can be beneficial for everyone involved.

6. Detach with Love

Detaching with love means setting emotional and psychological boundaries while still offering support. This approach helps you avoid becoming emotionally drained and allows your loved one to face the consequences of their actions.

7. Be Patient and Compassionate

Recovery is a journey that takes time. Be patient and compassionate with your loved one and yourself. Celebrate small victories and stay hopeful.

8. Avoid Judgment

Avoid being judgmental when discussing substance use. Offer support and understanding instead of criticism, which can help reduce feelings of shame and stigma.

References

Al-Anon Family Groups. (n.d.). Al-Anon and Alateen. Retrieved from https://al-anon.org/newcomers/what-is-al-anon-and-alateen

Australian Government Department of Health and Aged Care. (2024). Initiatives and programs. Retrieved from https://www.health.gov.au/about-us/what-we-do/initiatives-and-programs

Australian Institute of Health and Welfare. (2024). Health promotion and health protection. Retrieved from https://www.aihw.gov.au/reports/australias-health/health-promotion

Australian Government Department of Health. (2019). Alcohol and other drugs – Information for families. Retrieved from https://www.health.gov.au/resources/collections/alcohol-and-other-drugs-information-for-families

Mental Health Foundation. (2016). How to cope when supporting someone else. Retrieved from https://www.mentalhealth.org.uk/publications/how-cope-when-supporting-someone-else

Morrison, A. P., Birchwood, M., Pyle, M., Flach, C., Stewart, S. L. K., Byrne, R., Patterson, P., Jones, P. B., Fowler, D., & Gumley, A. I. (2013). Impact of cognitive therapy on internalised stigma in people with at-risk mental states. The British Journal of Psychiatry, 203(2), 140-145. https://doi.org/10.1192/bjp.bp.112.112110

National Institute on Drug Abuse. (2020). Family support in addiction recovery. Retrieved from https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/family-support-in-addiction-recovery

Substance Abuse and Mental Health Services Administration. (2015). Substance use disorders. Retrieved from https://www.samhsa.gov/find-help/disorders

Wood, L., Byrne, R., Burke, E., Enache, G., & Morrison, A. P. (2017). The impact of stigma on emotional distress and recovery from psychosis: The mediatory role of internalised shame and self-esteem. Retrieved from https://repository.essex.ac.uk/21927/1/woodpr2017.pdf

Your Room. (2021). Shame and self-stigma. Retrieved from https://yourroom.health.nsw.gov.au/whats-new/Pages/Shame-and-self-stigma.aspx

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Welcome to Webb TherapyWelcome to Webb Therapy

Webb Therapy is a casual, affirming, and confidential, talking therapeutic process dedicated to supporting people who are experiencing anything, and want to talk about it. Webb Therapy offers a warm and integrative counselling service based in Sydney City. Led by Mitch Webb—a registered counsellor with the Australian Counselling Association.

  • Substance use disorders, addiction, and recovery
  • Emotion regulation, stress management, anxiety, depression, and behavioural change

Mission & Goals
Webb Therapy is dedicated to offering a safe space for you to share your inner experience and learn how to navigate psychological and emotional pain, elevate self‑awareness, and build sustainable positive change – whether it’s improving relationships, setting meaningful goals, or ending patterns that no longer serve you.

Facebook Presence: Webb Therapy
The Facebook page encapsulates Webb Therapy’s core ethos: “Unlearn. Learn. Accept. Embrace. Change. Grow. Increase Self‑awareness,” reinforcing its person‑centred, self‑development focus.

Please Phone 0488 555 731 to schedule a booking.
Price: $120.00 for a 60 minute session.
Please enquire if you are a low income earner or receiving Centrelink benefit.

What’s the difference between an ‘excuse’ and a valid ‘reason’? Sometimes excuses sound like reasons.What’s the difference between an ‘excuse’ and a valid ‘reason’? Sometimes excuses sound like reasons.

This is a subtle but important distinction—excuses often sound like reasons, which is why it can be confusing. Let’s break it down clearly.


1. Core difference

AspectReasonExcuse
DefinitionAn explanation for why something happened, based on facts or legitimate circumstances.An attempt to justify or defend a behavior, often to avoid blame or responsibility.
PurposeTo clarify or explain objectively.To deflect responsibility or make oneself appear less accountable.
TruthfulnessUsually true and relevant.Can be true, partly true, or sometimes fabricated; often selectively presented.
EffectHelps others (or yourself) understand the situation.Helps avoid criticism or guilt; may not genuinely resolve the issue.

2. How they feel in practice

  • Reason example: “I missed the meeting because the train was delayed due to an accident.”
    • It’s factual, external, and unavoidable.
  • Excuse example: “I missed the meeting because traffic was terrible.”
    • May be partially true, but it avoids full responsibility, like leaving early, not planning ahead, or not checking alternatives.

Sometimes excuses can sound like reasons if they include a kernel of truth. The difference is often intention and accountability:

  • If the explanation acknowledges your role or is verifiable, it’s a reason.
  • If it shifts blame or deflects responsibility, it’s an excuse.

3. Quick test to distinguish them

Ask yourself:

  1. Does this explanation take ownership of what I could control?
  2. Is it meant to inform or to justify?
  3. Would I offer the same explanation if I were fully accountable?
  • If yes → Reason
  • If no → Excuse

everyday examples of reasons vs. excuses across different areas. I’ll show why some things sound like reasons but are actually excuses.


1. Dating / Social Life

ScenarioReasonExcuse
You cancel a date“I have a high fever and shouldn’t go out.” “I was too tired, traffic was bad, and it was going to rain.” ❌ (shifts responsibility to external factors rather than personal choice)
You forget to reply to messages“I was on a work trip with limited phone access.” “I didn’t reply because I was busy and you wouldn’t understand anyway.” ❌ (blames the other person and avoids owning the choice)

Key: A reason explains something honestly. An excuse tries to minimise perceived fault. Key insight here:

A statement can be part reason, part excuse. The difference often comes down to which element you emphasise and how you frame it.

  • Valid, reason-focused version: “I’m really exhausted and need to rest tonight so I can be ready for tomorrow. Can we reschedule?”
    • Takes ownership, honest, emphasises your physical/mental limit.
  • Excuse-heavy version: “I didn’t want to go because traffic was bad, potential rain, and I was tired.”
    • Blames external factors first, makes it sound like avoidance rather than legitimate self-care.

Your perception matters. If fatigue is real, it’s a valid reason, not an excuse. The “excuse” label is mostly about statements that use partially true or exaggerated external factors to justify avoidance, rather than honest, understandable limits.


2. Work / School

ScenarioReasonExcuse
Missed a deadline“I underestimated the time needed for this task; I’ll adjust my schedule next time.” “The instructions weren’t very clear and the system was going slow, so I couldn’t finish.” ❌ (shifts responsibility, even if partly true)
Poor performance“I didn’t have enough data to make a complete analysis.” “The team didn’t give me enough support, so it’s not my fault.” ❌ (focuses on others rather than personal accountability)

Key: Reasons acknowledge what happened and provide context. Excuses often imply “it’s not really my fault.”


3. Personal / Everyday Life

ScenarioReasonExcuse
Late to a social gathering“The bus broke down and I left early to catch it.” “I left on time but buses are always late.” ❌ (blames circumstances without taking steps to prevent being late)
Didn’t keep a promise“I forgot because I put it on the wrong calendar; I’ll set a reminder next time.” “I forgot because I’ve been too busy and stressed.” ❌ (partly true, but framed to deflect personal responsibility)

4. Key Patterns to Spot

  • Reason: Explains what happened, takes some ownership, is often verifiable.
  • Excuse: Explains why it’s not your fault, often blames external factors or minimises responsibility.
  • Trick: Excuses can be dressed up with facts, which is why they sound like reasons—but the difference is ownership and intention.

    There’s a substantial body of psychological research that touches on excuses, reasons, and how people justify their behaviour.


    1. Excuses in psychology

    • Often studied under concepts like self-justification, self-handicapping, and impression management.
    • Key idea: People sometimes give excuses to protect self-esteem or avoid negative social judgement.

    Examples from research:

    • Self-Handicapping: When people create obstacles for themselves (e.g., “I didn’t study because I was tired”) so if they fail, they have an excuse. This is well-studied in educational and performance psychology (e.g., Jones & Berglas, 1978).
    • Impression Management: Excuses can be used to manage how others perceive you—making yourself look less at fault or more sympathetic (Leary & Kowalski, 1990).
    • Moral Psychology: People distinguish between excuses (to deflect blame) and justifications (to explain actions as morally acceptable). Excuses are seen as reducing personal responsibility, whereas justifications are claiming the act is okay under circumstances (Shaver, 1985).

    2. Valid reasons

    • Studied more under attribution theory: how people explain causes for their behaviour.
    • Internal vs. external attribution:
      • Internal: “I didn’t finish because I didn’t plan properly.”
      • External: “I didn’t finish because the bus was late.”
    • A valid reason often corresponds to an explanation that is fact-based, relevant, and seen as legitimate by social norms, while an excuse may rely on controllable factors framed as uncontrollable.

    Research highlights:

    • People are more likely to accept explanations as valid reasons if they acknowledge personal responsibility (Miller & Ross, 1975).
    • Excuses are more likely to be accepted if they appeal to external constraints beyond one’s control, even if the person could have done something differently.

    3. Subtle distinctions in research

    • Excuse: Often functions to protect self-image or avoid punishment/blame.
    • Reason: Functions to inform others of causality; it may include personal responsibility and is usually perceived as legitimate.
    • Studies show that people are much more forgiving when a reason signals honesty and unavoidable constraints, versus an excuse that signals avoidance of responsibility.

    4. Practical implications

    • Being clear about whether you’re giving a reason or an excuse affects trust and credibility in relationships.
    • Psychologically, framing your explanation around ownership and unavoidable factors makes it more likely to be perceived as a reason rather than an excuse.

    Thinking About Change? How Motivational Interviewing Can HelpThinking About Change? How Motivational Interviewing Can Help

    If you’ve ever found yourself thinking “Part of me wants to change… but part of me’s not sure”, you’re not alone. That back-and-forth, weighing things up—“Should I? Shouldn’t I?”—is a normal part of how people process big (and small) decisions. In counselling, this is called ambivalence, and rather than seeing it as a barrier, Motivational Interviewing (MI) treats it as a starting point for meaningful conversations.

    What Is Motivational Interviewing?

    Motivational Interviewing is a counselling approach that helps people explore their own reasons for change, without pressure or judgment. It’s a respectful, supportive way of helping you work through the push-pull that often comes with making decisions. You’re in the driver’s seat—we’re just here to help you navigate.

    You might hear MI described in different ways:

    In simple terms:
    “MI is a collaborative conversation style that helps strengthen your own motivation and commitment to change.”

    In practice:
    “MI is about helping you make sense of mixed feelings and explore what’s right for you—based on your values, your goals, and your life.”

    MI isn’t about telling you what to do. It’s about listening deeply, asking thoughtful questions, and helping you make sense of where you’re at—and where you might want to go.

    Why It’s Not Just a Quick Fix

    While MI can be used in short sessions, the research shows it works best when there’s time to really explore your thinking. In studies where people had just one 15-minute session, the outcomes were decent. But when they had more time—say, several sessions of an hour—the results were much stronger. That’s probably because real change often takes time, reflection, and a bit of back-and-forth.

    MI originally started in the health world—helping people reduce alcohol use, manage weight, or improve their health. More recently, it’s been used to address things like vaccine hesitancy. But MI isn’t just for health issues. It can also help with things like relationship struggles, career decisions, or anything where you might feel stuck or unsure.

    Ambivalence Is Normal

    Let’s say you’re thinking about quitting smoking, leaving a relationship, or starting something new. You might feel torn—part of you is ready, and another part isn’t. That’s ambivalence.

    MI offers tools to help with this, including something called the Decisional Balance, which simply helps you look at both sides: What are the good things about staying the same? What are the reasons you might want to change?

    But here’s the thing—MI isn’t about pushing you toward a particular outcome. If you’re trying to make a decision where there’s no obvious “right” answer—like whether to stay in a relationship—the counsellor stays neutral. They don’t steer you in one direction. Instead, they help you explore what matters to you.

    Talking Your Way Toward Change

    One of the interesting things about MI is how it pays attention to the language you use when you talk about change.

    Some of the things people say when they’re starting to think about change include:

    • “I probably should cut down…”
    • “I’d like to feel better about this…”
    • “I don’t know if I can keep doing this…”

    These kinds of statements are called change talk—and they’re actually signs that something inside you is shifting. MI aims to gently encourage and grow this kind of talk, because research shows that the more someone talks about change, the more likely they are to act on it.

    There’s also sustain talk, which sounds like:

    • “I don’t smoke that much…”
    • “I know I should, but it helps me relax.”
    • “Now’s not really the right time.”

    Both are normal. In MI, there’s no need to rush. Instead, the focus is on listening to both sides of you—and helping you get clearer about what you want to do next.

    Getting Skilled Support

    Like any professional approach, MI works best when the counsellor is trained and skilled in using it. Some practitioners have their sessions reviewed (with consent) by independent experts to make sure the spirit and skills of MI are being used well.

    If you ever hear a practitioner say they “do MI”, you can ask what that looks like. The most effective use of MI goes beyond just asking open-ended questions or offering summaries—it’s about how your counsellor supports you in finding your own reasons for change.

    What a Session Might Involve

    Motivational Interviewing tends to follow a flexible process with four key parts:

    1. Engaging – Building trust and understanding
    2. Focusing – Exploring what matters most to you
    3. Evoking – Drawing out your own reasons for change
    4. Planning – When you’re ready, looking at possible next steps

    You don’t have to go through these in a straight line. Some days you might focus on one step, then circle back to another later. It’s all guided by you—your pace, your readiness, your goals.


    In Summary

    If you’re feeling uncertain about making a change—or you’ve been thinking about it for a while but haven’t quite landed on what to do—Motivational Interviewing could be a really helpful way to explore things.

    It’s not about being told what to do, and it’s not about “fixing” you. It’s a respectful, evidence-based approach that helps people work through their own ambivalence, connect with what matters to them, and move toward change when they’re ready.

    Change doesn’t have to be instant. And it doesn’t have to be perfect. But it can start with a conversation.