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

| Mitchell WebbMitchell Webb| 0 Comment |
Categories: Uncategorized

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

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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.

He also has strong expertise in helping with:

  • 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.

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Understanding Addiction: A Modern, Integrative PerspectiveUnderstanding Addiction: A Modern, Integrative Perspective

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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

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Fact. Truth. Belief. They are related but distinct. Here’s a clear explanation showing how they differ and interact:Fact. Truth. Belief. They are related but distinct. Here’s a clear explanation showing how they differ and interact:

| Mitchell WebbMitchell Webb| 0 Comment|

1. Fact

Definition:
A fact is something that is objectively real and can be proven to be true. It exists independently of what anyone thinks or believes.

Example:

  • It is a fact that Australia is in the Southern Hemisphere.

Key Points:

  • Facts don’t change based on opinion.
  • They can be verified with evidence (e.g. scientific data, observation, reliable records).
  • Facts are the foundation upon which truth claims and beliefs can be tested.

2. Truth

Definition:
Truth is a quality of a statement or belief that accurately reflects reality or fact.

Example:

  • “Australia is in the Southern Hemisphere” is a true statement because it corresponds with the fact.

Key Points:

  • Truth depends on alignment with facts.
  • Truth is often expressed in language or claims (“That’s true”, “That’s not true”).
  • Something can be true even if no one believes it (e.g. the Earth orbited the Sun even when most people thought otherwise).

3. Belief

Definition:
A belief is something a person thinks or accepts as true, whether or not it actually is.

Example:

  • Someone might believe that kangaroos can be kept as pets in all Australian states — but that belief isn’t necessarily true or factual.

Key Points:

  • Beliefs are subjective — they vary between individuals and cultures.
  • A belief can be true or false, depending on whether it aligns with facts.
  • People often act based on their beliefs, regardless of whether they are accurate.

How They Interact

  • A belief can be true or false:
    → If your belief aligns with fact, it’s true.
    → If not, it’s false — even if sincerely held.
  • Truth depends on fact:
    → A statement is true if it correctly describes a fact.
  • Facts stand alone:
    → They are not changed by belief or opinion.
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Mortality DeterminantsMortality Determinants

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Overall Global Leading Cause of Death

  • Ischemic heart disease (coronary artery disease) – Still the #1 cause of death worldwide.
  • Followed by: Stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, and cancer (e.g., lung, liver, colorectal).

Breakdown by Category

By Age

Age GroupLeading Cause(s) of Death
Infants (<1)Neonatal conditions, birth complications, infections
Children (1–14)Accidents (injuries), infections (low-income countries), cancers (e.g., leukemia)
Youth (15–24)Road injuries, suicide, homicide (varies by country)
Adults (25–44)Injuries (road, drug overdose), suicide, HIV/AIDS (in some countries), heart disease
Middle Age (45–64)Heart disease, cancer (esp. lung, colorectal, breast), liver disease
Older Adults (65+)Heart disease, stroke, cancer, Alzheimer’s disease

By Gender/Sex

GroupLeading Cause of Death
Cisgender MenHeart disease, cancer (lung, liver), accidents
Cisgender WomenHeart disease, cancer (breast, lung), stroke
Transgender IndividualsElevated risk from violence, suicide, and HIV/AIDS (especially trans women of color); limited large-scale data
Non-binaryInsufficient population-specific data, but risks often parallel those of trans populations or assigned sex at birth

By Race/Ethnicity (Example: United States)

GroupTop CausesUnique Issues
White (non-Hispanic)Heart disease, cancer, drug overdose
Black or African AmericanHeart disease, cancer, higher stroke risk
Hispanic/LatinoHeart disease, cancer, diabetes
Native AmericanAccidents, liver disease, diabetes, suicide
Asian AmericanCancer (leading cause), stroke, heart disease

Note: Disparities arise from systemic inequalities, access to care, and social determinants of health.

By Sexuality (LGBTQ+)

  • Limited global data, but in many regions:
    • Higher risk of suicide, mental health disorders, substance abuse, HIV/AIDS (especially among MSM and trans women).
    • Discrimination and healthcare avoidance contribute to worsened outcomes.
  • Common causes of death still include heart disease and cancer, with higher rates of premature death linked to stigma and healthcare disparities.

By Geographic Region

RegionLeading Cause(s)
High-Income CountriesHeart disease, cancer, Alzheimer’s, stroke
Low- and Middle-Income CountriesInfectious diseases (TB, HIV), maternal mortality, stroke, heart disease
AfricaHIV/AIDS, malaria, lower respiratory infections
AsiaStroke, heart disease, chronic lung disease
North AmericaHeart disease, cancer, drug overdose (opioid crisis)
EuropeHeart disease, stroke, cancer
Latin AmericaViolence (in younger adults), heart disease, diabetes

By Profession

  • Agricultural/farm workers: High injury rates, pesticide exposure, suicide
  • Construction workers: Falls, injuries, exposure to toxins (e.g., asbestos)
  • Healthcare workers: Infectious disease, burnout, mental health risks
  • Military/first responders: Combat-related injuries, PTSD, suicide
  • Office workers: Sedentary lifestyle risks (heart disease, diabetes)

Occupation-linked deaths often relate to environmental exposures, physical risks, or psychological stressors.

Conclusion:

Across almost all demographics, heart disease remains the leading cause of death, followed by cancer, stroke, and—in certain populations—accidents, suicide, or infectious diseases. However, the underlying causes (social, economic, political) differ significantly based on identity, geography, and profession.

Would you like this formatted into a chart, infographic, or specific to a country or report you’re working on?

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