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.

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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.

    Predicting behaviour: Social Psychological Models of BehaviourPredicting behaviour: Social Psychological Models of Behaviour

    Social psychological models of behaviour attempt to explain why individuals act the way they do in various social contexts. These models integrate individual, interpersonal, and societal factors to provide insights into behaviour. Here’s an overview of some key models:

    1. Theory of Planned Behaviour (TPB) proposes that behaviour is influenced by:

    – Attitudes toward the behaviour

    – Subjective norms (perceptions of others’ approval)

    – Perceived behavioural control (i.e., confidence in one’s ability to perform the behaviour [self-efficacy])

    2. Social Cognitive Theory (SCT) suggests that behaviour is the result of:

    – Reciprocal interaction between personal factors (beliefs, attitudes), environmental factors (social norms), and behaviour itself

    – Concepts like self-efficacy (belief in one’s ability) play a major role.

    3. Health Belief Model (HBM), designed to predict health-related behaviours. Behaviour is driven by factors such as perceived:

    – Susceptibility (risk of harm)

    – Severity (consequences of harm)

    – Benefits (advantages of action)

    – Barriers (obstacles to action)

    4. Cognitive Dissonance Theory explains how people strive for consistency between their beliefs, attitudes, and behaviours. When inconsistency arises, they feel dissonance (mental discomfort) and are motivated to reduce it by changing their attitudes or actions.

    5. Social Identity Theory examines how individuals define themselves within social groups. Behaviour is influenced by group membership, including in-group favouritism and out-group bias.

    6. Attribution Theory focuses on how people explain their own and others’ behaviours. Explains behaviour as being attributed either to internal (dispositional) or external (situational) factors. For example, it is common for people to attribute negative outcomes in their life to external factors rather than internal factors.

    7. Elaboration Likelihood Model (ELM) explains how people process persuasive messages and what determines whether those messages will change attitudes or behaviour. It’s often applied in areas like marketing, communication, and public health campaigns. The ELM identifies two primary routes through which persuasion can occur:

    – Central Route; this route involves deep, thoughtful consideration of the content and logic of a message. People are more likely to take the central route when they are motivated to process the message (e.g., the topic is personally relevant or important to them) and they can understand and evaluate the arguments (e.g., they aren’t distracted, and they have enough knowledge about the subject). Persuasion through the central route tends to result in long-lasting attitude change that is resistant to counterarguments. Example: A person researching the pros and cons of electric cars before deciding to buy one.

    – Peripheral Route, which relies on superficial cues or heuristics (mental shortcuts) rather than the message’s content. People are more likely to take the peripheral route when they are not highly motivated or lack the ability to process the message deeply, and when they focus on external factors like the attractiveness or credibility of the speaker, emotional appeals, or catchy slogans. Persuasion through this route tends to result in temporary attitude change that is less resistant to counterarguments. Example: A person choosing a product because their favourite celebrity endorsed it.

    8. Self-Determination Theory (SDT) emphasizes intrinsic and extrinsic motivation. It emphasizes the role of intrinsic motivation—doing something for its inherent satisfaction—over extrinsic motivation, which is driven by external rewards or pressures. It suggests that behaviour is influenced by the need for:

    – Autonomy (control over one’s actions); When people perceive they have a choice and are acting in alignment with their values, their motivation and satisfaction increase.

    – Competence; Refers to the need to feel effective, capable, and successful in achieving desired outcomes. People are motivated when tasks challenge them at an appropriate level and provide opportunities for growth and mastery. Example: A gamer progressing through increasingly difficult levels, gaining skills and confidence along the way.

    – Relatedness; Refers to the need to feel connected to others and experience a sense of belonging. Supportive relationships and positive social interactions enhance motivation and well-being. Example: Employees feeling a bond with their colleagues in a collaborative work environment.

    9. Social Learning Theory proposes that behaviour is learned through observation and imitation. Role models and reinforcement play a key role in shaping actions.

    10. Transtheoretical Model (Stages of Change) explains behaviour change as a process occurring in stages: precontemplation, contemplation (ambivalence), preparation, action, and maintenance

    These models provide frameworks to understand behaviours in contexts like health, decision-making, group dynamics, and social influence.