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

Related Post

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.

Unhelpful Cognitions (thoughts) and DistortionsUnhelpful Cognitions (thoughts) and Distortions

Unhelpful Cognitions

Mental Filter: This thinking style involves a “filtering in” and “filtering out” process – a sort of “tunnel vision”, focusing on only one part of a situation and ignoring the rest. Usually this means looking at the negative parts of a situation and forgetting the positive parts, and the whole picture is coloured by what may be a single negative detail.

Jumping to Conclusions: We jump to conclusions when we assume that we know what someone else is thinking (mind reading) and when we make predictions about what is going to happen in the future (predictive thinking).

Mind reading: Is a habitual thinking pattern characterized by expecting others to know what you’re thinking without having to tell them or expecting to know what others are thinking without them telling you. This is very common, and most people can identify. Oftentimes, when we are telling someone a story about an interaction, we’ve had with someone else, we will make mind reading assumptions without actually having fact or evidence e.g., “They haven’t phoned me in two weeks so they must be angry with me for cancelling on them last week.”

Personalisation: This involves blaming yourself for everything that goes wrong or could go wrong, even when you may only be partly responsible or not responsible at all. You might be taking 100% responsibility for the occurrence of external events. It can also involve blaming someone else for something for which they have no responsibility. This can often occur when setting a boundary with someone and you take responsibility for their guilt or anger.

Catastrophising: Catastrophising occurs when we “blow things out of proportion” and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself may be quite small.

Black & White Thinking: Also known as splitting, dichotomous thinking, and all-or-nothing thinking, involves seeing only one side or the other (the positives or the negatives, for example). You are either wrong or right, good or bad and so on. There are no in-betweens or shades of grey.

Should-ing and Must-ing: Sometimes by saying “I should…” or “I must…” you can put unreasonable demands or pressure on yourself and others. Although these statements are not always unhelpful (e.g., “I should not get drunk and drive home”), they can sometimes create unrealistic expectations.

Should-ing and must-ing can be a psychological distortion because it can “deny reality” e.g., I shouldn’t have had so much to drink last night. This is helpful in the sense that it communicates to us that we have exceeded our boundaries, however, saying “shouldn’t” about a past situation can be futile because it cannot be changed.

Overgeneralisation: When we overgeneralise, we take one instance in the past or present, and impose it on all current or future situations. If we say, “You always…” or “Everyone…”, or “I never…” then we are probably overgeneralising.

Labelling: We label ourselves and others when we make global statements based on behaviour in specific situations. We might use this label even though there are many more examples that are not consistent with that label. Labelling is a cognitive distortion whereby we take one characteristic of a person/group/situation and apply it to the whole person/group/situation. Example: “Because I failed a test, I am a failure” or “Because she is frequently late to work, she is irresponsible”.

Emotional Reasoning: This thinking style involves basing your view of situations or yourself on the way you are feeling. For example, the only evidence that something bad is going to happen is that you feel like something bad is going to happen. Emotions and feelings are real however they are not necessarily indicative of objective truth or fact.

Magnification and Minimisation: In this thinking style, you magnify the positive attributes of other people and minimise your own positive attributes. Also known as the binocular effect on thinking. Often it means that you enlarge (magnify) the positive attributes of other people and shrink (minimise) your own attributes, just like looking at the world through either end of the same pair of binoculars.

(CCI, 2008)

Three rules for identifying abnormal child sexual behavioursThree rules for identifying abnormal child sexual behaviours

Retrieved and edited 06/12/2021 from “Voice of Experience: Three rules for identifying abnormal child sexual behaviors” by Gregory K. Moffatt, a veteran counsellor with more than 30 years experience. If you are a survivor of sexual trauma at any age, I encourage you not to read this article.

From the perspective of Moffatt’s professional experience, childhood sexual behaviours can be grouped into three categories: 1. normal behaviours, 2. behaviours that are not normal but not unusual, and 3. behaviours that are abnormal or statistically rare. For the purpose of this post, I will be replacing the word “normal” with “natural” and/or “common” moving forward.


Rule No. 1: Natural or common sexual behaviours in children are never forced. The exploration is mutual. While one child likely had the idea first, both children must participate freely. This doesn’t mean that two children might willingly agree to engage in abnormal sexual behaviours, however, therefore read the next to rules for clarification.


Rule No. 2: Natural or common sexual behaviours in children are never painful. Children who behave within cultural and developmental norms will stop what they are doing when they realise they have caused pain.


Rule No. 3: Natural or common sexual behaviour in children is never invasive. Natural childhood curiosity does not include inserting objects or one’s own body parts into the cavities of others — anus, vagina, mouth, etc.


I’m unsure why Moffatt didn’t make this a 4th rule – he did add that most of the time, this type of childhood behaviour occurs between children of similar age. It is highly unusual for a young child to sexually engage with a teen without violating one of the three rules above. That behaviour definitely calls for further investigation. And, certainly, any sexual interaction between an adult and a child is cause for mandated reporting.

The Four Options for any Problem (Linehan, 1993)The Four Options for any Problem (Linehan, 1993)

Marsha Linehan, the creator of Dialectical Behavior Therapy, gives four options for any problem that you face: Solve the problem, change your perception of the problem, radically accept the situation, or stay miserable.

When we are overwhelmed by a life challenge, one way we might naturally respond is by defending our position. Perhaps, we’ll resort to an effective yet temporary coping strategy like denial, projection, victimhood, or blaming. We attempt to cope in ways that lessen the stress – the internal discomfort and unpleasantness. Coping strategies that offer temporary relief generally make the situation worse in the long run, especially when fostering relationships at work and in our personal lives. For example, crawling back into bed when you need to work or have commitments with friends. Maybe you over-eat, use chemicals or resent the world, which alleviates the immediate emotional pain, then feel guilty or ashamed afterward. 

Sometimes, in an effort to take action, people attempt to solve problems cognitively – problems that cannot be solved, becoming more and more frustrated when their efforts don’t work. Others become paralyzed or dissociate, unable to decide what to do. Intense emotions can be overwhelming, fatiguing, and compromise our ability to think with an open heart and a clear mind. Searching endlessly for the right solution adds to anxiety and distress.

Marsha Linehan, the creator of Dialectical Behavior Therapy, gives four options for any problem that you face: Solve the problem, change your perception of the problem, radically accept the situation, or stay miserable.

Choice 1: Solve the Problem.

There are many problem-solving strategies, but most use the same steps. First, define the problem. Be as specific as possible. Use numbers whenever possible. For example, “I’ve been late for work four days this week.”

Next, analyze the problem. Is it in your power to solve the problem? If not, then consider one of the other three options. If yes, then continue to analyze the problem.

What are the reasons you’ve been late? Is the reason always the same?  Does it depend on your mood or what time you went to bed? Does it depend on what tasks you have to do at work? Who you work with? Where you went the night before?  Consider the who, what, when, and where of the behavior you want to change.

The third step is to consider possible solutions. Think of various solutions that could solve the problem. Evaluate the solutions carefully to determine which might work best for you. What are the pros and cons of different actions? What could go wrong? What can you do to make the solution more likely to work?

For example, if you decide to give yourself a weekly budget and to freeze your credit cards in a block of ice, what would you do in case of an emergency? Would giving yourself a certain amount of spending money for the day work better than an amount for the week?

A key variable to remember is how difficult it is to make changes in behavior. A strong commitment to change is important. Be specific in stating the change you want to make. Be willing to make small changes at first. Implement the solution: Take action. Trouble-shoot as you go along, tweaking it to resolve any issues you didn’t anticipate.

Choice 2: Change Your Perception.

Changing your perception of the problem can be a challenge. An example of changing your perception of a problem might be to see a difficult boss as an opportunity to work on coping with someone who is disorganized and demanding. If you feel irritated because your house is cluttered with toys, maybe change your perception to one that the clutter is a signal to be grateful for young children in the home. Changing your perception could also mean changing your view of emotion. Instead of trying never to feel anger, look at your frustration as a source of information, perhaps a signal that you need to speak up for yourself.

Choice 3: Radically Accept the Situation.

Radical Acceptance means wholeheartedly accepting what is real. Radical acceptance is like saying, “It is what it is,” and giving up your resistance to the situation. Radical acceptance could be about issues we can’t control or concerns that we decide not to change, at least for the time being. It doesn’t mean you agree with what has happened or that you think it is reasonable.

Choice 4: Stay Miserable.

Of course, staying miserable is not a choice anyone wants to make, and no one would want to consider it as an option. But if you can’t solve the problem, can’t change your perception, and you aren’t ready to radically accept the situation, then staying miserable is the only option left.

Staying miserable may be all you can do in certain situations. Sometimes staying miserable may be what you have to do until you are ready to do something else. There are ways to cope that can help until another option can be used.

In future posts, we’ll look at specific skills that enhance your ability to problem-solve, change your perception, or radically accept situations. We’ll also consider ways to get through the times when you can’t make any of those choices.