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 offers a casual, comfortable, and confidential space for therapeutic conversation, supporting people who are experiencing challenges and want to talk about them. Based in Surry Hills, Webb Therapy provides a warm, integrative counselling service.

The practice is led by Mitch Webb, who has extensive experience working with substance use, addiction, depression, anxiety disorders, trauma, and the processes of treatment and recovery.

  • Gay men, men who have sex with men (MSM), and men exploring or questioning their sexuality, including those attracted to other men
  • Individuals experiencing suicidal ideation or intent
  • Individuals experiencing interpersonal challenges
  • Individuals experiencing existential challenges, including questions around meaning, purpose, identity, and direction

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.

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.

When “Trauma” Became a Buzzword: What We Gain and What We Lose when Clinical Language goes MainstreamWhen “Trauma” Became a Buzzword: What We Gain and What We Lose when Clinical Language goes Mainstream

Not long ago, words like “triggered,” “gaslighting,” “narcissist,” and “neurodivergent” belonged almost exclusively to therapists’ offices and psychology textbooks. Now they’re everywhere; in workplace training sessions, community organisations, TikTok comment sections, and casual conversation between friends over coffee. That shift has brought some genuinely important changes. But it’s also introduced some problems worth taking seriously.

The real wins

It would be unfair to dismiss this cultural shift outright. There are meaningful gains. More people today can identify manipulation, coercive dynamics, and emotional harm than any previous generation. Mental health conversations have been destigmatised in ways that would have been hard to imagine twenty years ago. People who were historically silenced, particularly those from marginalised communities, finally have language that validates their experiences and gives them permission to leave harmful situations. That’s progress

But then there’s “concept creep” (pathologising the ordinary or “diagnostic inflation”)

Psychologists use the term “concept creep” to describe what happens when a word originally defined by strict clinical boundaries starts expanding to cover increasingly ordinary experiences. And that’s precisely what happened with “trauma.”

Clinically, trauma refers to experiences that overwhelm the nervous system i.e., genuine threats to safety, severe harm, events that exceed a person’s capacity to cope. These days, the same word is regularly applied to being disagreed with, having a relationship end, receiving criticism, or simply feeling uncomfortable. Events like relationship breakdowns, job loss, or failure can be genuinely devastating, and for some people, under some circumstances, they absolutely do meet the clinical threshold for trauma. The distinction isn’t really about the type of event. It’s about the impact on the nervous system and the person’s capacity to integrate the experience.

When everything qualifies as trauma, the word stops doing useful work. Worse, it can actually undermine the resilience people need to navigate a genuinely difficult world.

The nervous system problem

Here’s where it gets important. In actual “clinical” trauma, the brain’s threat-response systems activate intensely. Memory processing is disrupted. The body mobilises for survival in ways that can leave lasting marks.

Discomfort is different. It involves real emotional activation, it’s not pleasant, but cognitive flexibility remains available. The capacity to think, reflect, and choose a response is still intact.

When people learn to label ordinary emotional discomfort as trauma activation, the consequences compound. If discomfort feels equivalent to harm, avoidance becomes a logical response. But avoidance prevents the gradual building of tolerance. And without tolerance, the world gets smaller.

Trauma as identity and social currency

In some online communities, there’s an uncomfortable dynamic worth naming: being “highly traumatised,” “chronically triggered,” or “deeply misunderstood” can confer real social benefits — belonging, validation, moral authority, and attention.

This doesn’t mean the experiences aren’t real. But when distress becomes central to someone’s identity, letting go of that distress can start to feel like losing themselves. Recovery, paradoxically, becomes threatening.

The fragility trap

In certain environments, fragility functions as a kind of protection. If I am highly sensitive, others must accommodate me. Challenge becomes inappropriate. Accountability becomes unsafe. The person is shielded, but the cost is enormous.

Resilience, both psychologically and biologically, develops through graded exposure to stress. We become capable through encountering difficulty, not by avoiding it. Systems that never face adaptive pressure weaken over time. This is simply how human development works.

Why this moment matters

Several things are converging right now. Social media algorithms reward extreme emotional narratives. Identity formation increasingly happens in digital spaces that amplify distress. Institutions have frequently overcorrected towards protective language in ways that, whatever their intentions, can inadvertently signal that discomfort is dangerous. And while there’s been important growth in awareness of systemic injustice, the corresponding emphasis on individual agency has sometimes been lost.

We’ve swung from “suppress your emotions entirely” to “your emotions define reality.” Neither extreme serves people well.

Holding the middle ground

What good support actually looks like isn’t dismissing people’s experiences, it’s deepening them. The distinction that matters is between trauma-informed practice and what might be called trauma-indulgent practice.

Trauma-informed means understanding that harm genuinely impacts nervous systems, avoiding shame, recognising power imbalances, and creating safety. It’s grounded and necessary.

Trauma-indulgent means treating all discomfort as harm, reinforcing avoidance, allowing emotional reasoning to override reality, and quietly removing personal responsibility from the picture. It feels compassionate in the moment but tends to leave people worse off over time.

In practice, holding the middle ground means validating what someone feels while gently asking whether something was truly unsafe or simply hard. It means acknowledging difficulty while also reinforcing capacity. It means introducing a reality that doesn’t get much airtime in online spaces — that we can’t always control how those around us speak or behave, but we can build our own tolerance and capacity to regulate.

The question underneath everything

There’s a deeper ethical question running through all of this: are we reducing suffering in the long run, or just distress in the short term?

Protecting people from discomfort today, if it increases fragility tomorrow, is not a kindness. But exposing people to challenge without adequate safety and support risks re-traumatising those with genuine wounds.

The balance isn’t complicated to describe, even if it’s genuinely difficult to hold: safety, combined with graduated exposure, combined with a genuine sense of agency.

Anyone supporting others through difficulty needs a calm nervous system, a high personal tolerance for distress, and the capacity to sit with being perceived as insensitive when holding a difficult but necessary line. Clear values and genuine boundaries aren’t optional extras — they’re the model.

The world remains economically uncertain, socially polarised, and digitally relentless. People will encounter disagreement, rejection, imperfect institutions, and others who handle things badly. Preparing people for a world where everyone is perfectly considerate is not just unrealistic — it’s a disservice.