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

All human beings experience anger at least occasionally. It’s a natural emotion helping us recognise that we or someone or something we care about has been violated or treated badly. When we feel threatened or our goals are thwarted, anger is a coping mechanism that enables us to act decisively, especially in situations where there is little time to reason things out. It can motivate problem-solving, goal-achievement, and the removing of threats. It serves a protective function and is not always a problem (Lowth, 2018; Stosny, 2020; Zega, 2009).

But anger is a complex emotion, and all too often manifests maladaptively in clients’ lives, when they perceive excessive need for protection, protect the “wrong” things, or use anger to thwart their longer-term best interests. The result is problem anger.

Perhaps because it is so multi-faceted, misperceptions about anger abound, and the question arises: how shall we regard anger? How do we advise the client to think about it? Folk wisdom often would say that the best thing to do is just let it all out, but is it? Clients complain that they cannot control it, that the tendency to be easily angered is inherited, but again, is there evidence for that? Here are common myths people tend to hold about anger, and factual statements following them that you can use to clarify for the client why learning to deal with problem anger is time well spent.

Myth 1: “Anger is inherited.”

This is the client that may try to claim that their father was short-tempered and they have inherited that trait from him, so there is nothing they can do. Such a stance implies an attitude that the expression of anger is a fixed, unalterable set of behaviours. Research shows, however, that expression of anger is learned, so if we have – say, through exposure to aggressive influential others, such as parents – learned to be violent in our expressions, we can also learn healthier, more appropriate, pro-social ways of dealing with it.

Myth 2: “Anger and aggression are the same thing.”

Fact: Nope. Anger is a felt emotional state. Aggression is a behaviour, sometimes carried out in response to anger, but not the same as it. A person can be angry, yet use healthy methods of expression without resorting to violence, threats, or other aggression. Anger does not always lead to aggression. In fact, some experts claim that most daily anger is not followed by aggression. When it does result in aggression the “I3 Model” (pronounced “I cubed”) is deemed responsible. This suggests that aggression emerges as a function of three interacting factors, which all begin with “I”:

Instigation, an event which instils an urge to aggress as a result of, say, being addressed rudely or learning that one’s partner has had an affair (or a relatively “minor” event, such as being cut off in traffic);

Impellance, meaning a force that increases the urge to act in response to an instigating stimulus. These could be strong hormonal releases or a belief system which says that the instigating event should not be tolerated, or even a sociocultural norm which demands that instigating stimuli be responded to immediately and harshly (such as punching back someone who has hit you);

Inhibition, referring to forces that typically work to counter aggression, such as cultural norms, awareness of negative consequences, or perspective-taking or empathy (Kassinove & Tafrate, 2019).

Myth 3: “Other people make me angry.”

Fact: How often in common parlance do we say things like, “He made me so angry!” or “You make me so mad I could kill you!”? Even though we may occasionally speak about people causing emotions other than anger, it is far more frequent to hear such statements in regard to anger. We can choose whether or not we let someone else’s behaviour make us happy, sad, or something else, but we often think and talk about it as if anger is caused directly by others. With the undiscerning listener, an angry person thus gets to use anger as an excuse for unacceptable behaviour. Ultimately, it is not the other person’s behaviour that causes our anger, and in fact, it’s not even their intention, though that may influence our behaviour. Being precise, we must acknowledge that it is our interpretation of their intention, expressed in their behaviour/language, which is causative.

Myth 4: “I shouldn’t hold anger in; it’s better to let it out” (either by venting or catharsis).

Fact: If by “holding it in” someone means that they suppress anger, it’s true; ignoring it won’t make it go away and squashing it down is not a healthy choice. Neither, however, is venting. Blowing up in an aggressive tirade only fuels the fire, reinforcing the problem anger. Ditto the use of pillow-punching or other means of catharsis; this may come as a surprise to therapists trained a few years ago, when catharsis was an anger management technique in good standing. Now researchers have found that, even though we feel better in the moment after hitting something, our brain notices, subtly changing its wiring. Then the next time we are angry it softly whispers, “Hit something; you’ll feel better”. The time after that, the wiring is stronger in the brain towards a hitting catharsis, and the angry-brain-voice speaks a little louder. Continuing in this vein means that eventually, we could decide to hit something more alive than a pillow. Rather than either angry venting or catharsis is the use of skills to manage the angry impulse.

Myth 5: “Anger, aggression, and intimidation help me to earn respect and get what I want.”

Fact: People may be afraid of a bully, but they don’t respect those who cannot control themselves or deal with opposing viewpoints. Communicating respectfully is a far superior way to get (most) people to listen and accommodate one’s needs. While the momentary power that comes with successful intimidation may feel heady in the moment, it does not help build the healthy relationships that most people coming to counselling yearn to have.

Myth 6: Anger affects only a certain category of people.

Fact: Anger is a universal emotion that affects everyone. It does not discriminate against people of any particular age, nationality, race, ethnicity, socioeconomic status, education, or religion. It is tempting for some people in the educated middle classes to believe that anger is more prevalent among the poor, or those who are less educated or lacking in social skills. Reality does not bear this out, although the expressions of anger do vary among different social groups. Remember, anger is just an emotion, one which does not make people “good” or “bad” for having it.

Myth 7: “I can’t help myself. Anger isn’t something you can control.”

We don’t always get to control the situations of our lives, and some of them may trigger our anger. In fact, it’s also agreed by experts that we don’t (in the short-term) control whether we have angry feelings or not; they just come – although there are longer-term ways to work with clients that see them less easily provoked, and therefore less prone to have the experience of anger. What we do have the short-term choice to control is how we express that anger. Continuing in sessions with you (the therapist) for the purpose of learning how to better handle anger means having more choices of response, even in highly provocative situations.

Myth 8: “When I’m angry I will say what I really mean.”

Fact: This is rarely true. Uncontrolled angry expressions are more about gaining control of or hurting others, not saying what a person’s deepest truth is. 

Myth 9: “By not saying what I’m thinking in the moment, I’m being dishonest and will be even angrier later.”

Fact: There is a strong pull to “speak our mind” when angry. But it is at this time that a person’s judgment is most severely flawed. To speak from anger is to allow the impulsive part of the brain to overrule the rational part. Better for relationships, career, and pretty much everything else to wait until that reasoning part can regain control.

Myth 10: “Men are angrier than women.”

Fact: The sexes experience the same amount of anger, says research; they just express it differently. Men often use aggressive tactics and expressions, whereas women (often constrained culturally) more frequently choose indirect means of expression, such as found in passive-aggressive tactics. This could mean getting back at someone by talking negatively about them or cutting them out of their lives (categories adapted from: Therapist Aid LLC, 2016; Segal & Smith, 2018; Morin, 2015; Morrow, n.d.; Better Relationships, 2021; Gallagher, 2001).

Thought for reflection

Anger has many facets to it, and we have introduced some information here that may seem either startling or counterintuitive. As you think back over the myths we just debunked, which aspect has surprised you the most? Do you have any sense of why that might be? One woman, for example, was very surprised to hear that “men are angrier than women” was only considered a myth; it turned out that in her family, women “never got angry” (we hypothesise that perhaps they were socialised to not show anger), and the men got angry all the time (perhaps more allowed in that woman’s family/culture). In what ways, if at all, might your views about anger have shaped how you behave? How you respond to others? 

And here’s the ultimate question if you share this material with a client: what are their responses to the above questions? How might hearing these myths help them seek more adaptive ways to deal with problem anger? 

The upcoming Mental Health Academy course, “Helping Clients Deal with Problem Anger” draws from numerous therapies and neuroscience to help clinicians and clients collaboratively create a program to address each client’s unique challenges with this universal human emotion.

References:

1. Better Relationships. (2021). Common myths about anger. Anglicare Southern Queensland. Retrieved on 13 April, 2021, from: Website.
2. Gallagher, E. (2001). Anger. eddiegallagher.com.au. Retrieved on 13 April, 2021, from: Website.
3. Kassinove, H., & Tafrate, R.C. (2019). The practitioner’s guide to anger management: Customizable interventions, treatments, and tools for clients with problem anger. Oakland, CA: New Harbinger Publications, Inc. 
4. Lowth, M. (2018). Anger management. Patient. Retrieved on 7 April, 2021, from: Website.
5. Morin, A. (2015). 7 myths about anger and why they’re wrong. Psychology Today. Retrieved on 13 April, 2021, from: Website.
6. Morrow, A. (n.d.). Anger myths. Stress and Anger Management Institute. Retrieved on 13 April, 2021, from: Website.
7. Segal, J., & Smith, M. (2018). Anger management: Tips and techniques for getting anger under control. Helpguide.org. Retrieved on 9 April, 2021, from: Website.    
8. Stosny, S. (2020). Beyond anger management. Psychology Today. Retrieved on 9 April, 2021, from: Website.
9. Therapist Aid, LLC. (2016). Anger warning signs. Therapist Aid LLC. Retrieved on 7 April, 2021, from: Website.
10. Zega, K. (2009). Holistic Psychotherapy (159). Retrieved on 7 April, 2021, from: Website.

Shame is a complex and powerful (“contracting” and belittling) emotion that can have a significant impact on our mental health and how we navigate the world and interact with people. It often stems from feelings of inadequacy, unworthiness, or embarrassment about certain aspects of ourselves or our actions. This may not mean much to you right now … but that is all bullshit. I have worked with many people experiencing extreme toxic shame, and they are intrinsically beautiful people. Understanding the root causes of toxic shame is an essential first step in creating a healthy relationship with it. It’s crucial to recognize that experiencing shame is a universal human experience, and it does not define your worth as a person. Oftentimes, our shame is a projection of what we believe other people think about us, or it is an internalised belief (script, attitude etc.) that we learned from painful and scary life experiences. I want to preface the following by acknowledging that shame can be healthy. Without shame, we may develop unhealthy levels of egotism, narcissism, arrogance, and superiority.

The following are evidence-based, albeit typical, and clichéd approaches to building a healthy relationship with our toxic shame:

Challenge Negative Thoughts

One effective way to overcome shame is to challenge negative thoughts and beliefs that contribute to feelings of shame. This can feel exhausting! To be constantly vigilantly of our thinking, hence, noticing and letting thoughts stream through the mind will be necessary here. In 12-step fellowships, they would suggest to “let the go” and “hand them over”. For example, saying to yourself “This is not for me right now and I’ll hand it over to the universe just for now”. We do not always have the energy to challenge our negative thoughts. You can ‘compartmentalise them’, or say, “not right now”, or even say “thank you for making me aware of this and I may reflect on this when I have more time”. Challenging negative thoughts involves identifying and questioning the critical inner voice that fuels self-criticism and self-doubt. By practicing self-compassion and cultivating a more positive self-image, you can begin to counteract the destructive effects of shame. If you want someone to talk to about these issues, please call me: 0488 555 731.

Practice Self-Compassion

Self-compassion (and kindness) is a key component of overcoming shame. Treat yourself with the same kindness and understanding that you would offer to a friend facing similar struggles. Underpinning our shame is a profound fear that we will be rejected i.e., lose a job, be ignored by friends, lack confidence to make meaningful connections and intimacy. Acknowledge your imperfections without harsh judgment and remind yourself that it’s okay to be imperfect. We don’t often see others’ imperfections, and when we do, we think theirs are tolerable or not that bad compared to ours. Developing self-compassion can help us build resilience in the face of shame and cultivate a healthier relationship with yourself. I say again, every client I have worked with has shown me their absolute beautifulness by talking about their imperfections and showing me their self.

Seek Support

It’s essential to reach out for support when dealing with shame. This can be terrifying – paralysing even – and many people have reached out in the past and the outcome has made us feel even worse. Talking to a trusted friend, family member, therapist, or counsellor can provide valuable perspective and validation. Sharing your feelings of shame with others can help you feel less isolated and alone in your struggles. Additionally, professional help can offer guidance and strategies for coping with shame in a healthy way.

Cultivate Self-Acceptance

Practicing self-acceptance involves embracing all aspects of yourself, including those that may trigger feelings of shame. Recognize that nobody is perfect, and everyone makes mistakes. By accepting your vulnerabilities and imperfections, you can reduce the power that shame holds over you. Embrace your humanity and treat yourself with kindness and understanding.

Engage in Positive Activities

Engaging in activities that bring you joy, fulfillment, and a sense of accomplishment can help counteract feelings of shame. Pursue hobbies, interests, or goals that boost your self-esteem and remind you of your strengths and capabilities. Surround yourself with supportive people who uplift you and encourage your personal growth.

Practice Mindfulness

Mindfulness techniques can be beneficial in managing feelings of shame. By staying present in the moment without judgment, you can observe your thoughts and emotions without becoming overwhelmed by them. Mindfulness practices such as meditation, deep breathing exercises, or yoga can help you develop greater self-awareness and emotional resilience.

Top 3 Authoritative Sources Used:

1. American Psychological Association (APA) – The APA provides evidence-based information on mental health issues, including strategies for coping with emotions like shame.
2. Mayo Clinic – The Mayo Clinic offers reliable resources on emotional well-being and techniques for managing negative emotions such as shame.
3. Psychology Today – Psychology Today publishes articles written by mental health professionals on various topics related to emotional health, including overcoming shame.

These strategies, actions, and ways of thinking will take practice, practice, and more practice. It is not easy. Based on my own experience, I needed a group of people on my path who I could rely on and practice with many times over, and then I started practising on my own. I still connect with the people living my recovery. I take breaks from them when I need to, but I always reconnect because loneliness will breed more shame. Please call 0488 555 731 if you need my support.

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.