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

Trauma: Emotional and Psychological WoundsTrauma: Emotional and Psychological Wounds

The word ‘trauma’ originates from the Greek word ‘wound”, which at the time, was primarily used to refer to physical injuries. Today, trauma is also frequently used to refer to “emotional wounds” that can cause psychological symptoms any time after the traumatic event has occurred, including years later. Emotional and psychological trauma can be lifelong.

The word ‘trauma’ has been popularised, and is arguably used carelessly or inaccurately, to indicate almost any kind of unpleasant experience or stressor by an individual (Haslam, 2016). A stressful life experience is more commonly being labelled as trauma or a traumatic experience. While both stress and trauma can impact our wellbeing, we must differentiate the two for diagnostic and treatment purposes within the mental health field.

Emotional and psychological trauma is associated with significant unexpected incidents that are, or perceived as, threatening to a person. The most recognised examples of traumatic events include unexpected natural disasters, a serious car accident, war, rape, bullying/intimidation, or losing a loved one. Traumatic experiences are often described as overwhelm the nervous system and experienced as deeply distressing events, and adverse short or long-term impacts are commonly experienced. It is also worth noting that some people may not recognise they have experience trauma. I once heard a story of a boy in high school who accidently severed a major artery of his peer with a school prop while joking around. His peer was taken to hospital and survived, but ears later he began having night terrors of the incident.

The following is a definition from the Substance Abuse and Mental Health Services Administration (SAMHSA) in the United States: “Individual trauma results from an event, a series of events or a set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.” (SAMHSA, 2014a, p. 7)

“Traumas can affect individuals, families, groups, communities, specific cultures, and generations. It generally overwhelms an individual’s or community’s resources to cope, and it often ignites the “fight, flight, or freeze” reaction at the time of the event(s). It frequently produces a sense of fear, vulnerability, and helplessness.” (SAMHSA, 2014b, p. 7)

The determinants of acquiring post-traumatic symptoms are influenced by how individuals interpret their circumstance(s), their developmental stage, cultural beliefs, availability of resources and support, and the physical and psychological disruptions they experienced (SAMHSA, 2014b). I have heard the word ‘trauma’ used to describe neglect and abuse during childhood. It’s important to note that while some caregivers may have neglected the emotional and psychological needs of a child, or used ‘smacking’ (positive punishment) to discipline children, not all individuals will develop symptoms that meet the current criteria by the Diagnostic and Statistical Manual (DMS) for Trauma. It is fair to say that all people have likely experienced life stressors that have conditioned them to think, behave, and react emotionally in specific or general social contexts, and will effect their quality of life and health.

As a rule of thumb, for trauma to be classified as a clinical psychological or emotional condition, I consider the 4 D’s: is there post-traumatic symptoms of DISTRESS, DYSFUNCTION in daily living, DANGER (to self or others), or DEVIANT behaviour. I think the word ‘deviant’ has prejudicial connotations so to clarify, it means departing from usual or accepted standards, especially in social or sexual behaviour.

Thank you for reading. Of course, there’s plenty more to say on the topic of emotional and psychological trauma, especially how cultures differentiate it from more commonly experienced yet individually meaningful life stressors. Stress that doesn’t fit the clinical criteria of ‘trauma’ is still valid and can be detrimental to our health. It can be helpful to seek psychological or psychiatric treatment, or spiritual alternatives to traditional Western health care.

References:

  1. Haslam, N. (2016, August 15). The problem with describing every misfortune as ‘trauma’. Chicago Tribute. From website.
  2. Substance Abuse and Mental Health Services Administration (SAMHSA, 2014a). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. Substance Abuse and Mental Health Services Administration. From website.
  3. Substance Abuse and Mental Health Services Administration. (2014b).  A treatment improvement protocol: Trauma-informed care in behavioral health services TIP 57. From website.

When our intelligent and necessary emotion – ANGER – becomes unhealthy and damagingWhen our intelligent and necessary emotion – ANGER – becomes unhealthy and damaging

The function of anger is to protect vulnerability and neutralize threat.

The threat humans cognitively perceive is almost always to the ego i.e., how we want to think of ourselves and have others think of us. Anger neutralizes ego-threat by devaluing, demeaning, or undermining the “power” of the person perceived to be threatening. Humans get angry when they don’t get what they want, when they’re disrespected, or when they perceive something is unjust/unfair. Anger, the emotion, is a chemical messenger. It communicates to us, to others, and motivates us to act, speak, do something. Healthy responses to anger include being assertive, feeling empowered, protecting ourselves and love ones from ACTUAL threat, setting boundaries with others, and making social change for justice (for example). It becomes unhealthy when we become passive-aggressive, violent, vengeful, spiteful, aggressive, resentful, sarcastic, “moody”, rude etc.

Receive the message and respond from a wise, calm place after the intensity of the emotion has past. Sometimes we have to act in the moment. Our ancestors may have required this for fight/flight survival. These days, we can generally PAUSE and calm the self before responding from a mindful and compassionate heart and mind. Remember: Hurt people, hurt people.