The Dynamics of Shame and Addiction

Written by Megan Bronson RN, MSN, CS on August 27, 2019

Guilt + Shame
Trauma / PTSD

The Problem

Addiction and shame are essential issues that need to be addressed by many burn survivors in the process of healing and recovery. Addiction is a common complication of healing from trauma as the addictive process drains energy and resources from the recovery process and from life.

The cycle of shame and addiction feed into and off  each other in an often desperate attempt to escape the uncomfortable and painful feelings of unresolved loss, grief, and trauma that become trapped in the mind, body, heart, and soul when unprocessed and unreleased can continue to be triggered and lead to the compulsive and shameful behaviors that we call addiction.

Compulsive behaviors, such as substance abuse, food addiction, exercise addiction, compulsive gambling, work addiction, relationship, love and sexual addiction, codependent behavior, or being trapped in perfectionism, can become attempts to relieve and control unresolved emotional pain and traumatic feelings. The emotional, physical, and cognitive energy that becomes trapped when unprocessed and unresolved 

Understanding Shame

In the process of recovery from addictive behavior, it is helpful to understand the difference between guilt and shame. Feelings of guilt are a message from our moral conscience that we are doing or have done something that violates the code of our inner moral compass.

Shame, on the other hand, sends the destructive message aimed at our “core self” that we ourselves are basically bad, unworthy, and forever flawed. Guilt says a behavior is not okay while shame says that we innately are not okay.

Shame is defined as a painful feeling of humiliation and disgrace leading to a loss of respect and esteem for oneself. Shame drives the core self into hiding, which feeds into compulsive behaviors to escape the pain  and sense of unworthiness. Shame is not just related to the hopelessness generated by trauma, but also begins forming when children are criticized in a way that attacks, shames, or demeans the core self. This degrading sort of input is especially damaging when the sense of self is developing during childhood, adolescence, and young adulthood. 

“You are a loser.”“You will never amount to anything.” “You’re not as smart as your brother.” “You can’t do anything right.” These are all examples of shaming statements. Sometimes the tone of voice or nonverbal behavior that conveys disdain and contempt can be shaming all by themselves. It is helpful for children to receive both positive and negative feedback that is behaviorally specific. However, it is destructive to use criticism in a way that demoralizes and attacks the self of the child.

Burn survivors may face an additional challenge with post traumatic shame when the public’s reaction to differences, such as scars, facial difference and loss of limbs, lead to a loss of anonymity and the possibility of unwanted negative responses. Public humiliation, such as staring, teasing, name-calling, intrusive questions,and bullying can further traumatize the burn-injured person. These shaming behaviors increase the likelihood of post traumatic stress symptoms developing. Shaming attacks and demeans the core self. The most powerful antidotes to shame are emotional honesty and authenticity as a human being.

Understanding Addiction

It is helpful to look at addiction as a survival response. This is a hard concept to embrace and it is not proposed here to condone substance abuse or addictive behavior. However, if we recognize that we may have begun to use substances or other compulsive behaviors to manage emotional and physical pain in the first place, it can help normalize the shame we feel when our lives have become out of control and centered around our drugs of choice. My co-facilitator and coauthor James Bosch suggests we ask, “What is the ‘monster’, or the  substance or the underlying issues that drive us to numb out and check out?”

Often we do not see other alternatives or have not been offered the tools to manage the devastating experience of trauma. Alcohol and drugs are everywhere and they provide a quick temporary relief or escape from our experience. This relief often then becomes dependence and we find ourselves unable to cope or connect with others without substances or other compulsive behavior. But starting to bring the underlying issues to the light and consciously engage with them is scary. Understanding this is a first step toward reducing shame and toward recovery.

Deactivating Trauma, Activating Relaxation

When human beings face a threat to life the brain automatically goes into the much written about “Fight, Flight, Freeze or Surrender” response. This response of the brain to a life-threatening situation is built into our mammalian brain to protect us and get us away from or neutralize the danger and threat. Helping the brain to move out of code red status after traumatic injury and traumatic loss is essential to healing after trauma. Many activities and methods are conducive to calming the traumatized brain and body and can help to deactivate the trauma response in the brain, as well as activate the brain’s relaxation response:

  • Therapies such as eye movement desensitization & reprocessing therapy and cognitive behavioral therapy that address the trauma response directly and are aimed at gradual exposure and desensitization, address negative and stuck thoughts related to the trauma, and help develop new ways of thinking about what happened and what can be

  • Yoga, Tai Chi

  • Mindfulness practices

  • Music

  • Calming breath work

  • Meditation and prayer

  • Support groups for burn survivors

  • Twelve-step programs that assist with controlling and stopping addiction and/or compulsive behaviors and provide a space to be authentic and emotionally honest

  • Learning social skills, such as boundary setting and responding to unwanted public attention

Finding Your Way Home

One of the essential steps in recovery is being able to tell one’s story and to mourn what has been lost. This requires a place of emotional safety and is best accomplished in the presence of people who express understanding and compassion. Overcoming the cycle of shame and addiction can be a challenge for burn trauma survivors but is not insurmountable. Finding safe people and places, such as the Phoenix World Burn Congress, that nurture and support your expression of emotions and authentic self can be very helpful in the service of recovery and healing. Learning to trust and rely on support will go a long way toward strengthening your sense of who you truly are and who you want to be on your journey of recovery and healing.

Breaking Addiction's Grip

By James Bosch, MA, MFTi

Shining Light on the Reasons We Use

One way to heal from the shame of addiction is to see that the substance use or compulsive behaviors originally served a purpose in medicating pain from our past or recent traumas. Substance use can also begin as a way to self-medicate a biological mental health issue, such as depression or anxiety. 

The fact is that alcohol and drugs do just what we want them to—they either numb out a painful feeling or help us reach a feeling that we are not able to reach on our own. For example, if we experience grief we can take something to have momentary relief from the sadness; however, when we sober up it is still there and often stronger.

Substances can also be used to deal with social anxiety or fear of intimacy. These substances can sometimes block our fears and inhibitions. The problem is that their use often gets us in trouble. When we start relying on substances and compulsive behaviors to help us get through all life experiences and then build a tolerance and dependence on them, it turns into addiction.

By seeing our substance use as a coping mechanism, albeit an unhealthy one, we can start to release from the shame and begin learning other ways to cope. First we must remove the substances and stop the addictive behaviors, or at least change our relationship to them. Then we can tackle the underlying “demons” or issues that drive us to self-medicate. This begins the process of healing.

Finding a Middle Path

A Native American fable describes two wolves that battle inside each of us. While there are several versions of this legend, here is one (author unknown):

An old Cherokee chief was teaching his grandson about life. “A fight is going on inside me,” he said to the boy. “It is a terrible fight and it is between two wolves. One is evil—he is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, self-doubt, and ego. The other is good—he is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith. This same fight is going on inside you—and inside every other person, too.”

The grandson thought about it for a minute and then asked his grandfather, “Which wolf will win?” The old chief simply replied, “The one you feed.”

This is a powerful lesson to help us see that where we place our energy determines the part of us that will win and develop. In recovery from addiction, this can be as simple as avoiding people, places, and things that trigger us to use or act on compulsive behavior. If we feed the part of ourselves that wants to move toward health in mind, body, and spirit with people and activities that are healthy and helpful, then we will have a better chance at staying sober and beating our addictions.

While the chief’s advice in the story may lead us to make better decisions, the fable also has the danger of perpetuating shame. It would be easy to tell yourself, “I am relapsing or doing destructive behavior because I am bad or feeding the wrong wolf.”

Perhaps a middle path we can take is to make friends with both wolves, both sides of ourselves.When one lives in this middle path with both wolves attended to, there is a commitment to finding new ways to deal with our pain while keeping in mind our triggers, past experiences, and the understanding that we have used substances and compulsive behaviors to cope. We remember  the deeply entrenched ways of coping do not just go away when the substance abuse or behavior is stopped. We can keep an eye on both our sober mind and our deeply entrenched survival resources that no longer serve us living in the “addictive mind.” You can also look at this as changing the diet of both your internal wolves. This is an act of self-compassion.

The Role of Self-Compassion

Being kind to ourselves is essential to breaking the cycle of shame. Most people reading this would probably say they are their own worst critics and often beat themselves up when they slip or do not reach a goal. If we turn the same loving kindness and compassion toward ourselves that we would give a child or an animal we love, we can begin to move away from shame and toward forgiveness. 

A term that is often used in recovery circles is “being right-sized,” basically meaning that you respond to life rather than react to it. This is a moving away from the fight, flight, or freeze responses to our environment or our thoughts and responding in ways that support us and help us grow and relate with others.

Dr. Christopher Germer shares a helpful tool called the Self-Compassion Break. When you are in shame or beating yourself up, stop, take a breath, and say to yourself the following:

  1. This is a moment of suffering (or your own variation, for example, “This hurts,” “Ouch,” “This is tough.”)

  2. This suffering is a part of living (“Others feel this way,” “I am not alone.”)

  3. May I be kind to myself (“May I accept myself,” “May I learn to accept myself as I am,” “I am vulnerable and that’s okay…)” 

The language used is not as important as being kind to yourself in the moment your thoughts are trying to demoralize you or keep you in painful state of living.

Finding a Door to Recovery

There are many ways to approach healing from shame and addiction. The important thing is to find one that speaks to you. For some people, it is a 12-step program, which is a powerful self-help model that has proven to be successful for many worldwide; however, it is not the only way to address addiction issues.

There are also secular recovery programs, such as Life Ring or SMART Recovery. Another method called harm reduction espouses cutting down or changing the use of substances or compulsive behaviors so they are not as damaging, rather than quitting “cold turkey.” 

It does not matter how you get there, just that you try different doors until you find a way to break the addiction’s grip on your life. The important thing is to approach your exploration into your relationship with substances and compulsive behaviors with a curious mind, like a scientist trying experiments until he or she gets the desired results. Check out the list of resources at the end of this article. Keep in mind that slips and setbacks can sometimes be part of the process. This is when self-compassion is most needed.

Wishing you strength on your journeys!


Phoenix Society for Burn Survivors Programs and Resource Library

Eye Movement Desensitization and Reprocessing International Association

National Association of Cognitive-Behavioral Therapists

Association for Behavioral and Cognitive Therapies

IAFF Center of Excellence - The Recovery Village

All Treatment (Teen Rehab Centers)

Start Your Recovery - Substance Abuse Resources + Support 

Self-Help Groups for Addiction

Alcoholics Anonymous:

Chemically Dependent Anonymous:

Cocaine Anonymous:

Crystal Meth Anonymous:

Heroin Anonymous:

LifeRing Secular Recovery:

Marijuana Anonymous:

Methadone Anonymous:

Narcotics Anonymous:

Secular Organizations for Sobriety/Save Our Selves:

SMART Recovery: www.

Women for Sobriety:


Gamblers Anonymous:

Overeaters Anonymous:

Group for People with Co-Occurring Disorders

Dual Diagnosis Resources:

Groups to Support Loved Ones



Families Anonymous: