Acting out our addictions can drive us to do things that we wouldn’t dream of doing in normal circumstances. We might be the most timid person in the world when we’re clean and sober, yet when we’re drunk, or high on drugs, we may become a snarling ogre who rages against everything.
Addiction can take us into arguments and fights; it can lead us to crash our cars and smash up property; and it can cause us to cheat on our partners. It can make us selfish and self-centred to an unacceptable degree. Even a ‘happy drunk’s’ behaviour will almost certainly have enormously negative consequences. Drunks and drug addicts are capable of the cruellest actions towards others, and if need be, they will lie, cheat and steal in order to feed their addictions.
This can be said of all forms of addiction, including those that are built around compulsive behaviour such as gambling, anorexia, and even self-harming. Addicts repeat these actions again and again, even though they may be aware that it’s damaging to both themselves and others. This creates a very powerful emotion within them, one that I believe stands out above all others: shame.
By the time most addicts reach rock bottom they’ve been carrying around years of hidden shame. It’s like a huge weight bearing down on their backs, and I call this the Shame Sack. Every time you get drunk and let someone down, every time you get smashed and cause a scene, or every time you blow your wages on some form of compulsion… it all goes into your Shame Sack.
Shame is one of the most unbearable emotions that a human can experience, which is what makes it such a dangerous one.
Guilt is when we feel bad about something that we’ve done wrong, but shame goes much deeper. Shame is when you feel fundamentally bad about your own value as a person.
Shame brings up anxiety, and it brings up reticence: it makes you feel as if you don’t even want people to look at you. It’s the ultimate experience of being ‘Less Than’. It’s a gut-wrenching sensation of worthlessness. When an addict experiences shame, the feeling it creates is so painful that they simply cannot bear it – which drives them even further towards more addictive behaviour.
If you wake up feeling like shit because of something you did the night before, then sooner or later the shame is likely to cause you to have another drink or drug – and the whole wretched cycle starts over again. These feelings of shame can lay dormant within us, stored away in our Shame Sack, continually weighing us down and eating away at our sense of self-worth.
When we hit rock bottom the feelings of remorse can be overwhelming: we no longer function adequately as a normal human being. Any alcoholic will tell you about the sense of utter despair they experience when they wake up sweating and with a thumping head, trying to patch together the events of the night before.
The shame they feel is wearying and exhausting. Every time they do something to make them feel this way, it accumulates a little bit more weight in their Shame Sack. Whenever they let themselves (and others) down with yet another drunken escapade, it adds to the emotional baggage they’re carrying.
I’ve met men who are consumed with shame because they’ve cheated on their partners (whom they profess to love dearly when they’re sober) and have contracted sexually transmitted diseases as a result. In some cases, their partners have become infected too, which is obviously soul-destroying.
The phenomenon of extreme sensitivity to shame isn’t limited to alcoholics and drug addicts – it affects all human beings. But shame has a particularly pronounced impact on those of us who have an addictive nature. People who binge on sugary food will feel furtive and guilty afterwards. When they see the effect that it has on their body – when their weight balloons – they feel ashamed of the way they look.
Shame is one of the most powerful drivers of addiction. It can stay locked inside us at a subconscious level, ready to manifest itself whenever we’re feeling ‘Less Than’.
Meanwhile, people who are addicted to sex are among those who experience the most intense shame, because of the highly intimate nature of their problem. It’s also important to note that shame isn’t just triggered by extreme behaviour; it can be generated by events that, to an outsider, might seem relatively trivial.
A friend of mine who spent 20 years as a suffering alcoholic got involved in some awful drunken escapades during that time, including being thrown into police cells. Yet one of the occasions that caused him the most shame was when he arrived home slightly worse for wear one evening, despite having promised to help his wife revise for a forthcoming exam. He was too fuzzy to be of any use.
It didn’t matter too much in the grand scale of things – the exam was still a few week’s off, so there was plenty of time to catch up. Nonetheless, the shame he felt after letting his wife down was very powerful, and it was one of the things that eventually contributed to him giving up alcohol.
Another source of secret shame for my friend was the fact that his drinking had meant he’d never made any effort to spend quality time with his niece, something he’d vowed to do when she was born. In my own case, one of the relatively minor things that caused me a lot of shame was seeing a photo of my daughter that I took by chance. It showed her peering around the door at me, clearly wondering why her dad was behaving like a drunken nut with a camera.
Of course, all this shame that we feel gets bottled up inside us and fuels more addictive behaviour, which in turn leads to even more shame. Like so many things connected to addiction, it’s a self-perpetuating vicious circle.
So when someone hits rock bottom and comes into recovery, we not only have to help them stop using drink or drugs (or whatever other form of compulsive behaviour they’re using), but we also have to tackle their feelings of shame. This is no easy task because in most cases, as well as carrying the fallout from years of addiction in their Shame Sack, addicts will also be carrying an enormous amount of baggage dating back to their childhood. Thankfully, treatment centres are starting to recognize this and act on it.
The One40 Group (at which I’m currently Director of Treatment) has adopted some very effective shame-reduction strategies for helping addicts come to terms with their feelings. These involve revisiting the shameful behaviour during therapy sessions in order to let go of it. This is done by non-cognitive therapy within the treatment process. By this I mean therapy that addresses the limbic (emotional) part of the brain, rather than the conscious cognitive part of our mind.
There are usually four layers to any addictive process – with each layer influenced by the one beneath it – and shame plays a key role in binding these four layers together.
As I will explain later, it’s a bit like the skin of an onion. When people come into recovery in a treatment centre, it’s the therapist’s job to peel back each one of these layers so we can deal with the emotional causes of addiction.
The outer layer is the using habit itself – the addiction. This is when we drink alcohol or abuse drugs – or take part in any other form of compulsive behaviour, such as overeating or obsessive sexual practices.
Beneath addiction, we have feelings, and below that are trauma, and then sensitivity in the centre. If this seems a little abstract, it might be helpful to see it as a diagram containing concentric circles:
People with an addictive nature – ‘The Watchers’ we learned about in Chapter 5 – are those who are born with a predisposition to be super-sensitive to emotional distress. So the inner core is sensitivity.
If these people experience traumatic events (particularly if they occur during their childhood), it triggers strong feelings within them, so the second layer is trauma. These traumatic experiences create powerful emotions, which are represented by the word ‘feelings’ on the third layer.
If you’re a ‘Watcher’ with an addictive nature, you’re extremely sensitive to these feelings. As we’ve learned, they’re visceral by nature and they exist in your limbic system, so you have very little cognitive control over them. The feelings become so unbearable that you seek to medicate them through drink and drugs (or anything else) in an attempt to escape them.
Shame is the main feeling that drives this process, so you can see that, in order to tackle addiction, we need to empty our Shame Sack. Of course, before we can do this, we need to stop acting out our addiction, since it’s continually fuelling more and more feelings of shame.
For this reason, when somebody comes into recovery the first thing we do is take away their ‘drug of choice’, regardless of whether it’s a substance or a process. Cutting down simply won’t work, as by the time somebody hits rock bottom the situation has gone way beyond that.
If a substance like alcohol, or a drug like heroin, are involved, this often requires a period of detoxification. These substances have a very depressive effect on the central nervous system, so if they’re stopped abruptly it causes a bounce effect that creates physical withdrawal symptoms. These require medical expertise to manage, so anyone who is quitting a heavy drinking habit, for example, is likely to be prescribed a drug called Librium for a few days.
Librium has a calming effect and ultimately reduces the risk of a seizure (as I mentioned earlier in this book, I suffered several grand mal fits when I tried to stop without medical help). The patient might also be given sleeping pills to help them through the initial period of withdrawal. This is because the substances they’re addicted to have a sedative effect on them, and if they’re suddenly removed the addict’s anxiety levels can rocket.
However, managing withdrawal symptoms is usually something that doctors are able to do with reasonable confidence, especially in a controlled environment like a treatment centre. This takes away the top layer of addiction – the using habit itself. However, this is only a very small step in a much longer process.
Beating physical withdrawal typically takes just a few days, but what we’re left with afterwards is feelings – lots and lots of them – and these are normally extremely powerful and painful.
Since an addict’s normal way of dealing with emotional distress is via their addiction, there’s a strong urge to resume abusing the substance. So the bigger challenge isn’t just detoxing – it’s staying clean.
A very important part of the recovery process is to let go of all the shame we’ve been carrying around. And the best way to deal with shame is to confront it head on. For an addict this involves a process of mental house cleaning in which we acknowledge our own part in contributing to our feelings of shame. If we’ve been acting out an addiction for many years, there’s likely to be no shortage of baggage we’ll need to unburden.
This is a very traumatic process in itself, but it’s also a very natural one. In simple terms, we feel better whenever we ‘get things off our chest.’ Typically, my work involves speaking to patients in group sessions, during which they explore their past behaviour, and we examine the emotional distress and shame it has caused them and other people.
At this stage, patients typically find themselves in a very raw state and they can become very emotional. Through group therapy (combined with one-to-one sessions if required), it’s possible for them to begin to understand the nature of the destructive process in which they’ve become trapped.
The overall effect of this is very cathartic, but it can take many weeks or even months to achieve. In some ways, it’s akin to clearing up the wreckage caused by addiction – and there are various techniques for this which I explore in subsequent chapters.
However, this emotional wreckage – the contents of our Shame Sack – is very much just an outer layer. At the heart of the addiction lies the thing that triggered the process in the first place. This is what therapists call the Shame Core.
The Shame Core consists of the buried feelings from childhood that exist within every addict. It predates those feelings of shame that are caused by the things we do when we’re drunk or smashed out of our brains on drugs.
Our Shame Core exists at the very centre of our being. It’s made up of the negative feelings and emotions that were picked up during childhood, and it continues to have a huge effect on us as adults. The Shame Core exists within our limbic system, so we have very little conscious control over how it causes us to behave. The feelings of shame that are generated by addiction itself are created later on, but our Shame Core has usually been with us from an early part of our life.
In every case of addiction that I’ve encountered, it’s the Shame Core that is at the root of the problem. This is an idea that has been pioneered by the therapist Pia Mellody, of the Meadows Clinic in Arizona, USA. I’m hugely indebted to Pia – I’ve been lucky enough to meet her on many occasions, and her thoughts have helped to shape my own understanding of addiction.
An addict is surrounded by shame, so not only do they need to tackle the outer circle of shame caused by the addictive process, they also need to get inside the Shame Core itself in order to achieve a lasting recovery. Their Shame Core was formed during childhood by the way that they interacted with their family or primary caregivers.
Before we can tackle the second layer of addiction – trauma – we therefore need to go back to study an addict’s Family of Origin: their family background. As we will see in the next chapter, it’s what makes them tick as a human being.