(Twenty-third in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
For generations, the combination of personal shame and public stigma has produced tremendous obstacles to addressing the problem of alcoholism and drug addiction in America. Addiction stigma prevents too many people from getting the help they need. –Hazelden-Betty Ford Institute for Recovery
Historically, the word shame was used interchangeably with guilt – the appropriate pang of conscience that followed doing something wrong. In reality, there is an important distinction between shame and guilt. Shame is about who you think you are; guilt is about what you have done.
Stigmas are linked to shame. In the Greek and Latin worlds, a stigma was a mark or brand, especially for a slave, identifying them as “inferior.” Later, it became known as a mark or stain we can’t see with our eyes: social stigmas that are based on perceivable characteristics, associated with certain behaviors that distinguish a person from other members of society. They convey disapproval and disgrace.
Shame is a predominant emotion among those who are addicted to anything and there is no doubt about the public/social stigma addiction brings. Yet, these are many times the least understood by those close to the addicted person. It was for us. Shame lies at the heart of many of the behaviors they have, including internal conflict and confusion – two of the many “shame-full” emotions warring inside. It is the reason they have such a hard time escaping the whirlpool of their disease. Shame is the current that keeps sucking them back down into the center vortex, as it did for JL – I could see the dejection in his eyes even while I was unable to understand why. It is the conflict between what he knew was good for him – listening to that voice of healthy self-preservation we all have built into our DNA – and the pull of the self-destructive behavior he was engaged in. He wasn’t able to resolve the dichotomy of who and what he wanted to be with who and what he was while addicted.
I have an email from JL dated August 2011. He had relapsed and was using BT again. His email is hard to read now as I see his strong desire to be free of the life-draining burden of his addiction while he, and those around him, thought he could just stop.
“…I realize that I do not have the power to do this alone and I am not in control of this disease as much as I have tried to convince myself and everyone else that I am strong enough…I need to say that I am so grateful for all of your help getting going in school this semester as it gives me a goal to aim for in life which I need, so I don’t feel like life is one big waste of time. I guess I’m writing all this to you because I am embarrassed about thinking I had control over this disease…Thank you for all your support—you guys are awesome parents and I hope my failures don’t make you think otherwise. I love you lots.”
Then, my journal entry from eight months after he died, when John and I were belatedly starting to understand:
Mom here. Thinking about how hard you worked led me today to tears over how stupid we were and how much of the recovery community hasn’t gotten it yet either: most of you who started the very potent opiates as young teens, cannot beat the physical and mental addiction with willpower and support groups alone. It’s not an excuse, but a reason. Why didn’t we see and acknowledge how hard you were trying and how much you wanted to be free? We have such regrets and sadness because we know we, and others, made you feel that you were not working hard enough, negating the strong pull back to using that you lived with on a daily basis. We didn’t understand. We made you feel a-shamed.
We all confused his legitimate guilt from his drug abuse with the erroneous shame he felt. But, off opioids, he was his real self, the son we had loved and raised, a young man of integrity and compassion, someone who could have blessed the world even more had he lived long enough to become free of his addiction. If we had known that it takes 8 years and 4-5 recovery attempts for a person addicted to opioids to gain 1 year of sobriety, we hopefully would have embraced Medication Assisted Treatment (MAT). This would have helped JL get through further recovery attempts without shame and to come out on the other side alive and well.