Shame and substance use are not related: Surprising results from the first ever meta-analysis of this relationship

Many researchers and theorists discuss shame as an inherently negative emotion that is always problematic. In this view, shame involves negatively evaluating one’s self and is often contrasted with guilt, which involves negatively evaluating one’s behavior. According to this view, shame motivates people to avoid situations and withdraw from others so that they can protect the “fragile, bad” self.

Cyclical models of substance misuse follow these ideas and hypothesize that substance use allows people to escape from and avoid painful feelings of shame, but also leads to behaviors that trigger shame.

In contrast, functional evolutionary views of emotion hold that shame evolved to alert individuals to threats to social belonging. Accordingly, shame occurs in response to situations involving failures of competency, or failures to conform to moral guidelines and social norms. From this perspective, the distinction between shame and guilt is often not as clear as from the previous view of shame.

While acknowledging that shame is often maladaptive, functional evolutionary views acknowledge data showing that shame may motivate cooperation, self-improvement, or altruism. According to this model, shame can be either helpful or harmful, depending upon the person and/or the context in which it is experienced.

We wanted to examine which of these models better explained how shame and substance use are related. So, we gathered up all of the research ever conducted on the association between shame and substance use to delve into the following questions:

  • How, and when, is shame related to substance use?
  • How is shame related to the problems associated with high levels of substance use, such as dependency?

Wine glassesFirst, we crunched numbers. Combining data across multiple studies (using meta-analysis) we found that shame was significantly (though modestly) related to problems associated with substance use. Shame was not, however, significantly related to substance use itself.

This finding runs contrary to what the vast majority of researchers would predict. So, we delved further into the studies to examine what might underlie this ‘null’ effect.

We discovered a couple of important patterns.

First, timescale mattered. Over longer periods (e.g. months-years), shame did not reliably predict substance use. Yet, over shorter periods (e.g. hours-days), shame predicted more substance use in at least some situations.

Secondly, when it came to alcohol, where people drank mattered. Shame tended to predict drinking at home/in solitude but not away from home/with others. Given that shame involves the perception of one’s self as bad and the fear of negative evaluation from others, shame appears to motivate people to withdraw from others and drink alone. Drinking alone may enable people to hide from the sense of rejection and separation involved in shame.

It seems that the motivation behind social drinking is not largely shame-driven, but solitary drinking does appear to be shame-driven, at least for some people.

Conclusions

Overall, our review suggests that shame is neither entirely good nor bad. Shame may be more relevant to solitary (as opposed to social) drinking; some studies found that shame led people to drink alone.

Some drinking situations also led people to experience shame. For example, people who didn’t feel they like they fit in well with their peer group and who also drank more than their peers, subsequently felt ashamed.

If you are someone who struggles with shame or substance use, it may be helpful to mindfully observe the situations that trigger either shame or substance use. With an understanding of your personal triggers, you can make specific plans to reduce the likelihood of risky drinking or work with a therapist to do so.

You can download a pre-print of the article here

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Written by Christina Chwyl and Jason Luoma

Christina Chwyl, B.A.

Author: Christina Chwyl, B.A.

Christina Chwyl serves as our full time research coordinator. She received her B.A in Psychology from Stanford University, and plans to pursue a PhD in clinical psychology. Her research interests include lifestyle interventions (e.g. nutrition, exercise), self-referential emotions (e.g. shame, guilt), and self-compassion and mindfulness interventions.

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