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.


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


Written by Christina Chwyl and Jason Luoma

It’s Not Your Fault: How the Mind Copes with Abuse by Someone Close to you

If you have been hurt by someone close to you, it’s likely you are bothered by feelings of shame. Maybe you find that it is hard to stop beating yourself up over small mistakes you make. Maybe you can’t stop thinking about the way you look to other people. Maybe you feel bad about yourself and you are not even sure why. Just because you feel shame doesn’t necessarily mean that you have done anything wrong or that there is anything wrong with you.

Research on Betrayal Trauma has found that if you have been abused by someone you are close to or depend on, you may be affected in particular ways. One way you might be affected is that you may feel a lot of shame . When you feel shame, you may focus on beliefs that you are bad or flawed, rather than noticing that someone is hurting you. In addition to feeling shame, people who are hurt by someone close to them are also more likely to forget that the abuse happened or “dissociate” or feel spacey. Forgetting, spacing out, and feeling shame may all be different ways in which your mind tries to protect you from knowing about abuse, or at least knowing how bad it is or was.

Why would your mind keep you from knowing?

People who are in danger will sometimes try to get away from the thing that is causing them danger, or maybe try to fight it. However, if you really need the person who is hurting you, for example if they are helping to raise your children or they are paying your bills, you are in a bind. If you fight or flee, you might lose those resources. In addition, if the person is violent, then fighting or fleeing might result in more violence and harm. As a result, sometimes your mind can simply block you from even knowing about the abuse to protect you from further harm. Or you might know that something feels bad, but make sense of it by telling yourself there is something wrong with you instead of recognizing that it is the other person who is doing something harmful.

You may also feel shame because of ways the abuser acts toward you. Dr. Jennifer Freyd, an expert on betrayal trauma, came up with an acronym called DARVO, which stands for “”Deny, Attack, and Reverse Victim and Offender.” What that means is that the person who is hurting you may make you believe that you are the one doing the hurting and they are the one being hurt. They may ​deny that the abuse ever happened or even say something like​, “You are the one who is hurting me by saying that I hurt you.” This response makes things even more confusing and causes more shame and not knowing.

If you have experienced abuse and had periods of shame and not knowing, your mind may have been trying to protect you from further harm. At the same time, shame and not knowing may cause problems in other parts of your life and may keep you from finding resources that could help you be safer. With the support of resources like domestic violence centers, hotlines, safe friends and family, and/or a trusted therapist, you can learn to recognize when you are feeling shame even though you’ve done nothing wrong. You can notice, “Oh, this is shame I’m feeling. It’s telling me I’m no good but I don’t have to listen to it.” Then, with the help of your support system, you will have ​more​ power to decide what works for you.

I know it can be hard to reach out for help, but reaching out can be a very powerful step in the process of healing from trauma and shame. If you are in the Portland area and ready for some support, feel free to contact me at Portland Psychotherapy, or take a look at some of these resources:

Local Oregon resources for adult survivors of child abuse and for survivors of domestic violence:




National/International resources: