ACT With Compassion

It’s commonly believed that shame, which involves viewing one’s self as flawed or inferior, leads people to drink as a means of escaping the painful emotion. However, there are few studies that have looked at whether shame directly precedes drinking. In fact, some researchers think that shame may actually inhibit drinking for some people.

We (researchers involved with ACT with Compassion) recently published a study where we examined when and how shame is linked to drinking. Specifically, we wanted to answer questions such as:

• Does experiencing shame on a given day predict drinking that evening?
• How common is shame as a consequence of drinking?
• Are there situations in which experiencing shame may actually reduce drinking?

To answer these questions, we conducted a study in which 70 drinkers completed a survey about their feelings and drinking, every day, for 21 days.

If shame does lead people to drink, we would expect that on days in which people experienced more shame, they would drink more, and on days in which people experienced less shame, they would drink less. We did find this overall pattern. However, this was only true when we looked at drinking when alone, as opposed to social drinking. In other words, shame seemed to motivate people to drink by themselves, but not with others. Given that shame involves the perception of one’s self as bad, perhaps shame motivates people to withdraw in an effort to protect or hide themselves.

We also wondered whether peoples’ response to shame depended upon their overall experience of shame. So, we placed participants into one of two groups: those who, overall, reported experiencing more shame across the 21 days (“high shame group”), and those who, overall, reported experiencing less shame across the 21 days (“low shame group”). A different pattern of findings emerged regarding whether daily shame was related to more or less solitary drinking for each group. Here’s where things get a little complex.

For the “high shame group,” on days where shame was higher than usual, participants were actually less likely to drink. However, they drank more when they did drink. For these individuals, shame may be a known, habitual drinking trigger. Therefore, feeling ashamed on a given day may motivate them to inhibit their drinking. However, if their “self-control resources” are used up and they do drink, they may drink a higher quantity of alcohol in order to cope. On the other hand, on days where shame was lower than usual, high shame participants were more likely to drink. However, if they did drink, they consumed lower quantities of alcohol. On these days, it’s possible that participants were feeling better about themselves (i.e. less ashamed). Therefore, they may not have felt compelled to drink higher quantities of alcohol. At the same time, when they did drink, they may have felt less of a reason to inhibit their drinking..

For the “low shame group,” on days where shame was higher than usual, participants were more likely to drink. However, they drank less when they did drink. For these individuals, shame may not be a known, habitual drinking trigger. Therefore, feeling ashamed on a given day may motivate people to drink to feel better, at least to a certain degree. On the other hand, on days where shame was lower than usual, participants were less likely to drink. However, they drank more when they did drink. On these days, it’s possible that participants felt less of a motivation to drink since they were feeling fine. Overall, these results suggest that daily shame had a weak influence on the low shame group’s drinking behaviors.

Clinical Take-Away

While findings from this study are preliminary, they do underscore the benefit of non-shaming therapeutic approaches. For high shame individuals, while daily shame may lead to a lower probability of drinking, it could also lead to heavier drinking. Findings from this study also suggest that for people trying to abstain from alcohol, periods of reduced shame could be risky in terms of relapse. In addition, it suggests that shame may be more linked to solitary drinking, whereas drinking in social contexts is likely to be linked to other risk factors. Thus, for people who are highly shame prone, it’s probably important to establish relapse prevention techniques for times when people feel both bad about themselves and especially good about themselves. Both of these timesmay be a particularly likely time for a slip.

Acknowledgements

This month’s research report comes from a paper created here at Portland Psychotherapy. A special thanks to all of the participants who donated their time to this project, and to all of the clients who, by coming to our center, support scientific research.

Read More

Luoma, J.B., Guinther, P., Lawless DesJardins, N. M., & Vilardaga, R. (in press). Is Shame a Proximal Trigger for Drinking? A Daily Process Study with a Community Sample. Journal of Experimental and Clinical Psychopharmacology, 26(3), 290-301. 

Article written by: Christina Chwyl and Jason Luoma