Shame is one of those emotions we don’t like to talk about—but it shapes our lives more than we realize. It’s been part of our human story for thousands of years. Think about the story of Adam and Eve. After eating the forbidden fruit, their first instinct wasn’t anger or fear—it was shame. They tried to cover themselves, to hide. That ancient story still speaks to how deeply human shame is.

Even the word “shame” comes from roots that mean “to cover.” When we feel exposed, vulnerable, or not enough, we often want to hide—physically, emotionally, or even spiritually.

Philosophers and scientists have long tried to understand shame. In the 1500s, a physician named Annabale Pocaterra was one of the first to study it in a thoughtful, personal way. Later, big thinkers like Darwin and Nietzsche called it a core part of what it means to be human. In the 1960s, psychologist Sylvan Tomkins went even deeper, describing shame as one of our fundamental emotional responses. He saw it as a survival reaction—one that can shape how we relate to ourselves and others.

Dr. Donald Nathanson later built on Tomkins’ work and created something called the “Compass of Shame,” (below) a model that shows the four ways people typically respond to shame: withdrawing, attacking themselves, lashing out at others, or avoiding the feeling altogether—often by numbing out with substances or distractions.

Shame and Substance Use: A Vicious Cycle

For many people struggling with addiction, shame is both the spark and the fuel. It often begins with that gut-wrenching feeling of not living up to one’s own standards—or to what society expects. The heartbreaking part is that many individuals with substance use disorders (SUDs) truly want to do better. They want to repair relationships, keep promises, and live with dignity. But addiction doesn’t loosen its grip easily. And when relapse happens, shame hits even harder.

That feeling of “I’ve failed again” reinforces a cycle that’s difficult to escape: feel ashamed → use substances to cope → feel more shame → repeat. Over time, this cycle chips away at self-esteem, leaving people feeling broken and helpless. It’s not just internal—society plays a role too. The way we judge people with addiction as “weak,” “untrustworthy,” or “dangerous” only deepens their isolation.

When someone internalizes those messages, it becomes something known as self-stigma—a kind of shame turned inward. And the more a person believes they’re “bad,” the harder it becomes to seek help, connect with others, or believe in their own worth.

The Cost of Hiding Pain

Using Nathanson’s “Compass of Shame” helps us understand how people try to cope:

1. Withdrawal – They pull away from loved ones and retreat inward.
2. Attack self – They may spiral into negative self-talk or even self-harm.
3. Attack others – Anger becomes a shield, pushing others away before they can reject them.
4. Avoidance – This is often where substance use enters the picture, serving as a way to numb pain or escape.

Of these, avoidance is especially common in addiction. Whether it’s through drugs, alcohol, risky behaviors, or distractions, many people are simply trying to get away from the crushing weight of shame.

Guilt vs. Shame: Why the Difference Matters

It’s important to understand that shame is not the same as guilt. Guilt says, “I did something wrong.” Shame says, “There’s something wrong with me.” That difference matters a lot, especially in recovery.

While guilt can motivate someone to make amends or change behavior, shame tends to make people hide, withdraw, or give up. Guilt connects us to our values. Shame disconnects us from ourselves and others.

Healing Begins with Awareness

For people navigating recovery, recognizing the role of shame—and its sneaky cousin, self-stigma—is a powerful first step. Many aren’t even aware that their behavior is being driven by deeply buried feelings of inadequacy. Helping people connect those dots can unlock new pathways to healing.

One promising tool is the practice of self-forgiveness. It’s not about letting yourself off the hook—it’s about acknowledging your pain, taking responsibility where needed, and choosing to treat yourself with compassion instead of condemnation.

Because here’s the truth: Addiction and shame are deeply intertwined. But with the right support, understanding, and self-compassion, healing is absolutely possible.

Written By:

Michael P. Verona

PhD, LPC, CAADC, NCC

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Healing is Not Just Possible, But Deserved.

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