Addiction Treatment

Understanding The Burden Of Guilt and Shame In Addiction Recovery

Key Points:

  • Guilt and shame are powerful negative emotions that can make a recovery more challenging.
  • Guilt is saying, “I did something bad,” whereas shame is saying, “I am bad.”
  • Guilt and shame can increase the odds of addiction relapse, which sparks fresh guilt and shame, thus furthering a harmful cycle.

Guilt vs. Shame

Have you ever wondered, “Do alcoholics feel guilty?” or “Do addicts feel remorse?” It’s a fair question to ask, but it also makes it more likely that if you ask either of those questions, you’ve probably never struggled with alcohol or drug abuse.

Yes. People absolutely experience shame and guilt over their addictions. If it seems to you like they are unbothered, don’t be fooled. The lows last much longer than the highs. Even if they seem unaffected, their addiction likely causes them a great deal of psychological disturbance.

In ways you cannot imagine, they must navigate the wreckage of their own choices daily. And when it comes to learning from their mistakes, shame actually makes it more difficult.

There are two different paths of regret some people with addictions can take:

  1. One is the path of guilt.
  2. The other is the path of shame.


Guilt in recovery can be a fair assessment of both personal and interpersonal trauma of addiction. It can be exaggerated, but it can also be fair. Guilt is like saying, “I’ve done bad things.” This is a highly critical admission because it forms the foundation of many 12-step therapies like Alcoholics Anonymous.

Knowing that you have made a mistake is the first step towards a new life in recovery. Feeling guilt is what compels us to seek forgiveness. The first person you must forgive is yourself. You must accept the past for what it is–something you cannot change. Then, you must move forward with the new knowledge you’ve learned from your mistake. You will strive to do better.

Then, you must seek forgiveness from others. Steps 8 and 9 of the 12-step process are making a list of all those who you’ve wronged during your addiction and then apologizing to those people. It is unrealistic to expect everyone to forgive you. Such idealistic thinking actually makes a person more susceptible to relapse (e.g., “everything will be better when XYZ happens”).

Guilt gives us an opportunity to learn. It makes a good tutor but a poor friend. That means guilt is helpful to learn but a bad companion to keep.


Shame in recovery is an unhelpful contamination of “guilt.” While people experiencing guilt think, “I did something bad,” people experiencing shame think, “I am bad.” If guilt describes a reaction to something you did, shame describes a reaction to who you are.

A more clinical definition of shame would be the (personal) perception of the (universal) devaluing of yourself.[2]

Unfortunately, shame and addiction go hand in hand. The experience of shame often exacerbates any present addiction and vice versa. To avoid feeling so crummy, people will abuse substances. After the euphoria dissipates, they will feel shame for having relapsed.

Shame often exerts an isolating effect on its sufferers. Its grip means they will distance themselves from their family, loved ones, and friends. These are also the people who could greatly assist in encouraging the sufferer to seek treatment. The relationship between shame and addiction is a spiraling, race-to-the-bottom type of interaction.

Shame says, “No matter if XYZ happens, you will always be worthless.” When shame becomes part of our identity, it cripples us. If you can’t dignify yourself as a human being worthy of self-respect, a cascading set of toxic thoughts follow close behind, which could end in relapse or suicide.

Recovery From Shame In Addiction

Recovery from shame and guilt in recovery is possible. Shame and alcoholism are often fellow travelers, just like shame and opioid use.

The uncomfortable response to shame has to be an acknowledgment of wrongdoing, but also in the reality of and hope for redemption. It’s easy to believe we are bad people. Sometimes, it’s hard to imagine we could be good people.

The opposite of shame is self-esteem. When we have high self-esteem, we also have the capacity for altruism, compassion, flexibility, and grit.[3]

At Recovery Unplugged, we will help you manage your experience of shame and guilt in a compassionate way. You’ve suffered enough alone. Come join our treatment program, and immerse yourself into a community of people who are charting a path out of addiction.

Frequently Asked Questions about Shame and Guilt

Where is shame held in the body?

Shame is a complex process and does not have a dedicated space like a liver or gallbladder. However, the part of your brain that processes moral reasoning is the prefrontal cortex. If something seems good or bad to you, it’s gone through your prefrontal cortex.

Therefore, if you have an extremely negative non-specific self-evaluation (i.e., shame), then it is stored in your prefrontal cortex.

Now, there is a visceral experience of shame, where you literally feel it.[4] That comes from the posterior insula. When it comes to feeling something “in the pit of your stomach,” that comes from the posterior insula.

Your prefrontal cortex and posterior insula work together to create the experience of shame. Since those two parts of your brain are part of the limbic system, the experience of shame is connected to the autonomic nervous system (involuntary physiological processes).

Therefore, the physical experience of shame coincides with the organs connected to the autonomic nervous system:

  • Heart
  • Liver
  • Bladder
  • Stomach

Can guilt make you sick?

In theory, it could. If the guilt you experience makes your stomach upset, it could have real consequences.

The experience of guilt is complex, having both physiological and cultural components. Guilt, like shame, is experienced by your prefrontal cortex and posterior insula. Those two parts of your brain are part of the limbic system, which controls involuntary physiological processes like heartbeats, digestion, and filtering your blood.

So, when guilt is felt, it’s also felt in the organs connected to the limbic system. And one of those organs is the stomach.

A yet-to-be peer-reviewed study was recently published, which connected the experience of subjective fear with an objective drop in stomach acid pH level.[5] This means stomach acid gets more acidic when fear is experienced.

Over time, much like people who suffer from queasy stomachs, the extra-acidic acid resulting from fear could wear down the gastric mucosa (lining of your stomach). If this goes untreated, ulcers could develop.

Don’t Suffer In Silence. Get Help Today.

We can help you overcome your substance or alcohol use disorder and start life anew. Call Recovery Unplugged today to learn more about how we can help.


  • [1] Wang, W., Song, S., Wang, J., Liu, Q., Huang, L., & Chen, X. (2021, October 6). Shame on you! when and why failure-induced shame impedes employees’ learning from failure in the Chinese context. Frontiers in psychology.
  • [2] Budiarto, Y., & Helmi, A. F. (2021, May 31). Shame and self-esteem: A meta-analysis. Europe’s journal of psychology.
  • [3] Branden, N. (1995). Six Pillars of Self-Esteem: The Definitive Work on Self-Esteem by the Leading Pioneer in the Field. Bantam.
  • [4] Uddin, L. Q., Nomi, J. S., Hébert-Seropian, B., Ghaziri, J., & Boucher, O. (2017, July). Structure and function of the human insula. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.
  • [5] Porciello, G., Monti, A., Panasiti, M. S., & Aglioti, S. M. (2023, January 1). Deep-body feelings: Ingestible pills reveal gastric correlates of emotions. bioRxiv.

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