How NOT to Get Someone Into Rehab–Are You Doing This?

  How do you get someone into rehab? You’re not the first person stumped by this question.When a loved one is in the grips of addiction, family and friends often find themselves stuck in a cycle of fear, panic, anger and despair. Desperate for the addict to change, loved ones may try a myriad of tactics, threats and emotional pulls to get them into treatment. It’s impossible to say what it will ultimately take for your loved one to choose help. However, it’s a lot easier to say what won’t work. In fact, most families’ first instincts to get a loved one into rehab won’t work.

Shame and Addiction: How Not to Get Some Into Rehab

Addiction already provides limitless opportunities to experience shame without misguided but well-intentioned loved ones adding more to the pot. Though a mountain of research proves addiction to be a disease of the brain, not a character flaw, the stigma surrounding it is still highly prevalent in society. Research indicates that the more shame an addict feels about their substance use, the more likely they are to relapse. Research also supports a correlation between shameful experiences early in life and substance use disorders down the road. Thus the vicious cycle: People abuse substances to cope with shame, and substance abuse is perpetuated by feelings of shame surrounding their addiction. What’s the solution?

Shame vs. Guilt: One Works

Deborah Okrina, LCSW, provides counseling to individuals struggling with addiction and mental health issues at Promises P.A.T.H addiction and mental health rehab in Texas. An expert on the complexities of shame and substance abuse, Okrina leads therapy groups addressing shame and is senior faculty for “The Daring Way” shame resilience curriculum. The Daring Way is a widely used and respected methodology based on the work of renowned researcher, author and speaker Dr. Brené Brown. Dr. Brown’s research distinguishes between guilt and shame, a topic she discusses in her TED Talk series. Like Dr. Brown, Okrina describes the fundamental difference between guilt and shame as:

  • Shame is, “I am bad.”
  • Guilt is, “I did something bad.”

“If you believe that you are inherently bad, there is no way to improve the situation,” says Okrina. “If you believe that you did something bad that is not indicative of your worth as a person, you can accept responsibility, and take action.”

Guilt Motivates Change; Shame Makes Change Impossible

Much research backs guilt as a motivator. One example is a study published in the Psychological Science journal, which indicates guilt as an effective stimulus for behavior change. Researchers found that inmates who expressed guilt for their actions while incarcerated for a crime were less likely to commit future crimes in the year after release. The Association for Consumer Research even found guilt to be a motivating factor in advertising, driving consumers to make purchases in an attempt to resolve guilt. So, just use guilt to persuade an addict instead of shame? That’s how you get someone into rehab, right? Unfortunately, it’s not that simple.

What Guilts One Person, Shames Another

Okrina describes the line between shame and guilt as murky and complex, based on each person’s perception. Perception is influenced by an individual’s past, thought patterns and unique experiences. For example, one person could take the statement, “I think you need to go to treatment,” as a personal attack and feel shame. They interpret it as, “You think I’m a bad person, because you want me to go to drug rehab.” Another person could interpret the same statement as, “You think I’ve done something bad and I need help.” This interpretation comes more from a place of guilt than shame, and is thus more motivating.

How to Get Someone Into Rehab by Minimizing Shame

Since it’s impossible to predict another person’s perception, Okrina recommends starting with yourself — addressing your shame and your perception. Through this process you’ll gain a better understanding of shame, guilt and other emotions, and in turn, be better able to relate to and empathize with your loved one.

1. Educate yourself on shame

The shame of addiction isn’t limited to the individual abusing drugs or alcohol. Loved ones may feel the same social stigma, hesitant to let others know their family is suffering for fear of being judged. Okrina recommends reading the works of Brené Brown as a starting place for understanding shame and triggers.

2. Educate your loved one on shame

If they’re in a space where they’ll listen, share what you’ve learned about your own shame with your addicted loved one. This approach shouldn’t put them on the defense, because it’s about you. Your conversation could present a non-threatening opportunity to suggest they explore their shame as well.

3. Use non-blaming language

Try using “I” statements instead of “you” statements. Phrase communication in a way that focuses on how their actions make you feel, and take ownership of your feelings. For example, “I felt betrayed when I found out you used drugs again and told me you didn’t,” versus, “You used drugs again. You can’t be trusted.” The first statement is more effective and less shaming.

4. Practice empathy

When you are feeling more empathetic, you are less likely to shame and blame others. “Empathy is the opposite of shame because shame disconnects us and empathy connects us,” Okrina said. Working on your own sense of shame and engaging in practices like mindfulness can help breed empathy.

5. Have someone else do the talking.

If you know your addicted loved one favors the opinion or company of a particular relative or friend, enlist them to help with communication. If the addicted individual is at ease and doesn’t feel immediately “on guard,” they might be more apt to accept suggestions, and feel guilt vs. shame.

You Can’t Control Your Loved One; Control You

Communicating with an addicted loved one is difficult. Getting them into rehab can be even more challenging. Make sure to take care of yourself during this time. Get the help you need to be resilient and stay healthy. By: Sara Schapmann Sources: Dana-Nicoleta Lascu (1991) ,”Consumer Guilt: Examining the Potential of a New Marketing Construct”, in NA – Advances in Consumer Research Volume 18, eds. Rebecca H. Holman and Michael R. Solomon, Provo, UT : Association for Consumer Research, Pages: 290-295. National Institute on Drug Abuse: “Drugs, brains, and behavior: the science of addiction.” Rahim M, Patton R. (2015) “The association between shame and substance use in young people: a systematic review.” PeerJ 3:e737. Randles, D., Tracy, J.L.  “Nonverbal Displays of Shame Predict Relapse and Declining Health in Recovering Alcoholics.” Clinical Psychology Science, April 2013 vol. 1 no. 2, Pages 149-155. Tangney, J.P., Stuewig, J., Mashek, D., Hastings, M. “Assessing Jail Inmates’ Proneness to Shame and Guilt Feeling Bad About the Behavior or the Self?” Criminal Justice and Behavior, July 2011 vol. 38 no. 7, Pages 710-734.

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