Introduction
Addiction is a complex and multi-dimensional topic that has been extensively studied in research literature through different lenses. Thus, there is an abundance of sources that can be used for an in-depth exploration of the issue and identifying trends and patterns in the findings. As noted by Hacker and Fister (2010), a literature review is intended to select the most relevant and important publications on a topic and, in addition to their categorization, to offer commentary on the leading scholarship. As a first step in the current literature review, this essay will focus on the analysis of one pertinent source on addiction, incorporating additional supporting references for a comprehensive overview.
Analysis of Snoek et al.’s Study
There is an overarching consensus among researchers that substance use disorder (SUD) hurts an addict’s physical and mental health, interpersonal relationships, and professional, educational, and financial outcomes. Moreover, self-concept suffers significantly as addicted individuals can feel severe guilt and shame as a result of stigmatization and biases surrounding addiction (Werder et al., 2021). In their study, Snoek et al. (2021) discussed therapeutic strategies that addicted individuals can practice to enhance their self-perception and feel more confident about their way toward recovery (Inanlou et al., 2020).
The research was based on challenging the dominant view of the opposing action tendencies between the two feelings. While guilt-prone individuals are more likely to tackle dysfunctional behaviors, shame-prone persons tend to persist in negative behavioral patterns, avoiding responsibility (Snoek et al., 2021). Drawing from these findings, addiction treatment strategies should incorporate such insight and adjust therapy to the extent of addicts ‘ proneness to either shame or guilt.
However, the scholars recommended a shift in theoretical perspective as both shame and guilt are interconnected and may not always get disentangled in the experience of persons with addiction. The theoretical shift the journal article proposes is an important qualifier for their study. The empathy-driven approach toward addiction therapy appears to be more compassionate than the traditional methods, allowing addicts to move away from retributive self-blame.
Feeling shame and guilt is counterproductive to the process of recovery, even though persons with addiction tend to experience diminished self-esteem as a result of both internal and external stigma (Werder et al., 2021). Moreover, even in the healthcare setting context, stigma has been a persistent problem due to the lack of trust between clinicians and patients, with the latter hiding drug use for fear of judgment or receiving lower-quality care (McCradden et al., 2019). Both guilt and shame drive such a decision, reflecting an individual’s concern about the impact of their behavior on others and the fear of being judged.
The article is highly valuable for approaching the issue qualitatively and including self-reported perspectives of individuals with addiction and their views of guilt and shame. The reports illustrated that, for example, feelings of guilt had no impact on positive behavior change and, rather, had the opposite effect (Snoek et al., 2021). Based on the coding system derived from the thematic analysis of interviews, one key node that repeatedly appeared was “guilt reinforced use” (Snoek et al., 2021, p. 106954).
As a feeling, guilt caused avoidance among interviewees who reported re-intoxicating themselves to avoid experiencing it: “Well, I think it was just … not an escape, but just something to numb the guilt and the shame. And just how much I’d let myself down” (Snoek et al., 2021, p. 106954). These findings offer an insight that is opposite to the dominant view of guilt, as responders indicated that it did not lead to tackling dysfunctional behaviors.
To counter the limitations of the traditional approach, the researchers proposed a strategy to shift addicts from retributive self-blame to a forward-looking perspective allowed by scaffolding self-reproach. The therapeutic model aims to help individuals envision a self with the power to change the direction of their lives. Within the alternative approach toward recovery, addicts are tasked with seeing their dysfunctional attitudes and dispositions as flexible, which means that they do not define the future direction of their recovery and identity. Such persons should be inspired to wish for a life without drugs and project themselves into such a desired future. In contrast to retributive self-blame, which can evoke feelings of hopelessness, the scaffolding method aims to stabilize and secure individuals in a position to reclaim a positive identity.
Conclusion
To conclude, the research article brings out important considerations regarding the need to abandon the dominant views of the relationship between addiction recovery and feeling guilt and shame. Instead, practitioners are recommended to facilitate the scaffolding approach and support individuals with addiction by inspiring a positive vision of a better future without addiction. This vision should be of a person who has the power to attract change and internalize only those skills that lead to a significant transformation. The study offers a framework for future research on the success of self-scaffolding and the role of the healthcare provider in establishing a supportive environment in which former addicts can thrive.
References
Hacker, D. & Fister, B. (2010). Research and documentation in the electronic age (5th ed.). Bedford/St. Martin’s.
Inanlou, M., Bahmani, B., Farhoudian, A., & Rafiee, F. (2020). Addiction Recovery: A systematized review. Iranian Journal of Psychiatry, 15(2), 172-181.
McCradden, M. D., Vasileva, D., Orchanian-Cheff, A., & Buchman, D. Z. (2019). Ambiguous identities of drugs and people: A scoping review of opioid-related stigma. International Journal of Drug Policy, 74, 205-215.
Snoek, A., McGeer, V., Brandenburg, D., & Kennett, J. (2021). Managing shame and guilt in addiction: A pathway to recovery. Addictive Behaviors, 120.
Werder, J., Curtis, A., Reynolds, S., & Satterfield, J. (2021). Addressing bias and stigma in the language we use with persons with opioid use disorder: A narrative review. Journal of the American Psychiatric Nurses Association, 28(1), 9-22.