Karrol-Jo Foster, LMHC, CAP, ACRPS

Toxic shame

Shame is a complex emotional state which can be difficult to define and understand. Many think of shame as similar to guilt but they are inherently different emotions. A very simple way of understanding the difference is in the way we think and behave in response to these emotions. When we feel guilty about something we’ve done, our self-talk about the situation is usually something like “I feel bad about what I did,” and typically we will move toward the source of our mistake in order to apologize or otherwise repair the misconduct. On the other hand, when we feel shame we think and behave very differently. Our thinking, or self-talk, is more along the lines of “I am such an idiot” or “I am so stupid” instead of “I did something wrong” or “I made a mistake.” Unlike guilt, however, where we move toward connection in an attempt to restore and repair, when we experience shame we will move away, avoid, or even hide in order to disconnect from others and our feeling of shame.

When trying to understand the role shame plays in addiction, it is further complicated and misunderstood because of the dual nature of shame. Shame is experienced at healthy levels (innate moral shame) and toxic levels (internalized shame). John Bradshaw, in his book Healing the Shame That Binds You, does a great job explaining this dual nature of shame with his cholesterol analogy. Just as there are two kinds of cholesterol, HDL (healthy) and LDL (toxic), there are also two forms of shame; healthy and toxic.

Healthy shame keeps us grounded. It is our reminder that we are not supreme and all powerful (aka God), that we are human, and we make mistakes. Healthy shame points us in the direction of some larger meaning. Healthy shame is the essential foundation for spirituality and the psychological ground for our humility. Healthy shame is good for us and will often be the emotional prompting that encourages individuals to seek help for their addiction. Any true surrender can’t occur without a healthy dose of shame. I can’t tell you how many times I’ve heard people say “I couldn’t stand to even look at myself in the mirror. I was disgusted with the person I had become.” This rings true regarding my own recovery from addiction.

Internalized shame, on the other hand, is like LDL cholesterol. It
is destructive and if left unchecked will ultimately kill us. Instead of a momentary feeling of being embarrassed, making a mistake or feeling less than, a person comes to believe that their whole self is fundamentally flawed and defective. We are no longer perfectly imperfect human beings; we are totally and absolutely imperfect. When shame becomes internalized or absolutized, it becomes a state of being. Toxic shame is the most destructive emotional sickness of self a person can have. It is a true soul sickness that serves as both root cause and perpetuator of all addictions. It lethally disgraces us to the point where we literally disown ourselves. This self-alienation requires an elaborate masking or cover-up of the true and authentic self by creating a false self, which is essentially our protection against our felt sense of toxic shame.

The fuel of all addictive behavior is this rupturing of the self, the belief that we are flawed and defective human beings; we are a mistake. Deep, internalized, toxic shame gives rise to distorted thinking where our worth is measured on the outside instead of the inside, “I need something outside myself (alcohol, drugs, sex, money, power, food, etc.) in order to be okay,” which results in acting out on this thinking, followed by more shame over the consequences of our behavior. Addiction in and of itself can quickly turn healthy shame into toxic shame. I see this very often with the young people I work with who are barely out of their teens. The role of addict is the only identity they’ve ever known, with the compulsive cycle of addiction being fueled and regenerated by their identity and shame as an addict.

Healing toxic shame is an essential part of all addiction recovery. Unfortunately, it is an extremely painful process and especially difficult because pain is essentially the very thing we are trying to avoid. The pain comes in having to expose and look at the toxic shame, which is necessary and critical in order to reduce, and ultimately heal internalized shame. Shame thrives in darkness. The more we avoid it, the more it grows and the worse it becomes. We need to bring it out of hiding. Healing internalized, toxic shame requires what Bradshaw refers to as “externalizing” the shame. This can be tricky because there is the risk of premature exposure, or exposing our shame before we are ready, which can, in turn, create more internalized shame. The key to successful externalization is finding a non-shaming intimate person or support group and honestly sharing our innermost feelings. Brene Brown, in her research on shame, credits this willingness to become vulnerable and exposed as an essential element in the healing of shame. When we trust someone and experience their unconditional love and acceptance, we begin to change our beliefs about ourselves. One of the reasons 12 Step programs are so successful is in their inherent ability to heal toxic shame. The birth of AA was created through the very act of two people coming together (Bill W. and Dr. Bob) and exposing themselves and their pain to each other and then, of course, ultimately, to other suffering alcoholics.

Alcoholics Anonymous and 12 Step Recovery has by far been the most successful approach to healing toxic shame. That being said, there is a significant population of individuals for whom 12 Step programs are not appealing and who continue to suffer and struggle because of their reluctance to engage in the healing process 12 Step recovery affords. And although I am a devoted supporter of 12 Step programs, and credit it with my own personal recovery, I believe it is possible to heal toxic shame without a 12 Step program. Conversely, I have also found that many struggling with toxic shame require more than a 12 Step program in order to fully heal their internalized shame. I am in no way recommending anyone forego 12 Step recovery, but simply acknowledge that it is possible to heal toxic shame through other means. This can be accomplished through an intimate, unconditionally loving, and non-shaming, relationship with a support group, mentor, clergyman or therapist. Whichever the route, however,in order to heal, we must come out of hiding and connect with others. There is virtually no other way.

Karrol-Jo (KJ) Foster is a Licensed Mental Health Counselor, Certified Addiction Professional, Advanced Certified Relapse Prevention Specialist, and Researcher. KJ works as a clinical research therapist at The Treatment Center of the Palm Beaches. She is also a PhD student at FAU researching relapse prevention and the impact of shame on addiction recovery. In addition to her relapse prevention and shame research, KJ is co-author of the research project “Spiritual Competence in Counseling and Supervision” which is currently in progress. She recently facilitated a learning institute on Integrating Spirituality into Counseling at the American Counseling Association Annual Conference in Montreal. KJ is a member of ACA, ASERVIC, FMHCA and President of the Beta Rho Chi Chapter of Chi Sigma Iota Counseling Academic & Professional Honor Society International. She may be contacted at