Issue link: https://maltatoday.uberflip.com/i/1517916
13 Unity SUNDAY 24 MARCH 2024 David Gregor De Bono M.Phil/Ph.D. Candidate Department of Psychology ACCORDING to the National Institute on Drug Abuse, addiction is a chronic and recurring brain ailment characterised by the unmanageable consumption of a sub- stance or the repetition of specific behav- iours, such as gambling, even when faced with negative consequences. Despite ex- periencing a range of detrimental effects, individuals afflicted with substance use disorder (SUD) persist in engaging in ir- responsible behaviour. The widespread acceptance of the bio- medical model can potentially be attrib- uted to a tendency to provide biologi- cal explanations for human behaviour, even in cases where these explanations lack theoretical consistency or obvious empirical support. Multiple research studies have consistently demonstrat- ed that individuals have the capacity to modulate and change their addictive behaviours merges with the biology and psychology of addiction. These findings suggest a dynamic interaction between volitional aspects and a significant so- cial component that influences the or- igin and nature of addiction. Irrational behaviour and perceived lack of control can indeed be understood as motivat- ed behaviour, ultimately prioritising immediate rewards over long-term ad- vantages. It is only when the balance between the costs and benefits of sub- stance use is altered that individuals may contemplate reducing or discon- tinuing their drug consumption. One much-cited definition of shame confers it as an "intensely painful feel- ing or experience of believing we are flawed and therefore unworthy of ac- ceptance and belonging…shame creates feelings of fear, blame and disconnect" (Brown, 2006, p. 29). Shame has been labelled as the master emotion "because no other emotion plays such a central role in affective, cognitive, motivation- al, and behavioural experiences" (Turn- er & Schallert, 2001, p. 320) Shame manifests itself in the intrapsy- chic, a feeling of being flawed, and in the relational, 'the exposure of a flawed self' (Wiechelt, 2007, p. 400) instilling the need to hide. Shame is the force that unites us as social beings, compelling us to reflect upon the social norms we have violated and urging us to restore our wounded sense of self. While pro- found shame can erode our very core, it also serves as a crucial motivating factor for addicts, compelling them to reclaim their lives, reconstruct themselves, and strive for personal growth. It ignites their desire to regain control. While it is still not fully understood whether shame directly causes addic- tive behaviours (and/or vice versa), re- search indicates that individuals who experience high levels of shame are more prone to developing substance use disorders. The emotional baggage and negative self-talk that we carry from our early years can contribute to certain behaviours that provide tem- porary comfort and can lead to addic- tion. This creates a harmful cycle where active addiction triggers actions that evoke shame, causing one to increas- ingly rely on substances for short-term relief. Being ashamed of losing control or not meeting personal goals can drive individuals to hide their shortcomings. When societal shaming is added to the equation, the burden becomes over- whelming, leading to greater secrecy and dependence on substance use. Despite a growing interest in that in- terface between shame and substance use, there is still a lack of comprehen- sive understanding when it comes to the complexities and nuances of shame. Whilst there are multiple viewpoints on shame that have yet to be explored through empirical research, little is understood on how individuals who engage in substance use perceive and grapple with shame. This gap in knowl- edge is particularly significant as well as problematic when one considers how therapists' reactions can influence cli- ents' feelings of shame. Concerned with such gaps and the dearth of research within the Maltese context, I am currently carrying out an M.Phil/Ph.D research that explores the ways shame effects persons who use drugs problematically could contribute to improving the quality of care pro- vided to people using health services. Delving into and comprehending the real-life experiences of individuals af- fected by this phenomenon enhances our existing knowledge of the link be- tween shame and addiction. The ob- jective of this research is to assist prac- titioners when providing therapeutic support to these individuals with re- gards to the emotion of shame. Over- all findings are expected to provide a more detailed understanding of shame related issues to addiction and its im- plication on addictive trajectories and desistance, as well as pave the way for the established use of shame resilience applications and further research in the subject, since there are existing gaps in knowledge in the Maltese context with regards to these issues. References Brown, B. (2006). Shame resilience the- ory: A grounded theory study on women and shame. The Journal of Contemporary Social Services, 87(1), 43-52. Turner, J. E., & Schallert, D. L. (2001). Ex- pectancy-value relationships of shame reactions and shame resiliency. Journal of Educational Psychology, 93(2), 320- 330. Wiechelt, S. A. (2007). The specter of shame in substance misuse. Substance Use & Misuse, 42(2-3), 399-409. SHAME AND SUBSTANCE USE Individuals who experience high levels of shame are more prone to developing substance use disorders in point. Amidst the political turmoil of the 1980s, we had the important dissenting voic- es of Tan-Numri, Iż-Żgħażagħ ta' Taħt l-Art and the student movement (amongst others) championing change, as did the multitude of uncompro- mising rock bands based at Tigné's Rokarja and elsewhere. The 1990s saw the rise of vociferous and effective envi- ronmental groups and today, we have a potent civil society (spurred by the ultimate price paid by Daphne Caruana Gali- zia) spearheaded by young dis- senters who dare to dream of a better Malta. On the fringes of the literary and artistic world we have myriad forces express- ing dissent while pursuing a DIY ethos away from the con- trolling hands of the State and market forces. Examples of this are evident even though several are still off the radar for many. And it is in relation to this last observation that I wish to end this piece. Dissent is the anti-thesis of indifference and passivity. It is crucial for de- bate, effective dialogue and social innovation. It must be spurred, fostered and encour- aged. A national critical mind- set and effective political and media literacy are essential for meaningful dissent to foster. Our education system is pivot- al to this effect. The State has the responsibility to nurture the space for such dissonance and critique, while ensuring that the autonomy and inde- pendence of dissenters remains intact. This is essential for the status quo to be continuously challenged and eroded. References Brake, M. (1980/2013). The soci- ology of youth culture and youth subcultures: Sex, drugs and rock 'n' roll?. London: Routledge. Cloward, R. A., & Ohlin, L. E. (1960). Delinquency and oippor- tunity: A theory of delinquent gangs. Glencoe, IL: Free Press. Cohen, A. K. (1955). Delinquent boys: The culture of the gang. Glencoe, IL: Free Press. Merton, R. K. (1938). Social structure and anomie. American Sociological Review, 3,672–682. Substance abuse