The role of shame in alcohol dependence : narratives from those in recovery.

A relationship between shame and alcohol dependence has been reported in the literature, however the precise nature of this relationship is largely unexplored. A review of the literature suggested that experiencing shame is considered to be a risk factor of relapse. The drinking of alcohol temporarily relieves the negative feelings of shame therefore reinforcing further drinking and maintaining addictive behaviour. As a consequence, learning how to cope with shame without drinking, may improve recovery. On the other hand, some evidence suggests that experiencing shame may be helpful for developing reasons for stopping drinking and also a necessary protective factor that helps to prevent relapse.This study sought to explore how shame is experienced and understood by those ‘in recovery’ from alcohol dependence, by looking at the different ways that shame is spoken about in personal narratives. Eight participants were recruited from Alcoholic Anonymous (AA) groups and invited to tell their story of recovery. Transcripts were analysed using a narrative approach, focusing on how participants narrated their stories and made sense of their experiences, by identifying specific narrative techniques used to talk about shame. An analysis across all transcripts then identified narrative themes in relation to shame and from this a tentative model of shame in alcohol dependence was proposed. A discussion of the findings evaluated evidence for the model, taking into account the results from this study and those from existing theory and research, whilst identifying areas of further research that are needed. Clinical implications in relation to addressing shame in recovery are also discussed