Teens, Shame and Addiction, a Devastating Mix (Part One)
by Bruce Thomson, Thomson Therapy Center PC
For many people, the teen years are the most challenging time of their life. Tremendous changes in the body, the brain and the social environment combine to create a shifting landscape that requires careful piloting. When you add substance abuse to the mix things can quickly move out of control. 12 to 17-year-olds often see themselves as immortal and invulnerable. This is in part because their frontal lobes, the seat of long-term, consequential thinking, are not fully developed until age 25-29. The all too common consequence is a teen that understands in principle the dangers of drugs and alcohol but is convinced that “it won’t happen to me”.
Teens are using drugs and drinking at increasingly young ages. In a 2011 study, the Partnership at Drugfree.org found the average age of first drink to be 14, with 25% of teens starting before age 12! Now, I know what you are thinking – not my kid. Here is the hard truth: In 2011, the C. S. Mott Poll on Children’s Health asked parents if their child had a drink in the last year. 10% of parents said yes. When they asked the children from those same families, 52% said yes they had been drinking. Unfortunately, many parents simply do not know what their children are using.
A theme that I will return to over and over again in these columns is that addiction is a brain disease . It is a neuro-biological disorder that changes the structure of the brain and how it functions in producing and processing the chemicals that drive action. Addiction is characterized by compulsive drug seeking and use, despite numerous adverse consequences. It is a chronic, relapsing disease with great variation in onset, and it can be fatal. Addiction works through the Meso-Limbic system, a primitive part of the brain. Unlike the frontal lobes, this part of the brain is fully formed by age 4. The Limbic System is extremely vulnerable to being hijacked by drugs because they create a rush of the same chemicals (neurotransmitters) that the brain naturally produces. These are the chemicals that encourage us to eat and sleep and exercise. If you flood the brain with these chemicals courtesy of drugs or alcohol, the brain begins to frame using as being just as essential to survival as eating! In a future column I will explain in more detail the mechanisms of addiction in the brain.
You will notice that nowhere in the definition of addiction is there any language about willpower. Here is what addiction is not. It is not a failure of will. It is not a lack of trying or a lack of caring. It is not proof that the afflicted person just doesn’t love their family enough. And it is not a problem that only shallow losers have to deal with. In 1842, 170 years ago, Abraham Lincoln said: “If we take habitual drunkards as a class, their heads and their hearts will bear an advantageous comparison with those of any other class. There seems ever to have been a proneness in the brilliant and warm-blooded to fall into this vice. The demon of intemperance ever seems to have delighted in sucking the blood of genius and generosity”. Despite all of the research that indicates a genetically based, biological foundation for addiction, many Americans still see addiction as a moral weakness.
Because of this inaccurate perception, and because of all the negative consequences associated with using alcohol and drugs, there is a great deal of stigma with addiction. Addicts say that people treat them differently, are more afraid of them, give up on them and even lower their pay. While this type of reaction is hard for anyone to deal with, it is excruciating for teens whose world is centered around peer relationships. Even though addiction affects approximately 10% of the U.S. population, (30 million people!), we still don’t like to talk about it. For vulnerable teens this can lead to a recurring pattern of shame and use.
Those struggling with drugs and alcohol will often internalize the stigma of such use as shame, adding to the shame they already feel. Their response is often to hide the problem instead of getting help. Families, friends and loved ones often collude in this deception and keep things hidden. They try to protect team membership, grades, college admission and reputations. While it may feel loving and protective, this response is actually enabling, and increases the chances of disaster and death. The more constructive response is to shine a great big spotlight on using behaviors, look at them openly and discuss their impact on everyone involved. And the impact will be felt by everyone connected to the user. As Joyce Rebeta-Burditt, author of The Cracker Factory , said: “Alcoholism isn't a spectator sport. Eventually the whole family gets to play”. This tendency to deny the problem and avoid treatment is so common that the U.S. government says 1.8 million adolescents (12-17 years old) needed treatment in 2011, but only 138,000 received it.
Now mind you, I am not talking about guilt. Guilt, in appropriate amounts, can be useful and even motivating. Guilt is when you think: “I did a bad thing”. It can impel you to apologize, make amends and change your future behavior. I am talking about shame. Shame is when you think: “I am a bad thing”. This type of thinking is toxic and destructive. It serves no useful purpose and often impels the individual to want to use drugs or alcohol to drown out the feeling, thus perpetuating the cycle. Shame acts to limit the amount of information and understanding an addicted person can tolerate about their condition. It also acts to reinforce a self-image of unworthiness and inadequacy. The central idea is that I am a failure. Not that I made a mistake, but that I am a mistake. You end up feeling uniquely undeserving of love and happiness. You may feel helpless to effect change and participate in life, and isolated by the feeling of overwhelming shame.
For the teen this often plays out in an attempt to be attractive, lovable, in fact, perfect. This is an impossible goal to attain. The addict will always fail in the attempt and feel more shame as a result. Toxic shame sets people up for compulsive and addictive behaviors. Since you cannot trust your own self-love you turn to addiction and you seek out co-dependent relationships. The addict may seek to fill this bottomless void with behaviors, substances and people who will compensate for the lack of internal self-validation. So again we see addiction leading to shame and shame leading to addiction in a cruel cycle.
In Part Two I will address what parents should be looking for to detect teen use and addiction, how to help protect your teen from drugs and alcohol, and what we all can do to help alleviate stigma and shame
Bruce Thomson, M.S., L.M.S.W., is a Psychotherapist in private practice in Ann Arbor, Michigan ( www.ThomsonTherapyCenter.com). He can be reached at [email protected] or at 734.994.8120. Bruce specializes in marriage and couples counseling and works with adolescents and adults on addiction and recovery issues.