Guilt is an emotion wherein we feel that we’ve made a mistake. It is defined as a feeling of having committed some wrong or failed in an obligation. Shame, on the other hand, is an emotion where the feeling is that we are a mistake. Shame is defined as a painful feeling of humiliation or distress that may be caused by the conscious awareness of wrong or foolish behavior. Often it is not even attached to a specific behavior, but to how we perceive ourselves internally. These two feelings often exist in partnership for people with chronic pain. The emotional experience of shame is based on a belief that there’s something intrinsically wrong with you as a person. Deep inside you feel fundamentally flawed, and believe that everyone knows it. Having chronic pain feeds into and strengthens this belief. For many people, it is difficult to escape from the burden of shame that has been internalized as a result of growing up in families whose emotional style was to shower their members with shame through an ongoing torrent of put-downs, insults, and blaming. When you are “shame-based,” anything you do that is less than exemplary reinforces the belief that you are defective and have been all along. In addition to reinforcing shame, having chronic pain can be also be shame-inducing, along the lines of “I have this problem so there’s obviously something wrong with me.” This feeling can be further compounded by being dependent upon or addicted to pain medications because of the stigma attached to that. Shame is self-defeating to the point of being self-destructive. Guilt is emotional distress or discomfort based on the belief that there is a problem related to your behavior, rather than to you as a person. It is ordinarily related to a specific action or an event. “Authentic” guilt can be healthy and helpful insofar as it’s a sign that we’ve violated our own values or a more universal moral code. It helps keep us honest and self-aware in ways that contribute to emotional balance. In contrast, “false” guilt is a sense of responsibility for things that go wrong for which you are not responsible. It is easy to fall into a pattern of guilt-driven self-blame—for being in pain, for not being a “man” or “woman” anymore, for not being able to work exercise or perform other physical activities as before; for not being able to stop taking drugs, etc. Feelings of shame and false guilt emerge when you begin to believe the lies that other people have told you about yourself. The direct connection between thoughts and emotions is clear in patterns of guilt and shame that are enhanced by thinking characterized by shame-based statements, such as:
- I should be more patient with my spouse and kids; it’s not their fault that I’m in pain.
- I should be back to work by now.
- I shouldn’t be in this much pain.
Shame-based statements from others include:
- What’s wrong with you?
- How could you do this to us?
- I wish we had never met.
Self-pity is defined as excessive, self-absorbed unhappiness over one’s own troubles. It is the emotional state of feeling sorry for yourself, sometimes in exaggerated ways. Self-pity is often a characteristic of chronic pain and addiction—after all, these troubles are very real. But the fact that self-pity often results from significant problems does not make it any less destructive in terms of its impact on emotional balance. When you are feeling self-pity, you are almost exclusively focused on what is wrong or not working in your life. This blog post is an excerpt from Pain Recovery – How to Find Balance and Reduce Suffering from Chronic Pain by Mel Pohl, MD, FASAM, Frank Szabo, LADC, Daniel Shiode, PhD, Robert Hunter, PhD; Published by Central Recovery Press (CRP).