Pubdate: Thu, 04 Feb 2016
Source: New York Times (NY)
Copyright: 2016 The New York Times Company
Contact: http://www.nytimes.com/ref/membercenter/help/lettertoeditor.html
Website: http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Larry S. Sandberg

IS SHAME AN ANTIDOTE TO ADDICTION?

To the Editor:

Sally L. Satel and Scott O. Lilienfeld criticize American culture for 
promulgating the idea that shame is "a damaging, useless emotion." 
They criticize efforts to "eradicate" shame (by likening drug 
addiction to cancer) for those with addictions, worrying that such 
people will see their "habits as unalterable."

Shame, as a universal social emotion, serves an evolutionarily 
adaptive function. It is also extremely painful and often dealt with 
by hiding. Contrary to the writers' assertions, our culture tends to 
stigmatize people with addictions - to wit, Drs. Satel and Lilienfeld 
use the pejorative label "addicts." Such people avoid treatment 
because of shame and destroy themselves in the process.

The role of agency is complex in illness whether dealing with 
addictions or illnesses the writers categorize as "biological." For 
example, a patient with lung cancer who smokes is a different patient 
from a nonsmoker.

Regardless of the condition, it is critical to mobilize the healthy 
part of the patient to take responsibility for his or her health. 
This has more to do with mobilizing self-love in the setting of shame.

Diminishing the stigma attached to addictive illness may help some 
people more readily enter treatment and come out of hiding.

LARRY S. SANDBERG

New York

The writer is clinical associate professor of psychiatry at Weill 
Cornell Medical Center.
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MAP posted-by: Jay Bergstrom