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Guilt shame depression


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    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

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Last Updated: 08/30/2022

Alcohol, Tobacco, and Other Drugs

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Misusing alcohol, tobacco, and other drugs can have both immediate and long-term health effects.

The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. NSDUH estimates allow researchers, clinicians, policymakers, and the general public to better understand and improve the nation’s behavioral health. These reports and detailed tables present estimates from the 2021 National Survey on Drug Use and Health (NSDUH).

Alcohol

Data:

  • Among the 133.1 million current alcohol users aged 12 or older in 2021, 60.0 million people (or 45.1%) were past month binge drinkers. The percentage of people who were past month binge drinkers was highest among young adults aged 18 to 25 (29.2% or 9.8 million people), followed by adults aged 26 or older (22.4% or 49.3 million people), then by adolescents aged 12 to 17 (3.8% or 995,000 people). (2021 NSDUH)
  • Among people aged 12 to 20 in 2021, 15.1% (or 5.9 million people) were past month alcohol users. Estimates of binge alcohol use and heavy alcohol use in the past month among underage people were 8.3% (or 3.2 million people) and 1.6% (or 613,000 people), respectively. (2021 NSDUH)
  • In 2020, 50.0% of people aged 12 or older (or 138.5 million people) used alcohol in the past month (i.e., current alcohol users) (2020 NSDUH)
  • Among the 138.5 million people who were current alcohol users, 61.6 million people (or 44. 4%) were classified as binge drinkers and 17.7 million people (28.8% of current binge drinkers and 12.8% of current alcohol users) were classified as heavy drinkers (2020 NSDUH)
  • The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (31.4%) compared with 22.9% of adults aged 26 or older and 4.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer, and other serious health conditions
  • Excessive alcohol use can also lead to risk-taking behavior, including driving while impaired. The Centers for Disease Control and Prevention reports that 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily

Programs/Initiatives:

  • STOP Underage Drinking interagency portal - Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Talk. They Hear You.
  • Underage Drinking: Myths vs. Facts
  • Talking with your College-Bound Young Adult About Alcohol

Relevant links:

  • National Association of State Alcohol and Drug Abuse Directors
  • Department of Transportation Office of Drug & Alcohol Policy & Compliance
  • Alcohol Policy Information Systems Database (APIS)
  • National Institute on Alcohol Abuse and Alcoholism

Tobacco

Data:

  • In 2020, 20.7% of people aged 12 or older (or 57.3 million people) used nicotine products (i.e., used tobacco products or vaped nicotine) in the past month (2020 NSDUH)
  • Among past month users of nicotine products, nearly two thirds of adolescents aged 12 to 17 (63.1%) vaped nicotine but did not use tobacco products. In contrast, 88.9% of past month nicotine product users aged 26 or older used only tobacco products (2020 NSDUH)
  • Tobacco use is the leading cause of preventable death, often leading to lung cancer, respiratory disorders, heart disease, stroke, and other serious illnesses. The CDC reports that cigarette smoking causes more than 480,000 deaths each year in the United States
  • The CDC’s Office on Smoking and Health reports that more than 16 million Americans are living with a disease caused by smoking cigarettes

Electronic cigarette (e-cigarette) use data:

  • In 2021, 13.2 million people aged 12 or older (or 4.7%) used an e-cigarette or other vaping device to vape nicotine in the past month. The percentage of people who vaped nicotine was highest among young adults aged 18 to 25 (14.1% or 4.7 million people), followed by adolescents aged 12 to 17 (5.2% or 1.4 million people), then by adults aged 26 or older (3.2% or 7.1 million people).
  • Among people aged 12 to 20 in 2021, 11.0% (or 4.3 million people) used tobacco products or used an e-cigarette or other vaping device to vape nicotine in the past month. Among people in this age group, 8.1% (or 3.1 million people) vaped nicotine, 5.4% (or 2.1 million people) used tobacco products, and 3. 4% (or 1.3 million people) smoked cigarettes in the past month. (2021 NSDUH)
  • Data from the Centers for Disease Control and Prevention’s 2020 National Youth Tobacco Survey. Among both middle and high school students, current use of e-cigarettes declined from 2019 to 2020, reversing previous trends and returning current e-cigarette use to levels similar to those observed in 2018
  • E-cigarettes are not safe for youth, young adults, or pregnant women, especially because they contain nicotine and other chemicals

Resources:

  • Tips for Teens: Tobacco
  • Tips for Teens: E-cigarettes
  • Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
  • Synar Amendment Program

Links:

  • Truth Initiative
  • FDA Center for Tobacco Products
  • CDC Office on Smoking and Health
  • National Institute on Drug Abuse: Tobacco, Nicotine, and E-Cigarettes
  • National Institute on Drug Abuse: E-Cigarettes

Opioids

Data:

  • Among people aged 12 or older in 2021, 3. 3% (or 9.2 million people) misused opioids (heroin or prescription pain relievers) in the past year. Among the 9.2 million people who misused opioids in the past year, 8.7 million people misused prescription pain relievers compared with 1.1 million people who used heroin. These numbers include 574,000 people who both misused prescription pain relievers and used heroin in the past year. (2021 NSDUH)
  • Among people aged 12 or older in 2020, 3.4% (or 9.5 million people) misused opioids in the past year. Among the 9.5 million people who misused opioids in the past year, 9.3 million people misused prescription pain relievers and 902,000 people used heroin (2020 NSDUH)
  • According to the Centers for Disease Control and Prevention’s Understanding the Epidemic, an average of 128 Americans die every day from an opioid overdose

Resources:

  • Medications for Substance Use Disorders
  • Opioid Overdose Prevention Toolkit
  • TIP 63: Medications for Opioid Use Disorder
  • Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
  • Opioid Use Disorder and Pregnancy
  • Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
  • The Facts about Buprenorphine for Treatment of Opioid Addiction
  • Pregnancy Planning for Women Being Treated for Opioid Use Disorder
  • Tips for Teens: Opioids
  • Rural Opioid Technical Assistance Grants
  • Tribal Opioid Response Grants
  • Provider’s Clinical Support System - Medication Assisted Treatment Grant Program

Links:

  • National Institute on Drug Abuse: Opioids
  • National Institute on Drug Abuse: Heroin
  • HHS Prevent Opioid Abuse
  • Community Anti-Drug Coalitions of America
  • Addiction Technology Transfer Center (ATTC) Network
  • Prevention Technology Transfer Center (PTTC) Network

Marijuana

Data:

  • In 2021, marijuana was the most commonly used illicit drug, with 18. 7% of people aged 12 or older (or 52.5 million people) using it in the past year. The percentage was highest among young adults aged 18 to 25 (35.4% or 11.8 million people), followed by adults aged 26 or older (17.2% or 37.9 million people), then by adolescents aged 12 to 17 (10.5% or 2.7 million people).
  • The percentage of people who used marijuana in the past year was highest among young adults aged 18 to 25 (34.5%) compared with 16.3% of adults aged 26 or older and 10.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term
  • Marijuana can have significant health effects on youth and pregnant women.

Resources:

  • Know the Risks of Marijuana
  • Marijuana and Pregnancy
  • Tips for Teens: Marijuana

Relevant links:

  • National Institute on Drug Abuse: Marijuana
  • Addiction Technology Transfer Centers on Marijuana
  • CDC Marijuana and Public Health

Emerging Trends in Substance Misuse:

  • Methamphetamine—In 2019, NSDUH data show that approximately 2 million people used methamphetamine in the past year. Approximately 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2018. The National Institute on Drug Abuse Data shows that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia.
  • Cocaine—In 2019, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 778,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
  • Kratom—In 2019, NSDUH data show that about 825,000 people had used Kratom in the past month. Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors. It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.

Resources:

  • Tips for Teens: Methamphetamine
  • Tips for Teens: Cocaine
  • National Institute on Drug Abuse

More SAMHSA publications on substance use prevention and treatment.

Last Updated: 03/22/2023

How chronic shame and guilt lead to depression. Deadly Emotions

How Chronic Shame and Guilt Lead to Depression. Deadly emotions

WikiReading

Deadly Emotions
Colbert Don

Contents

How chronic shame and guilt lead to depression

Let's talk about feelings of guilt and shame, as they are often associated with depression.

Both feelings, guilt and shame, are rooted in events and actions that are unacceptable or unacceptable for us. Guilt arises when a person does something unseemly or illegal. Guilt is a painful feeling caused by remorse for a sin, crime, erroneous or immoral act. Shame usually arises from what another person does to you, if in society these actions are considered a sin or a crime. Shame, as it were, projects a bad act of an outsider onto the victim. In addition, shame is born if you turn out to be "not like" what you believe (often wrongly) that other people can accept and love you.

Shame first of all awakens feelings of grief and deep sadness, leading to a loss of self-esteem. Guilt always carries a certain amount of anger - because we feel trapped, caught in something unworthy. Both shame and guilt contribute to feelings of worthlessness, hopelessness, and helplessness, which lead to depression, anger, anxiety, and a host of other destructive emotions that open the way to stress reactions.

For many people, shame is associated with painful memories of rejection. Events from the past give rise to feelings of their insignificance and uselessness. For some, these feelings cause depression, while for others - anger, hatred and burning resentment. Shame and guilt create a vicious circle of negative thoughts, blocking the path to freedom, strength and health - physical, mental and spiritual.

Shame

Shame The paint of shame is the livery of virtue.F. Bacon 2, 74 Shame points to the inner limit of human sin; when a person turns blue, his nobler self begins. Geibel 1, 184 Contempt for a good name is called shamelessness.T. Hobbes Should be ashamed of himself

3. Shame.

3. Shame. a) Psychological and existential shame. - Where my insufficiency attracts attention, I am ashamed - or I am ashamed of possible insufficiencies whenever I catch the eye of others at all. Nudity causes shame where it is visible to others as such,

c) Protective and destructive shame.

c) Protective and destructive shame. - The deepest shame exists as an endless silence, which is from an existence that is certain about itself, but cannot know itself. She would not want to draw attention to herself, because she wants to save herself, so as not to lose herself

Chapter 3. Figures of female depression

Chapter 3 The following fragments lead us not to the universe of clinical melancholia, but to the neurotic edges of the depressive-melancholic complex. There we find an alternation of depression and anxiety, depression and perverse actions, losses

shame

SHAME Theory: Everything has already been written by others. I have nothing to add. Process: 1. What (else) would you be ashamed of? 2. What (else) would you not be ashamed of?

Pride or shame

Pride or shame Sir, someone once asked Ramana Maharishi, "If India were to gain independence from England, would the individuals who took part in it have any right to be proud of it?" And he said, “Theoretically, no. But since we all consider ourselves individuals, then

Biochemistry of depression

Biochemistry of depression Modern scientific methods make it possible to study the structure and functioning of various parts of the brain of a living person and identify disorders that lead to mental disorders. Neurophysiologist and child psychiatrist Daniel Amen has been studying

for many years

Depression and chronic stress

Depression and chronic stress So, depression plunges a person into a stressful state. But often chronic stress can lead to depression. Thus, depression, illness and stress form a vicious circle. One of my patients named George once said:

Help with major depression

Help with major depression People who are severely depressed recover best if they receive both psychotherapy and medication. Many psychiatrists treat depression with appropriate drugs, since most

Learned helplessness and deepening depression

Learned helplessness and deepening depression According to some studies, if there is a case of severe depression in the family, then the likelihood of its occurrence in the next two generations increases tenfold. I am convinced that the predisposition to depression

Appendix 3 Zung Depression Scale

Appendix 3 Zung Depression Scale Mark your condition on the proposed scale. Calculate the total points. For most people suffering from depression, that number is between 50 and 69..The maximum possible amount is 80. 1 State Occasionally and

Shame (Honte)

shame Not guilt at all, because you can feel shame knowing that you are not to blame for anything. It is this kind of suffering that the mocking gaze of others causes us - we feel absurd and pitiful. Sometimes awkwardness is enough for this, physical

Dealing with Guilt - Snob

In Alpina Publisher's new book Mood Therapy, British professor of psychology and behavioral sciences David Burns talks about how to spot early signs of depression, deal with feelings of guilt and how to understand yourself. "Snob" publishes one of the chapters of

Photo: Isai Ramos

No book on depression is complete without a chapter on guilt. What is the function of guilt? Writers, spiritual leaders, psychologists and philosophers have been trying to answer this question for centuries. What is guilt based on? Maybe it was the concept of "original sin" that gave rise to it? Or the Oedipal incest fantasies and other taboos that Freud talked about? Is guilt a realistic and useful component of the human experience? Or is it a "useless emotion" that humanity would be better off without, as some modern writers in the field of popular psychology suggest?

When computational mathematics was introduced, scientists found that they could now easily solve complex motion and acceleration problems that were extremely difficult to solve with the old methods. Cognitive theory has similarly given us a kind of emotional "calculus" tool that facilitates progress through the thorns of philosophical and psychological questions.

Let's see what can be learned from the cognitive approach. Guilt is the emotion you feel when you have the following thoughts:

  1. I did something that I shouldn't have done (or didn't do that I should have done) that doesn't meet my moral standards or notions of justice.
  2. Such "bad behavior" shows that I am a bad person (or I have a tendency to do harm, I have a spoiled character, a rotten gut, etc.).

The idea of ​​one's own "badness" is the main cause of feelings of guilt. Without it, actions that cause harm lead to healthy feelings of remorse, but not guilt. Remorse arises from an adequate understanding that you intentionally and unreasonably harmed yourself or another person, which violates your personal ethical standards. Remorse is different from guilt because it does not mean that your wrongdoing shows how bad, evil, or immoral you are. In short, you feel remorse or regret about your behavior, while guilt is directed at your Self.

If, in addition to feeling guilty, you are feeling depressed, ashamed, or anxious, you are probably following one of the following mental assumptions:

  1. My "bad behavior" makes me inferior or useless (this interpretation leads to depression).
  2. If others knew what I did, they would begin to despise me (this thought causes a feeling of shame).
  3. I may be avenged, or I may be punished (this thought is disturbing).

The easiest way to assess whether these feelings are beneficial or destructive is to determine whether they contain any of the ten cognitive distortions described in Chapter 3. If these thought errors are present, your guilt, anxiety, depression, or shame are certainly unjustified. and unrealistic. I suspect you will find that many of your negative feelings are actually based on such thinking errors.

The first distortion when you feel guilty may be that you did something wrong. Perhaps it is, but perhaps not. Is the behavior that you condemn in yourself really so terrible, immoral, wrong? Or are you exaggerating the scale of the problem? A charming medical laboratory assistant recently brought me a sealed envelope with a sheet of paper on which she wrote something so terrible about herself that she could not say it out loud. When she handed me the envelope with trembling hands, she made me promise not to read it aloud and not to laugh at her. Inside was a message: "I pick my nose and eat boogers!" The premonition of catastrophe and the horror on her face contrasted so strikingly with the trifle written on a piece of paper that I began to laugh. I lost all professional self-control and laughed. Luckily, she laughed heartily, too, and felt relieved.

Am I saying that you never misbehave? No. Such a position would be highly unrealistic. I just want to emphasize that the more you exaggerate the scale of your mistakes, the greater will be the needless torment and self-criticism.

The second key distortion that leads to guilt is the tendency to label yourself a "bad person" because of what you have done. It was this superstitious destructive thinking that led to witch hunts in the Middle Ages! You may have actually done something bad, spiteful, hurtful, but it's inappropriate to call yourself "bad" or "spoiled" because you'll end up wasting energy on worrying and self-blaming rather than creatively looking for the best problem-solving strategy.

Another common guilt-producing distortion is personalization. You unreasonably take responsibility for something you didn't do. Let's say you offer constructive criticism to your boyfriend, who reacts defensively and offended. You may blame yourself for being upset and jump to the conclusion that your comment was inappropriate. In fact, it was his own negative thoughts that upset him, not your comment. Moreover, these thoughts are probably distorted. Perhaps he thought that your criticism implied that he was not good enough, and concluded that you did not respect him.

And besides, did you put this illogical thought into his head? Obviously not. He did it himself, so you can't take responsibility for his reaction.

Since cognitive therapy claims that it is thoughts that create feelings, you may come to the nihilistic conclusion that you cannot harm anyone no matter what you do, and therefore you have the right to do anything. After all, why not leave the family, cheat on your wife, or cheat on a business partner? If they're upset, it's their problem, it's their thoughts, right?

No! Here we again emphasize the importance of the concept of "cognitive biases". As long as a person's feelings of frustration are caused by distorted thoughts, you can say that he himself is responsible for his suffering. If you blame yourself for this person's pain, it's a personalization error. Conversely, if a person's suffering is caused by valid, undistorted thoughts, then it is real and may indeed have an external cause. For example, if you hit me in the stomach, I will probably think, “You hit me! It hurts you!” In this case, you are responsible for my pain, and your opinion that you hurt me is in no way the result of a distorted perception. Your remorse and my discomfort are real and authentic.

Inadequate demands with the word "should" is a direct path to guilt. Irrational demands on yourself mean that you should be perfect, omniscient or omnipotent. Such perfectionist “rules of life” harm you by creating impossible expectations and making you inflexible. One such example is "I should always be happy." And here is the corollary of this rule: every time you are upset, you feel like a failure. Since it is obvious that the goal of achieving eternal happiness is unrealistic for any person, such a rule only harms and replaces the real responsibility for oneself.

Other inadequate "should" requirements are based on the premise that you know everything. They assume that you have all the knowledge in the universe and can predict the future with absolute accuracy. For example, you think, “I shouldn't have gone to the beach this weekend because I started to get the flu. What a fool I am! Now I'm so sick I'll have to lie in bed for a week. " Such reproaches are unrealistic, because you did not know for sure that due to a trip to the beach, the condition would worsen so much. If you knew this, you would have acted differently. You are human and made that decision, later realizing that your guess was wrong.

The third kind of "must" requirement is based on the premise that you are omnipotent. They assume that, like God, you have limitless possibilities, you can control yourself and other people and achieve whatever goal you want. You miss a tennis pitch and startle, exclaiming, "I shouldn't have missed that shot!" Why not? Is your tennis game so perfect that you can't miss a serve?

It is clear that these three categories of demands with the word “must” create an inadequate sense of guilt, since they are not based on reasonable arguments.

In addition to distortions, several other criteria can help distinguish abnormal guilt from healthy feelings of remorse or regret. It is the intensity, duration and consequences of your negative emotions. Let's apply them to assess the unbearable guilt of a married 52-year-old high school teacher named Janice. For many years, Janice was in severe depression. Her problem was that she was relentlessly tormented by the memories of two cases of shoplifting that happened when she was 15. Having led a completely honest life since then, she could not overcome the memory of those two incidents. She was haunted by guilt-creating thoughts: "I am a thief, a liar, a bad person, I am a fake." The agony of her guilt was so intense that every night she prayed that God would let her die in her sleep. Every morning, waking up alive, she experienced bitter disappointment and said to herself: “I am such a bad person that even God does not want to take me away.” In desperation, she loaded her husband's gun, pointed it at her heart, and pulled the trigger. The weapon misfired. She didn't cock the trigger properly. Janice felt the final fiasco: she couldn't even kill herself! Throwing down the gun, she sobbed in despair.

Janice's guilt is not justified not only because of the obvious distortions, but also because of the intensity, duration and consequences of what she felt and said to herself. Her feelings are nothing like healthy remorse or regret about shoplifting, it's an irresponsible destruction of her self-esteem that blinds her, does not allow her to live in the here and now, and does not correspond to any real transgression. The consequences of her guilt create the ultimate paradox: the belief that she is a bad person forced her to attempt suicide, the most destructive and senseless act in the world.

The vicious circle of guilt

Even if you experience unhealthy guilt based on distortions, you can become trapped in the illusion that your guilt is justified as soon as you start to feel guilty. Such illusions can be very powerful and convincing. Here are your thoughts:

  1. I feel guilty and condemned. It means I'm really bad.
  2. Because I am bad, I deserve to suffer.

Thus, guilt convinces you of your own worthlessness and leads to even greater feelings of guilt. This cognitive-emotional connection locks your thoughts and feelings into each other. You are caught in a vicious circle that I call the "vicious circle of guilt."

This vicious cycle is fueled by emotional rationale (see the chapter on cognitive distortions). You automatically assume that because you feel guilty, you must have failed somewhere and therefore deserve to suffer. You probably think like this: "I'm bad, so I'm probably bad." This is irrational because your self-hatred does not necessarily prove that you did something wrong. Your guilt only reflects your opinion that you behaved badly. Perhaps this is true, but often this is far from the truth. For example, children are often punished for no reason when parents are tired, irritated, and misinterpret their behavior. Under these circumstances, the child's feelings of guilt obviously do not prove that he or she has done something so terrible.

Self-flagellation only fuels the cycle of guilt. Guilty thoughts lead to unproductive actions that reinforce your belief that you are worthless. For example, a guilt-prone female neurologist was trying to study for her certification exam. It was difficult for her to study for the test, and she felt guilty that she did not study well. Therefore, she spent a lot of time every evening watching TV, and at this time the following thoughts were spinning in her head: “I should not watch TV. I have to prepare for the exam. I am lazy. I don't deserve to be a doctor. I'm too selfish. I deserve punishment." These thoughts made her feel great guilt. Then she reasoned like this: "This guilt only proves that I am a lazy, bad person." Her self-flagellation and guilt only fueled each other.

Like many people who are prone to guilt, she held to the idea that if she punished herself enough, she would eventually be set free. Unfortunately, the opposite is true. Guilt simply sapped her strength and reinforced her belief that she was lazy and inept. The only result of her self-hatred was obsessive nightly raids on the refrigerator, during which she gorged herself on ice cream or peanut butter.

The vicious circle she got into is shown in figure 8.1. Her negative thoughts, feelings, and behaviors combined to create a self-destructive, cruel illusion that she was "bad" and couldn't control herself.

Guilt is irresponsible

If you really did something inappropriate or harmful, does it follow that you deserve to suffer? If you feel the answer to this question is yes, ask yourself, “How long must I suffer? Day? Year? For the rest of your life?" What judgment would you choose to pass on yourself? Are you ready to end your own suffering and stop torturing yourself when your sentence is up? This would at least be a responsible form of time-limited punishment. But first, what is the point of torturing yourself with guilt? If you make a mistake and cause harm, your guilt will not magically undo the mistake. It will not speed up the learning process, nor will it make you less likely to do it again in the future. Other people won't love and respect you more because you feel guilty and put yourself down that way. Guilt will not lead to a productive life. So what's the point?

Many people ask, "But how can I act morally and control my impulses if I don't feel guilty?" This is the prison guard's approach. Apparently, you think that you are so malicious and out of control that you must constantly punish yourself so as not to break loose. Of course, if your behavior hurts others, a small dose of agonizing remorse will help you realize the consequences of your actions than a neutral, non-emotional admission of wrongdoing. But without a doubt, it never helped anyone to consider themselves a bad person. Most often, the belief in one's own worthlessness only contributes to further "bad" behavior.

Change and learning happen faster when you a) recognize that a mistake has occurred and b) develop a strategy to correct the problem. You will make the process much easier if you treat yourself with love and relax. And guilt will only get in the way.

For example, I am sometimes criticized by patients for making a harsh comment that causes them to think in the wrong way. This criticism usually hurts me and makes me feel guilty only if there is some truth in it. If I feel guilty and call myself "bad," I tend to react defensively. I have a desire to deny the mistake, to justify it or to go on the counterattack, because it is disgusting to feel like a “bad person”. This makes it difficult to admit your mistake and correct it. If, on the contrary, I do not scold myself and do not feel that my self-esteem is hurt, it is easy for me to admit a mistake. Then I can easily fix the problem and learn something. The less guilt I feel, the more effectively I deal with the situation.

Thus, if you make a mistake, you need to recognize it, learn from it and change the situation. Does guilt help here? I do not believe in this. Instead of helping to admit one's own mistake, guilt only obscures the tracks. You don't want to hear any criticism. You can't stand your own mistakes because they make you feel terrible. This is why guilt is unproductive.

You might object, “How can I know if I did something wrong if I don't feel guilty? What if I start to indulge in blind excesses, uncontrollable, destructive selfishness, if I don’t feel guilty?

Anything is possible, but I honestly doubt it. You can replace guilt with a more conscious basis of moral behavior - empathy. Empathy is the ability to visualize the consequences of your behavior, both good and bad. This is the ability to realize the impact of your actions on you and on other people, and to feel reasonable, sincere sadness and regret, without calling yourself bad in essence. Empathy creates the necessary mental and emotional climate to regulate behavior in a moral and self-learning way, without having to use the whip of guilt.

Using the following criteria, you can easily determine whether your feelings are normal and healthy remorse or self-destructive, distorted guilt. Ask yourself:

  1. Did I do something “bad”, “unfair”, hurt knowingly and intentionally? Or am I unreasonably demanding of myself to be perfect, omniscient, or omnipotent?
  2. Do I call myself a bad or nasty person because of this? Do my thoughts also contain other cognitive distortions such as exaggeration, overgeneralization, etc.?
  3. Is my regret or repentance realistic? Does it stem from an empathic awareness of the negative consequences of my actions? Is the intensity and duration of my painful emotional reaction appropriate to the act?
  4. Am I ready to learn from my mistake? What am I doing for this? Do you think how to fix the current situation? Or whine, scrolling through the thoughts of what happened? Or maybe I am punishing myself unjustifiably?

Now let's look at some methods that will help you get rid of misplaced guilt and build self-respect.

1. Diary of recording automatic thoughts. In the previous chapters, you have been introduced to the Automatic Thought Journal, which helps you overcome low self-esteem and feelings of worthlessness. This method gracefully handles many unwanted emotions, including guilt. Write down the event that makes you feel guilty in the Situation column. For example, "I was rude to a colleague" or "Instead of putting in ten dollars, I threw the alumni fundraiser in the trash." Then "tune in" to the tyrant's voice in your head and write down the specific accusations that make you feel guilty. Finally, identify distortions and write down more objective thoughts. You will feel better.

An example of such operation is shown in Table 8.1. Shirley was a sensitive young woman who decided to move to New York to start her career as an actress. After spending a long and exhausting day looking for an apartment, he and his mother took the train back to Philadelphia. Boarding the train, they discovered that no food was provided. Shirley's mother began to complain about the lack of service, and Shirley felt guilt and a wave of self-criticism engulf her. When she wrote down the guilt-producing thoughts and answered them, she experienced significant relief. She told me that by dealing with her guilt, she avoided the tantrum she usually threw in such unpleasant situations (see Table 8.1).

2. Techniques for neutralizing demands on oneself. Here are some methods for neutralizing the irrational "should" demands you make on yourself. First, ask yourself, “Who said I should? Where is that written?" The point is for you to realize that you are not justified in criticizing yourself. Ultimately, you are the one who sets your own rules. As soon as you see that the rule does not benefit you, you have the right to revise or cancel it. Suppose you tell yourself that you must be able to make your spouse happy all the time. If you understand from experience that this is unrealistic and useless to even try, then you can rewrite this rule, bringing it closer to reality. For example: “I can sometimes make my spouse happy, but of course not all the time. Ultimately, his happiness depends on himself. And I am no more perfect or perfect than he is. Therefore, I will not expect constant gratitude for what I do.

When deciding how useful a particular rule is, ask yourself: “What are the advantages and disadvantages of this rule?”, “How does the requirement to always keep my spouse happy helps me, and what is the price of such a belief?” You can evaluate the pros and cons of this internal rule using two columns, as shown in Table 8.2.

Another simple but effective way to save yourself from excessive demands on yourself involves replacing the word “should” with others, also using the two-column technique. For this, the expressions "It would be nice if" or "If I could, I would ..." are well suited. They often turn out to be more realistic and not as frustrating. For example, instead of "I should make my wife happy," you could say, "It would be great if I could make my wife happy because she's upset. I can ask her what's upsetting her and think about how I might be able to help." Or instead of "I shouldn't have eaten ice cream," you could say, "It would have been better if I hadn't eaten that ice cream, but what I did is not the end of the world.

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