Shame

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When I was a teenager I used to say I would die when I was 37. What can I say? I was a weird kid. My sister can tell you. Now I am 37 and this belief that I had when I was younger has affected me a lot. Getting sober at age 36, I started to think that rather than dying at 37, perhaps I was supposed to start a new life. Perhaps rather than literally dying, the ‘old me’ would die and I would experience a rebirth. A lot of fate and superstition for someone who’s supposed to be critical thinker/scientist/atheist huh?

Well the crazy thing is, that I came really close to changing my life significantly, getting a new job and moving to a different country. Not only was I really excited about this opportunity, it seemed fated. I was set to work in an alcohol addiction research group, in a fabulous city at one of the best Universities in the world. And I’m 37! It was meant to be!! Mentally I had already created my new life and left the old one behind. I knew what suburb I would live in, what transport I would get to work each day etc. I got through the first two Skype interviews, flew all the way out there for a full day of interviewing, gave it my best shot… and then I didn’t get the job. Shiiiiiit.

When I was younger. I suffered from depression on and off many, many times. I have had a lot of therapy to work through these issues, and tried various medications. It’s part of the reason I wanted to become a behavioural neuroscientist, I wanted to understand how my brain worked and why I am the way I am. Through all of my personal experiences as well as my studies I have realised something: the times when I feel depressed are the times when I feel like I am just not good enough as a person. When I feel like there’s something fundamentally wrong with me. When I was younger I thought this meant that no-one would ever love me, that I am unloveable. I think that wound has been healed now with the help of my loving family. However, now my self-esteem issues revolve around my job and not thinking that I am good enough. As Brene Brown talks about, it is about shame.

If you don’t like it, put a label on it?

I never thought much about shame when I was still drinking. Even though that’s what I was often drinking to escape, I never had a label for it. It wasn’t until I wasn’t until I was listening to a recovery podcast that recommended Brene Brown’s book “The gifts of imperfection” which I downloaded and read, that I really connected with this concept of shame. I honestly think that one of the biggest breakthroughs for me from listening to/reading Brene’s work is simply that it helped put a name on the shame I was feeling. By putting a label on it and knowing that most people experience this feeling, it made me realise that to feel shame was normal. Shame is widespread, and I am not alone. PHEW!

When I was still drinking I would have scoffed at reading this kind of book. Even now, self-help books are not really my vibe. I’m currently listening to “the subtle art of not giving a F*ck” which is entertaining, but I’m not really buying into it. It just seems to me like a whole lot of someone’s opinion. I’m a scientist. I need evidence. That is why Brene Brown is SO on the money. She’s not just talking about her opinion, she’s telling us about what the data show. She’s a researcher, and has studied shame for many, many years. She’s also sober, although this isn’t a prominent feature of her work.

Layers of shame

When I was younger and depressed, people would say things to me like “what do you have to be depressed about? You are young, attractive, intelligent. You have everything going for you! Just put on a big smile and go out into the world!”. Not only did this kind of advice not make me feel better, it made me feel worse because I was depressed and I had no good reason to be. So I would feel shame that I felt shame – if that isn’t the most ridiculous thing you’ve ever heard. More recently when I didn’t get the job this feeling again reared its head. I am a member of a lot of recovery groups, and in those people are going to jail, their kids are getting in car crashes. People are dying of this disease, and I’m sad that I didn’t get a job. Boo hoo. So now I also have shame that my problems are not important enough.

Then I posted something about having first world problems on twitter. A couple of well-meaning respondents told me that I wasn’t unique, and that there are other people as educated as me in recovery. So on top of how ashamed I was starting to feel about not getting the job, and my problems not being important enough, I added yet another layer of shame – I felt like a pretentious twat for suggesting that my problems were unique, or that I was special compared to others in recovery. Shame, shame shame!

shame

Vulnerability: a Path to Resilience?

The point of course is that these respondents were right. My problems are not special, and I am not unique. Just because not everyone has the same problems as me, doesn’t mean that they cannot relate to how I was feeling. Many people know how it feels to put yourself out there and fail.

So what did I do differently this time to ensure that my shame didn’t overtake me? Well, I wrote to two members of the selection committee and asked for feedback, which they very graciously provided me in great detail. Overall, receiving this feedback did two things 1) it allowed me to stop speculating (ruminating) about all the reasons I might not have gotten the job (spoiler alert – it wasn’t because I wore the wrong trousers), and 2) gave me an idea of what I can work on to do better next time. And the important thing is that I CAN work on everything they mentioned in their email. Nothing in there said I was fundamentally a bad researcher or not good enough.

So there it was. There is nothing fundamentally wrong with me. I just need to work a bit harder in certain areas, and next time I will do better.

Another lesson that I learned was, as Brene Brown also says: vulnerability is not weakness. I’m sad to say that it did briefly occur to me that if I were still drinking I wouldn’t have gotten so far in the interview process, and therefore wouldn’t have failed. But what good would that have done me? If I hadn’t gotten this far, had a go, and failed, then what would I have learned? Not just in my work, but personally, about being vulnerable and overcoming my fears. Ultimately, about how resilient I can be (shout out to my recovery coach Omar Pinto for helping me gain this new perspective on my situation). I flipping flew all the way to another country, interviewed at a top University, and it was terrifying! But I did it! I had great conversations with amazing neuroscientists, made some great contacts, and honestly had a great day. I also had a great holiday with my family who tagged along. So really, I gained a hell of a lot more than I lost.

As Brene Brown says “vulnerability is courage. Vulnerability is the birth place of innovation, creativity, and change”. So now, in sobriety, I once again have learned to try and to fail, and to become resilient. Most of all, I learned not to drink through my failures and to come out the other side with more knowledge and a little more maturity. Maybe this was the lesson I was supposed to learn at 37. Or maybe I’ll get hit by a car tomorrow and die as I always imagined. But if I do at least if I do I won’t be dying with any regrets about missed opportunities.

Alcoholics Anonymous Part 1: Bali

Bali Cravings
About 4 months into sobriety, I visited Bali with my family (including my parents and mother-in-law). When I got there, a feeling came over me… a peace and tranquillity like I’d never before experienced. Then I got in touch with my spiritual side and found God. Next I saw unicorns flying through the sky whilst pooping rainbows…

NOT!

Yeah OK, that never happened. I mean, I did go to Bali but faaaark me. It was hard. I experienced something that in the lab we refer to as ‘context-induced reinstatement’. Basically, it has been known for sometime, that addictions can be context-specific – one well-known example from real life is when many heroin-addicted soldiers returned home to the United States from the Vietnam war. Surprisingly, once home about 90% of these soldiers were able to shed their addiction, and only 10% remained addicted. However, what this also means is that addictions and can be ‘reinstated’ (i.e. the addict can relapse) when they return to a ‘context’ (place) previously paired with alcohol/drugs, or even visit a new place that is similar to the one associated with alcohol drugs, like a new pub or restaurant etc.

Contextually-mediated relapse in the lab
Similar effects have been shown in rats and mice too. The typical experiment goes something like this: the rat or mouse is first trained to press a lever for alcohol, or cocaine, or amphetamine, or whatever the drug of interest is, in a particular context, usually a skinner box with stripey walls, a grid floor, and vanilla odour. That same rat is then put into a different box with spotty walls, a smooth floor, and a peppermint odour, but in this box, the lever doesn’t earn the drug. In fact, in this box, the lever doesn’t earn anything (known as ‘exinguishing’ the lever press-drug association). If you put that rat back into the ‘extinction’ (lever-no drug) box the next day, s/he will press the lever at a low rates. If, however, you put the rat back in the original box, however, responding will be high again.
In drug addiction, this effect is mediated in the brain by circuits that regulates decision-making generally; structures such as the nucleus accumbens (often reported to be the brain’s hedonic ‘hot spot’, although it does more than just detect pleasure) and its projections to the ventral pallidum and lateral hypothalamus. Further, such ‘relapse’ isn’t only bought on by contexts (places), but can be caused by cues such as the sight of a particular beer label or a wine glass. It makes evolutionary sense for a brain circuit to ‘hold on’ to the knowledge that an action previously earned a reward in a particular place, or to explore whether that action earns a reward in a new place, because if it didn’t the person/animal might miss out on a reward. Unfortunately, however, in drug addicts this effect provides another example of circuitry that evolved to optimise receiving useful rewards, like food or sexual pleasure, going awry and supporting drug-seeking when this is not adaptive.

Contextually mediated relapse in real life
If you are an addict like me, the likelihood is that you have experienced this. You might never experience cravings anymore in your normal surroundings, having ‘extinguished’ the association between walking to your local pub and buying a beer. But then you go on holiday, or into a new environment and see a different pub and the craving comes back to you with full force. Well that’s what happened to me in Bali.
Bali ticked a lot of boxes driving me to drink: 1) it was sunny which I always associate with drinking, 2) I was on holiday so I didn’t have work, 3) my parents were there to be responsible adults and help out with my daughter so I didn’t have to be as responsible, and 4) parents were there being parents (i.e. driving me slightly nuts – love you Mum!). It was very, very, very hard. So I posted in my lovely facebook group about my troubles and so many of them said what I often hear in the group: go to a meeting. And I thought, “actually yeah, why the hell not? So I found the nearest meeting that was on in one hour, started walking there before I lost my nerve, got lost on the way so was a little bit late, but I got there. And it was good.

AA
When I got to the meeting I mentioned straight away that I was a first-timer and I was welcomed with open arms. Then people started to share. To begin with, it was only the men that shared, and they talked about many things. Some talked about how they had ended up in jail, or mental institutions, or how they had lost custody of their children and so on. This was bad. I couldn’t identify with this at all. After several days in Bali with a little voice in my brain (which part of my brain? That I can’t tell you sorry!) telling me I am not really an alcoholic, this was not what I needed to hear. Suddenly that voice started getting louder. “I’ve never experienced consequences like those, so maybe I’m not really an alcoholic?” “Maybe I can get out of here and go drink! And party! Woooo Hoooooo”
But then another voice (in my head) chimed in and asked: “why the hell are you sitting here if you don’t have a problem?” “And if you really don’t have a problem, how come pretty much every area of your life (work, health, fitness, relationships, happiness, anxiety) has gotten so much better since you quit drinking?”. If it wasn’t a problem, that wouldn’t have happened, surely.
So I shared. Can’t remember exactly what I said, but I sat there with my fake tan, thinking that all these people just think I’m some dumb blonde with resting bitch face (oops there’s those self-esteem issues again) and here I am talking about the fact I have a good job, and a loving family, but that alcohol has caused a lot of problems for me, so am I really an alcoholic after all?
But after I spoke up the other women in the group started to speak up. It was at this point that I heard my own story reflected back to me, over and over and over. Being there for your kids but not really being present. Waiting until they go to bed so you can drink. Getting angry with their partners over nothing. Dragging their sorry butts to work hungover and giving a sub-optimal performance. I realise now what I didn’t at the time: that alcoholism seems to manifest differently in men and women. I’m not sure why this is (scientific studies in rodents have by far and away used mostly males, although this is now starting to change). I know that in the human research there have been some differences found in how reactive men and women are to cues, but I’m not sure how that might translate to different manifestations of addiction.
In any case, that meeting saved me from a major relapse. I stayed and had coffee with some of the members afterwards, and they all were so welcoming and lovely and non-judgemental. Noone seemed to judge me for my resting bitch face, or blonde hair. No-one seemed to change their manner immediately and start acting a little self-consciously when I said that I was a behavioural neuroscientist, as often happens when meeting new people. Two of the women gave me their email addresses and numbers, and I messaged them a few times throughout the rest of the trip. And most importantly I didn’t drink.

Returning Home
So you would think that after I returned home after such a positive experience that I would continue to attend AA. Initially I did intend to, I looked up the beginners meeting and there was one nearby. I told my husband I was going to go that night. It was all sorted. Then I got to the evening and I just… didn’t. The cravings certainly dissipated when I returned home (i.e. as I returned to the extinction context), but I knew enough to be wary of this lack of craving, and that it could return at any time. However, I did think long and hard about it, and eventually decided instead to sign up to recovery coaching with the person who runs the podcast I had been listening to instead. In my next post I will elaborate on why.