TRANSFORMATIVE EMOTIONAL JOURNEYS: RECONCEPTUALIZING GUILT, SHAME, HOPE, AND COMPASSION IN ADDICTION THERAPY

Yıl 2024, Cilt: 8 Sayı: 2, 123 - 156, 17.07.2024

Eda Yılmazer , Metin Çınaroğlu

https://doi.org/10.54707/meric.1473774

Öz

This paper reconceptualizes four key emotions—guilt, shame, hope, and compassion—in addiction therapy, proposing a novel framework that acknowledges their transformative potential. Traditional perceptions cast guilt and shame as purely negative, but this study posits them as motivators for change when reframed positively. Hope and compassion are re-envisioned as active forces, essential for resilience and recovery. Integrating positive psychology and Acceptance and Commitment Therapy, the paper advocates for a therapeutic approach that focuses on strengths and growth, promoting a balanced treatment that fosters personal development. A literature review and theoretical analysis support the framework, calling for therapeutic engagement with emotions as central to the recovery process. The new model aims for a holistic, empathetic practice, empowering clients and suggesting a paradigm shift in clinical addiction therapy. Future research is encouraged to establish long-term efficacy and explore integration with conventional methods.

Anahtar Kelimeler

Emotional Reconceptualization, Guilt, Shame, Hope, Compassion.

Dönüştürücü Duygusal Yolculuklar: Bağımlılık Terapisinde Suçluluk, Utanç, Umut ve Merhameti Yeniden Kavramsallaştırmak

Öz

Bu makale, bağımlılık terapisinde suçluluk, utanç, umut ve merhamet olmak üzere dört temel duygunun dönüştürücü potansiyelini yeniden kavramsallaştırmaktadır ve bunların iyileşme sürecinde güçlü destekleyiciler olarak kullanılabileceğini ileri sürmektedir. Geleneksel algılar suçluluk ve utanç duygularını tamamen olumsuz olarak etiketlemekteyken, bu çalışma onları doğru bir şekilde yeniden çerçeveleme yapıldığında değişim için motivatörler olarak sunmaktadır. Umut ve merhamet, direnç ve iyileşme için hayati aktif güçler olarak yeniden değerlendirilmektedir. Pozitif psikoloji ve Kabul ve Bağlanma Terapisinin entegrasyonu ile, makale, güçlü yönler ve kişisel büyüme üzerine odaklanan terapötik bir yaklaşımı savunmaktadır. Bu yaklaşım, kişisel gelişimi teşvik eden dengeli bir tedavi sunmayı amaçlamaktadır. Literatür taraması ve teorik analizlerle desteklenen bu yeni çerçeve, terapide duyguların merkezi bir rol oynaması gerektiğini öne sürmektedir. Model, bütüncül ve empatik bir uygulama için bir paradigma değişikliği önermekte ve klinik bağımlılık terapisinde danışanları güçlendirmeyi amaçlamaktadır. Uzun vadeli etkinliği belirlemek ve geleneksel yöntemlerle entegrasyonu keşfetmek için daha fazla araştırmaya ihtiyaç vardır.

Anahtar Kelimeler

Duygusal Yeniden Kavramlaştırma, Suçluluk, Utanç, Umut, Şefkat.

Kaynakça

• Alotaibi, S. M., Amin, M., & Winterton, J. (2020). Does emotional intelligence and empowering leadership affect psychological empowerment and work engagement?. Leadership & Organization Development Journal, 41(8), 971-991.
• Avery, S. N., Clauss, J. A., & Blackford, J. U. (2016). The human BNST: functional role in anxiety and addiction. Neuropsychopharmacology, 41(1), 126-141.
• Batchelder, A. W., Glynn, T. R., Moskowitz, J. T., Neilands, T. B., Dilworth, S., Rodriguez, S. L., & Carrico, A. W. (2022). The shame spiral of addiction: Negative self-conscious emotion and substance use. PloS one, 17(3), e0265480.
• Beddoe, D., & Beddoe, D. (2019). The Heart of Recovery: How Compassion and Community Offer Hope in the Wake of Addiction. Revell.
• Blum, A. (2008). Shame and guilt, misconceptions and controversies: A critical review of the literature. Traumatology, 14(3), 91-102.
• Blum, K., Febo, M., D Badgaiyan, R., Demetrovics, Z., Simpatico, T., Fahlke, C., ... & S Gold, M. (2017). Common neurogenetic diagnosis and meso-limbic manipulation of hypodopaminergic function in reward deficiency syndrome (RDS): Changing the recovery landscape. Current neuropharmacology, 15(1), 184-194.
• Bowen, S., & Vieten, C. (2012). A compassionate approach to the treatment of addictive behaviors: The contributions of Alan Marlatt to the field of mindfulness-based interventions. Addiction Research & Theory, 20(3), 243-249.
• Bowen, S., Parks, G. A., & Coumar, A. (2006). Mindfulness meditation in the prevention and treatment of addictive behaviors. In Buddhist thought and applied psychological research (pp. 429-449). Routledge.
• Bradshaw, J. (2005). Healing the shame that binds you: Recovery classics edition. Health Communications, Inc..
• Buhle, J. T., Silvers, J. A., Wager, T. D., Lopez, R., Onyemekwu, C., Kober, H., ... & Ochsner, K. N. (2014). Cognitive reappraisal of emotion: a meta-analysis of human neuroimaging studies. Cerebral cortex, 24(11), 2981-2990.
• Calloway, D. (2009). Using mindfulness practice to work with emotions. Nev. LJ, 10, 338.
• Carlyle, M., Rockliff, H., Edwards, R., Ene, C., Karl, A., Marsh, B., ... & Morgan, C. J. (2019a). Investigating the feasibility of brief compassion focused therapy in individuals in treatment for opioid use disorder. Substance Abuse: Research and Treatment, 13, 1178221819836726.
• Carlyle, M., Rockliff, H., Edwards, R., Ene, C., Karl, A., Marsh, B., ... & Morgan, C. J. (2019b). Investigating the feasibility of brief compassion focused therapy in individuals in treatment for opioid use disorder. Substance Abuse: Research and Treatment, 13, 1178221819836726.
• Cavicchioli, M., Movalli, M., Vassena, G., Ramella, P., Prudenziati, F., & Maffei, C. (2019). The therapeutic role of emotion regulation and coping strategies during a stand-alone DBT Skills training program for alcohol use disorder and concurrent substance use disorders. Addictive behaviors, 98, 106035.
• Chen, G. (2019). The role of self-compassion in recovery from substance use disorders. OBM integrative and complementary medicine, 4(2), 1-14.
• Colla, R., Williams, P., Oades, L. G., & Camacho-Morles, J. (2022). “A New Hope” for positive psychology: a dynamic systems reconceptualization of hope theory. Frontiers in Psychology, 13, 809053.
• Coto-Lesmes, R., Fernández-Rodríguez, C., & González-Fernández, S. (2020). Acceptance and Commitment Therapy in group format for anxiety and depression. A systematic review. Journal of affective disorders, 263, 107-120.
• Dayton, T. (2000). Trauma and addiction: Ending the cycle of pain through emotional literacy. Simon and Schuster.
• Deegan, P. (1996). Recovery as a journey of the heart. Psychiatric rehabilitation journal, 19(3), 91. Derakhshandeh, N. G., Shahidi, S., & Ghanbari, S. (2023). Feeling of Shame and Guilt in Recovering Addicts: A Qualitative Study. The Open Psychology Journal, 16(1).
• Dewi, R., Fitri Rahmadana, M., Pangaribuan, W., & Bukhori Dalimunthe, M. (2020). Self-resilience model of drug initiation and drug addiction (A structural equation model approach). Archives of Psychiatry Research: An International Journal of Psychiatry and Related Sciences, 56(1), 5-18.
• Dull, B. D., Hoyt, L. T., Grzanka, P. R., & Zeiders, K. H. (2021). Can White guilt motivate action? The role of civic beliefs. Journal of youth and adolescence, 50, 1081-1097.
• Elster, J. (2009). Strong feelings: Emotion, addiction, and human behavior. mit Press.
• Erden, S., & Hatun, O. (2015). İnternet bağımlılığı ile başa çıkmada bilişsel davranışçı yaklaşımın kullanılması: Bir olgu sunumu. Addicta: The Turkish Journal on Addictions, 2(1), 53-83.
• Eryilmaz, A. (2017). Pozitif psikoterapiler. Psikiyatride Güncel Yaklaşımlar, 9(3), 346-362. Fernández-Rodríguez, C., González-Fernández, S., Coto-Lesmes, R., & Pedrosa, I. (2021). Behavioral activation and acceptance and commitment therapy in the treatment of anxiety and depression in cancer survivors: a randomized clinical trial. Behavior modification, 45(5), 822-859.
• Flora, K., & Stalikas, A. (2015). Positive emotions and addiction.
• Fogelkvist, M., Gustafsson, S. A., Kjellin, L., & Parling, T. (2020). Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms: A randomized controlled trial. Body image, 32, 155-166.
• Garland, E. L. (2021). Mindful positive emotion regulation as a treatment for addiction: From hedonic pleasure to self-transcendent meaning. Current Opinion in Behavioral Sciences, 39, 168-177.
• Garland, E. L., Hanley, A. W., Riquino, M. R., Reese, S. E., Baker, A. K., Salas, K., ... & Howard, M. O. (2019). Mindfulness-oriented recovery enhancement reduces opioid misuse risk via analgesic and positive psychological mechanisms: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 87(10), 927.
• Gilbert, P., & Irons, C. (2005). Focused therapies and compassionate mind training for shame and self-attacking. In Compassion (pp. 263-325). Routledge.
• Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P., & Karekla, M. (2020). The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of contextual behavioral science, 18, 181-192.
• Googhari, Z. S., Hafezi, F., Asgari, P., & Heidari, A. (2022). The effectiveness of mindfulness-based cognitive therapy and acceptance and commitment therapy on medical science students’ subjective well-being, psychological distress, and emotion regulation. Journal of Shahrekord University of Medical Sciences, 24(1), 35-41.
• Greenspan, P. S. (1995). Practical guilt: Moral dilemmas, emotions, and social norms. Oxford University Press, USA.
• Greenwood, B. (2016). From Shame to Self-acceptance: A Hermenetuic Literature Review.
• Grégoire, S., Lachance, L., Bouffard, T., & Dionne, F. (2018). The use of acceptance and commitment therapy to promote mental health and school engagement in university students: A multisite randomized controlled trial. Behavior therapy, 49(3), 360-372.
• Gutierrez, D. (2019). Spiritus contra spiritum: Addiction, hope, and the search for meaning. Spirituality in Clinical Practice, 6(4), 229.
• Hayes, S. C., Masuda, A., Bissett, R., Luoma, J., & Guerrero, L. F. (2004). DBT, FAP, and ACT: How empirically oriented are the new behavior therapy technologies?. Behavior therapy, 35(1), 35-54.
• Henning, C., Crane, A. G., Taylor, R. N., & Parker, J. D. (2021). Emotional intelligence: relevance and implications for addiction. Current Addiction Reports, 8, 28-34.
• Hurley, W. C. (2021). Compassion's COMPASS: Strategies for Developing Insight, Kindness, and Empathy. Rowman & Littlefield.
• Hurlocker, M. C., Madson, M. B., & Schumacher, J. A. (2020). Motivational interviewing quality assurance: A systematic review of assessment tools across research contexts. Clinical psychology review, 82, 101909.
• Jaffe, K., Korthuis, T., & Richardson, L. (2021). ‘This could be my last chance’: Therapeutic optimism in a randomised controlled trial for substance use disorders. Sociology of Health & Illness, 43(5), 1286-1300.
• Jha, D., & Singh, R. (2020). Analysis of associations between emotions and activities of drug users and their addiction recovery tendencies from social media posts using structural equation modeling. BMC bioinformatics, 21(18), 1-38.
• Khadjesari, Z., Brown, T., & Naughton, F. (2021). Regulation and accreditation of addictive behaviour applications—navigating the landscape. Addiction, 116(12), 3276-3283.
• Kılıçarslan, F. (2007). Madde Bağımlısı Ergenlerde Aile Terapileri Ve Bir Olgu Sunumu. Journal of Dependence, 8, 42-45.
• Koob, G. F. (2015). The dark side of emotion: the addiction perspective. European journal of pharmacology, 753, 73-87.
• Kotera, Y., Green, P., & Sheffield, D. (2022). Positive psychology for mental wellbeing of UK therapeutic students: relationships with engagement, motivation, resilience and self-compassion. International Journal of Mental Health and Addiction, 20(3), 1611-1626.
• Krentzman, A. R., Hoeppner, B. B., Hoeppner, S. S., & Barnett, N. P. (2023). Development, feasibility, acceptability, and impact of a positive psychology journaling intervention to support addiction recovery. The Journal of Positive Psychology, 18(4), 573-591.
• Lee, E. B., An, W., Levin, M. E., & Twohig, M. P. (2015). An initial meta-analysis of Acceptance and Commitment Therapy for treating substance use disorders. Drug and alcohol dependence, 155, 1-7.
• Lerman, D. C., Kelley, M. E., Camp, C. M. V., & Roane, H. S. (1999). Effects of reinforcement magnitude on spontaneous recovery. Journal of Applied Behavior Analysis, 32(2), 197-200.
• Levin, M. E., Krafft, J., Hicks, E. T., Pierce, B., & Twohig, M. P. (2020). A randomized dismantling trial of the open and engaged components of acceptance and commitment therapy in an online intervention for distressed college students. Behaviour Research and Therapy, 126, 103557.
• Loizzo, J., Charlson, M., & Peterson, J. (2009). A program in contemplative self‐healing: stress, allostasis, and learning in the indo‐Tibetan tradition. Annals of the New York Academy of Sciences, 1172(1), 123-147.
• Lopez, S. J., Snyder, C. R., Magyar‐Moe, J. L., Edwards, L. M., Pedrotti, J. T., Janowski, K., ... & Pressgrove, C. (2004). Strategies for accentuating hope. Positive psychology in practice, 388-404.
• Lu, L., Liu, Y., Zhu, W., Shi, J., Liu, Y., Ling, W., & Kosten, T. R. (2009). Traditional medicine in the treatment of drug addiction. The American journal of drug and alcohol abuse, 35(1), 1-11.
• Luoma, J. B., Kohlenberg, B. S., Hayes, S. C., Bunting, K., & Rye, A. K. (2008). Reducing self-stigma in substance abuse through acceptance and commitment therapy: Model, manual development, and pilot outcomes. Addiction research & theory, 16(2), 149-165.
• Malti, T. (2016). Toward an integrated clinical-developmental model of guilt. Developmental Review, 39, 16-36.
• Matthews, S. (2019). Self-stigma and addiction. In The stigma of addiction: An essential guide (pp. 5-32). Cham: Springer International Publishing.
• Mayer, C. H., & Vanderheiden, E. (2019a). The bright side of shame. Transforming and growing through practical applications in cultural contexts. Cham: Springer.
• Mayer, C. H., & Vanderheiden, E. (2019b). The bright side of shame. Transforming and growing through practical applications in cultural contexts. Cham: Springer.
• McClintock, A. S., & Marcus, M. (2021). Mindfulness-based approaches in addiction treatment. Textbook of Addiction Treatment: International Perspectives, 391-400.
• McKenzie, H. A., Dell, C. A., & Fornssler, B. (2016). Understanding addictions among Indigenous people through social determinants of health frameworks and strength-based approaches: a review of the research literature from 2013 to 2016. Current Addiction Reports, 3, 378-386.
• Miceli, M., & Castelfranchi, C. (2018). Reconsidering the differences between shame and guilt. Europe's journal of psychology, 14(3), 710.
• Montaser, A. A. A., El Malky, M. I., & Atia, M. M. (2023). The Effect of a Dialectical Behavioral Therapy on Anxiety Level and Emotional Regulation among Drug Addict Patients. Menoufia Nursing Journal, 8(2), 423-441.
• Nakken, C. (2009). The addictive personality: Understanding the addictive process and compulsive behavior. Simon and Schuster.
• Neff, K. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and identity, 2(2), 85-101.
• Nencini, A., & Meneghini, A. M. (2013). How relational bonds influence strategies for coping with guilt. Journal of Relationships Research, 4, e9.
• Nicotera, A. (2023). The Circle of Insight: A Process for Deepening Ignatian Imagination and Inviting Hope. Jesuit Higher Education: A Journal, 12(2).
• Reddon, H., & Ivers, J. H. (2023). Increased levels of hope are associated with slower rates of relapse following detoxification among people living with opioid dependence. Addiction Research & Theory, 31(2), 148-154.
• Reyes‐Ortega, M. A., Miranda, E. M., Fresán, A., Vargas, A. N., Barragán, S. C., Robles García, R., & Arango, I. (2020). Clinical efficacy of a combined acceptance and commitment therapy, dialectical behavioural therapy, and functional analytic psychotherapy intervention in patients with borderline personality disorder. Psychology and Psychotherapy: Theory, Research and Practice, 93(3), 474-489.
• Rezaei Fard, A., & Heidari, M. (2022). Investigating the Effectiveness of Compassion-Based Group Therapy On the Quality of Life, Self-Esteem and Mental Health of Spouses of Substance-Abusers. Women and Family Studies, 15(57), 181-198.
• Ridgeway, P., McDiarmid, D., Davidson, L., Bayes, J., & Ratzlaff, S. (2011). Pathways to recovery: A strengths recovery self-help workbook. University of Kansas, School of Social Welfare.
• Ruork, A. K., Finkelstein, J., McLean, C. L., & Rizvi, S. L. (2022). Dialectical behavior therapy and acceptance and commitment therapy: areas of overlap and distinction. Journal of Contemporary Psychotherapy, 52(4), 281-292.
• Saboor, Z., Rahimi Pordanjani, T., & Mohammadzadeh Ebrahimi, A. (2019). Effect of hope therapy on general self-efficacy among substance abusers. Journal of Research and Health, 9(4), 302-308.
• Samaan, M., Diefenbacher, A., Schade, C., Dambacher, C., Pontow, I. M., Pakenham, K., & Fydrich, T. (2021). A clinical effectiveness trial comparing ACT and CBT for inpatients with depressive and mixed mental disorders. Psychotherapy Research, 31(3), 372-385.
• Seligman, M. E. (2002). Positive psychology, positive prevention, and positive therapy. Handbook of positive psychology, 2(2002), 3-12.
• Selvam, S. G. (2015). Positive Psychology's Character Strengths in Addiction-Spirituality Research: A Qualitative Systematic Literature Review. Qualitative Report, 20(4).
• Şenormancı, Ö., Konkan, R., & Sungur, M. Z. (2010). İnternet bağımlılığı ve bilişsel davranışçı terapisi. Psychiatry, 11, 261-268.
• Shaima, N., & Narayanan, G. (2018). A glass half full not empty: Strength-based practice in persons with substance use disorders. Psychological Studies, 63, 19-24.
• Shao, K., Nicholson, L. J., Kutuk, G., & Lei, F. (2020). Emotions and instructed language learning: Proposing a second language emotions and positive psychology model. Frontiers in psychology, 11, 559865.
• Shaughnessy, M. J. (2018). Integrative literature review on shame. Nursing Science Quarterly, 31(1), 86-94.
• Siegel, D. J. (2023). Interpersonal connection, compassion, and well-being: the science and art of healing relationships. In Advances in Contemplative Psychotherapy (pp. 181-196). Routledge.
• Singer, J. A., Singer, B. F., & Berry, M. (2013). A meaning-based intervention for addiction: Using narrative therapy and mindfulness to treat alcohol abuse. In The experience of meaning in life: Classical perspectives, emerging themes, and controversies (pp. 379-391). Dordrecht: Springer Netherlands.
• Slade, M. (2010). Mental illness and well-being: the central importance of positive psychology and recovery approaches. BMC health services research, 10, 1-14.
• Snoek, A., McGeer, V., Brandenburg, D., & Kennett, J. (2021). Managing shame and guilt in addiction: A pathway to recovery. Addictive behaviors, 120, 106954.
• Snoek, A., McGeer, V., Brandenburg, D., & Kennett, J. (2021). Managing shame and guilt in addiction: A pathway to recovery. Addictive behaviors, 120, 106954.
• Snyder, C. R. (1994). The psychology of hope: You can get there from here. Simon and Schuster.
• Snyder, C. R., Rand, K. L., & Sigmon, D. R. (2002). Hope theory. Handbook of positive psychology, 257, 276.
• Sun, A. P. (2007). Relapse among substance-abusing women: Components and processes. Substance use & misuse, 42(1), 1-21.
• Swaby, S. M. (2017). The positive psychology of recovery: A review. MOJ Addiction Medicine & Therapy, 3(3), 91-94.
• Thompson, G. (2012). A meaning-centered therapy for addictions. International Journal of Mental Health and Addiction, 10(3), 428-440.
• Thompson, G. R. (2016). Meaning therapy for addictions: A case study. Journal of Humanistic Psychology, 56(5), 457-482.
• Torres, A., Catena, A., Megías, A., Maldonado, A., Cándido, A., Verdejo-García, A., & Perales, J. C. (2013). Emotional and non-emotional pathways to impulsive behavior and addiction. Frontiers in human neuroscience, 7, 43.
• Tracy, K., & Wallace, S. P. (2016). Benefits of peer support groups in the treatment of addiction. Substance abuse and rehabilitation, 143-154.
• Verdejo-García, A., & Bechara, A. (2009). A somatic marker theory of addiction. Neuropharmacology, 56, 48-62.
• Vijayakone, B., & Abdullah, H. S. L. (2019). Self-Compassion and Self-Control Amongst Recovering Addicts. ‘Abqari Journal, 21(1), 69-79.
• Weegmann, M. (2010). Just a story? Narrative approaches to addiction and recovery. Drugs and Alcohol Today, 10(3), 29-36.
• White, W., Laudet, A., & Becker, J. (2006). Life meaning and purpose in addiction recovery. Addiction Professional, 4(4), 18-23.
• Whiting, D. L., Simpson, G. K., Deane, F. P., Chuah, S. L., Maitz, M., & Weaver, J. (2021). Protocol for a phase two, parallel three-armed non-inferiority randomized controlled trial of acceptance and commitment therapy (ACT-adjust) comparing face-to-face and video conferencing delivery to individuals with traumatic brain injury experiencing psychological distress. Frontiers in Psychology, 12, 652323.
• Wing, D. M. (1991). Goal setting and recovery from alcoholism. Archives of Psychiatric Nursing, 5(3), 178-184.
• Yıldız, E. (2020). The effects of acceptance and commitment therapy on lifestyle and behavioral changes: A systematic review of randomized controlled trials. Perspectives in psychiatric care, 56(3), 657-690.
• Zarling, A., Lawrence, E., & Marchman, J. (2015). A randomized controlled trial of acceptance and commitment therapy for aggressive behavior. Journal of consulting and clinical psychology, 83(1), 199.
• Zilverstand, A., Parvaz, M. A., Moeller, S. J., & Goldstein, R. Z. (2016). Cognitive interventions for addiction medicine: Understanding the underlying neurobiological mechanisms. Progress in brain research, 224, 285-304.