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: Maia Szalavitz

IS SHAME AN ANTIDOTE TO ADDICTION?

To the Editor:

Sally L. Satel and Scott O. Lilienfeld argue that we should shame 
people to fight addiction. Unfortunately, while they cite data on 
shame in non-addicted populations, they ignore far more relevant 
research, which shows uniformly negative results.

In 2007, William R. Miller and William L. White reviewed research on 
"confrontation" in addiction treatment, a strategy that aims to shame 
and humiliate, using verbal attacks and even extreme tactics like 
making people wear diapers or dress as "bums" or prostitutes.

Their conclusion? "Four decades of research have failed to yield a 
single clinical trial showing efficacy ... whereas a number have 
documented harmful effects."

Moreover, a 2013 study of members of Alcoholics Anonymous found that 
the more shame they displayed when discussing their past, the more 
likely they were to relapse.

Similarly bad outcomes were seen in studies of drunken drivers, 
shamed by facing their victims in impact panels.

Shame and stigma are the exact opposite of what fights addiction. If 
shame worked, so would criminal penalties for drug use, which haven't 
exactly ended addiction.

MAIA SZALAVITZ

New York

The writer is a journalist and the author of the forthcoming book 
"Unbroken Brain: A Revolutionary New Way of Understanding Addiction."
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