Similar Emotions, Different Results

A few years back, NPR published an interview with Neil Steinberg, author of books on addiction, who points out that when an addict eventually reaches out for help, it is usually because of a very regrettable precipitating incident. They wrecked the car, ruined their sister’s wedding, or did some other unacceptable thing that resulted in outside intervention, or at least in some self-reckoning. He says, “I think most people are deeply ashamed of their addictions” and children are not exempt from human emotions, so this aspect needs to be taken into account.

Keep it low-key

Another obstacle presented by public opinion is that most recovering addicts have no wish to make a big public deal of how well they are doing, because as Steinberg reminds us, “relapse is always waiting under your feet.” That is why people “slip,” and if anybody is looking, the person with the problem feels like either a laughingstock or an object of pity. Again, children possess these emotions too.

And if something really bad happens, like a fatal overdose, it is likely to also turn the addict’s family into liars, because they do not exactly want to go public about the true cause of death. Steinberg then quotes Russell Brand:

It is difficult to suffer the selfishness of a drug addict who will lie to you and steal from you and then forgive them and offer them help. Can there be any other disease that renders its victims so unappealing?

There may be guilt for lying, stealing, etc., which of course calls for more substance-assisted oblivion to bury that guilt. Still, the good news is that guilt as an emotional “first responder” can be beneficial, like the different sounds that car tires make on the road’s shoulder, and the warning to get back in the lane. Guilt can serve as a “note to self” that behavior needs to be corrected.

Two things

Is there a difference between guilt and shame? Northstar Transitions runs programs to help people get off alcohol, street drugs and prescription drugs. Their uncredited writer says,

Guilt is the feeling you have when you’ve done something terrible or said you would do something and then didn’t.

This definition resonates with the ancient Catholic concept of sins of commission and sins of omission — either doing something you shouldn’t have, or not doing something you should have done. Guilt is about doing a bad thing, while shame self-defines a person as being bad.

Shame […] is about internalizing that guilt and believing that you are a terrible person because of what you did.

Are kids included?

The issues surrounding these emotions are not the exclusive property of reflective adults. Guilt is a biggie. In Dr. Pretlow’s book, Overweight — What Kids Say, he quotes messages from many teenagers:

— [T]he thought of getting together with friends just makes me feel fatter, grosser, guiltier.
— I can’t control myself! I eat too much and feel so guilty afterwards!
— You pig out and eat a ton. in a effect you feel incredibally guilty and then to feel better and feel like you didnt mess up, you make yourself throw up…
— There are two types of feelings when it comes to food — craving the food and then the inital guilt that comes after overindulging.

Your responses and feedback are welcome!

Source: “Shame, Guilt Pose Significant Hurdles For Those Recovering From Addiction,”, 07/15/17
Source: “What roles do guilt and shame play in addiction?,”, 01/23/21
Image by Purple Slog/CC BY 2.0

Leave a Reply

Your email address will not be published. Required fields are marked *

FAQs and Media Requests: Click here…

Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources