How Does Trauma-Informed Care Help Heal Old Wounds of Shame?


Childhood can be a mixture of fond memories and difficult times with family. For some, there is exposure to a lot of painful memories of trauma. Trauma-informed care can help reshape old wounds of shame and patterns of behavior that keep people stuck in unhealthy patterns, including addiction. A good program with trained therapists can be helpful in getting the right level of care for people who have past experiences of trauma in their background. Treatment programs for addiction are more inclusive of trauma-informed practices and working to help people heal. Learn what it means to receive care that is trauma-informed and why shame is so significant to this experience of healing. 


Self-compassion is the ability to offer oneself grace in the journey of life. Self-compassion draws from many places, including psychology, which looks at how people extend compassion to themselves and others. The first step is to offer self-kindness and gentleness. Judging oneself for past issues and trauma can lead to blaming that is carried with a person for their entire lives. Recognition of it and mindfulness towards triggers can help a person recognize when they are feeling shame about a particular situation. The average person may feel some shame about different things in their lives, but those who have been exposed to any type of trauma don’t believe they deserve self-kindness. To get to a better place within themselves, they have to find space to heal and forgive both themselves and others for the issues they face.

Finding Hope in Treatment

People with addiction and substance use disorder often come to treatment with past histories of trauma. These may be small traumas, big traumas, exposure to chronic trauma, and generational trauma. All these add up to create a storm in someone’s life where they felt inadequate, unable to cope properly, and they struggled to live a life that was focused on health and wholeness. A growing focus on trauma-informed care can increase the odds of success for people who need mental health support and addiction treatment. The goal is not to focus on the past trauma, but to hold it in tension with the current treatment plan and ask how it informs where the person is now and how to support their future goals. Too much digging in the past can re-traumatize a person, but with a carefully informed approach, they may find they are able to deal more effectively with the positive effects of treatment.

Trauma-Informed Treatment

Exposure to trauma early in a person’s life can cause significant challenges for them going forward. Common traumas include physical or sexual abuse, neglect, and other dysfunctions. These traumas can cause feelings of isolation or low self-worth. People often turn to substances as a means of coping with past trauma. Trauma-informed treatment looks at how a person functions and copes with trauma and offers positive coping skills for their journey of healing. Treatment plans are designed around a person’s past trauma so they can focus on positive coping skills. Through recognition of destructive behaviors, people who suffered trauma can begin to pursue healthier self-soothing strategies like journaling or meditation. 

Guilt and Shame as Trauma

People who experience violence in their past or traumatic encounters may feel guilty or have shame around it. Someone who drives a car that causes a fatal accident may feel shame. Assault survivors may feel guilty they triggered the issue or did not prevent the assault. Due to the growing recognition of shame and trauma, the DSM V now includes guilt and shame as a symptom of post-traumatic stress disorder (PTSD) for the first time. People who suffer from guilt and shame may:

  • Have more mental health challenges
  • Use substances to cope
  • Have higher rates of depression
  • Become more socially isolated

Having severe impairment in social and occupational functioning are also issues people have with past trauma. Guilt and shame are also core features of ‘moral injury,’ highly prevalent among military service members and veterans who served in combat. 

Moral Injury

One of the big issues with moral injury is that it affects a person at a deeper level than psychological. This often includes the person doing things out of line with their values or morals, such as killing civilians, wounding people in battle, and harming children in combat. They often respond to the killing of others by disconnecting from their feelings but still feeling guilt and shame for what they have done. PTSD and shame are important to understand how they coincide. Evidence-based treatments for PTSD reduce trauma-related guilt. These treatments are effective in reducing guilt. Some studies have shown guilt to be a residual symptom, even with those who may have benefited from treatment. 

Shame Recovery

The recovery from feelings of shame and trauma can take a lifetime. The healing journey starts with recognizing what has happened as a result of the initial trauma. Treatment for substance abuse and mental health disorders can expose shame and painful memories in a safe space where trauma-informed care approaches a person with compassion and helps them develop self-compassion so they can move forward. Healing will take time but it is a good place to start by accepting treatment and taking it one step at a time. 

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