Women and Shame: Stories of Recovery from Alcohol Dependence

Background: Historically women have been underrepresented in alcohol dependence (AD) research, and gender-sensitive treatment is scarce. Extant literature indicates women have specific pathways into AD and recovery, with shame and stigma as key factors, yet there is a paucity of research exploring shame in AD and recovery from women’s perspectives, taking account of their relational and socio-cultural contexts.
Aim: This research aimed to explore how shame features in women’s narratives of recovery from AD.

Methodology: Taking a critical realist epistemological position, unstructured life story interviews were analysed via narrative analysis to explore how seven women from the UK storied shame in AD and recovery.

Findings: Shame followed a common trajectory across participants’ stories, leading up to AD through to recovery. Participants narrated shame as gendered, contributing to a loss of personal control in defining a valued personal identity. Drinking began as a shame-management strategy to feel ‘normal’ but later became a source of shame, compounded by fears of being labelled an ‘alcoholic woman’ constructed within medicalised, disease-based grand narratives of alcohol addiction. Recovery involved reclaiming the self through de-shaming a shame-based identity and developing a positive, non-drinking identity. Positive sobriety narratives offered less-shameful frameworks for sense-making in recovery. By sharing stories and reconstructing their own, participants were able to work through shame, resist pathologising identity labels and internalise esteemed ‘sober’ identities.

Conclusions: This novel study reveals the significance of shame in women’s AD and recovery at the intersection of identity, gender and culture. Dominant medicalised narratives of alcohol addiction were revealed as especially stigmatising for women. The need for gender-sensitive treatments and a more social and relational understanding of AD as a response to gender oppressive experiences is highlighted. Implications for clinical practice, future research and policy are considered.