Reducing Shame in Care: Trauma, Addiction, and Meeting People Where They Are
Neurodiversity, Trauma, Addiction & Compassionate Care
If there’s one thread that runs through so much of the work I care about, it’s this:
People don’t heal when they feel judged.
They heal when they feel understood.
Whether someone is struggling with substance use, disordered eating, executive functioning challenges, chronic stress, or the long tail of trauma, shame is often the quiet force underneath it all.
Shame says:
Why can’t you just try harder?
What’s wrong with you?
Everyone else can do this.
And unfortunately, healthcare systems sometimes echo those messages — even unintentionally.
Over the years, I’ve intentionally sought out trainings that help me practice in ways that actively reduce shame rather than reinforce it. That means learning how to meet people where they are, understanding behavior through the lens of trauma and neurobiology, and approaching coping strategies with curiosity instead of judgment.
Because most of the time, what looks like “resistance,” “noncompliance,” or “bad choices” is actually adaptation.
Adaptation to pain.
Adaptation to overwhelm.
Adaptation to systems that weren’t built for you.
A Different Starting Point
Much of traditional care (medical model) quietly asks:
How do we fix this behavior?
But trauma-informed and harm-reduction approaches ask something different:
What is this behavior doing for this person?
What pain is it helping them survive?
What would make change feel safer?
That shift — from correction to compassion — changes everything.
It softens the room.
It builds trust.
It makes honesty possible.
And honesty is where real change begins.
Trainings That Shaped This Lens
These continuing education courses have influenced how I think about addiction, trauma, stigma, and compassionate, person-centered care:
S.A.V.E Suicidal Thoughts- Completed 2026
Defeating Habits and Addictions — Completed 2026
Do I Need to Be an Addictions Expert? Engaging and Supporting People Who Use Drugs — Completed 2023
Working with People Who Use Drugs: Understanding Stigma — Completed 2023
Intersections Between Trauma and Addiction — Completed 2023
Eating Disorders – What to Say (or Not) and Getting Your Client Proper Help — Completed 2023
Brief Interventions in Primary Care — Completed February 22, 2023
Across these trainings, a consistent philosophy emerged.
Care works better when it’s grounded in:
harm reduction over moralizing
reducing stigma in language
understanding substance use as coping, not character
building trust before pushing change
respecting autonomy
One of the biggest takeaways for me was this:
People often avoid care not because they “don’t want help,”
but because they expect to be shamed.
When we lower judgment, people come closer.
Trauma, Addiction, and the Nervous System
Many of these trainings explored how deeply trauma and substance use are intertwined.
Addictive behaviors are rarely random or reckless.
More often, they’re attempts to regulate overwhelmed nervous systems.
Substances can:
numb intrusive memories
reduce hyperarousal
soften shame
create temporary relief or connection
When we understand this, the question becomes less:
“Why would you keep doing this?”
And more:
“Of course you reached for something that helped you survive. What else might support you now?”
That stance preserves dignity — and dignity is essential for healing.
Small note-Eating Disorders & Addiction: Where They Overlap — and Where They Differ
Eating disorders and substance use can look very different on the surface, but underneath, they often grow from similar roots.
Both are frequently ways the nervous system tries to cope with overwhelm, trauma, shame, or a sense of powerlessness. Both can become cycles of relief and regret — offering short-term soothing while creating longer-term consequences. And both are heavily stigmatized, which often keeps people silent and disconnected from support.
In that way, they aren’t failures of willpower or character.
They’re adaptations. Strategies that once helped someone survive.
Where they differ is often in how society responds. Substance use is more readily labeled “addiction,” while eating disorders are sometimes framed as discipline, control, or even virtue — especially in diet culture. This can make disordered eating harder to recognize and more socially reinforced, delaying care. Food also adds complexity: unlike substances, we can’t abstain from eating. Recovery requires relationship and regulation, not avoidance.
Understanding both through a trauma-informed, shame-sensitive lens helps us move away from blame and toward curiosity:
What is this behavior protecting?
What need is it trying to meet?
What safer supports could exist instead?
When we approach both addiction and eating disorders with compassion rather than correction, people are far more likely to feel safe enough to heal.
Even well-meaning comments can unintentionally reinforce shame, especially around food, bodies, and control.
These trainings reinforced the importance of:
neutral, nonjudgmental language
avoiding moralizing food or weight, avoid moralizing substances or addictive habits.
understanding eating disorders and body struggles as nervous-system adaptations
focusing on safety and support rather than compliance
So many body-based struggles live at the intersection of trauma, control, and shame.
Gentleness matters here.
A lot.
The Common Thread: Reducing Shame
Across all of these trainings, the themes were remarkably consistent:
stigma reduction
harm reduction
trauma-informed care
meeting people where they are
body and nervous-system awareness
collaboration instead of authority
compassion over correction
How Neurodiversity Shapes My Approach
This lens is also personal for me.
As someone with ADHD and dyslexia, I know what it feels like to grow up internalizing messages like:
Why can’t you just be more organized?
Why is this so hard for you?
You’re not trying hard enough.
Executive functioning differences are often misunderstood as laziness or lack of motivation — when really they’re brain-based differences in how we process, plan, and regulate.
That experience has made me especially sensitive to how quickly systems can pathologize people for struggling.
So when I sit with clients navigating addiction, food struggles, or trauma responses, I don’t see “lack of willpower.”
I see:
nervous systems doing their best
brains adapting to survive
people carrying more than anyone should have to alone
And that naturally leads me toward compassion.
Not because it’s soft —
but because it’s effective.
Meeting People Where They Are
For me, “meeting people where they are” means:
not demanding readiness before offering care
not requiring perfection to deserve support
not shaming coping strategies before safer ones are available
not assuming motivation equals capacity
recognizing the role of systems, trauma, and access
It means working with people, not on them.
Change tends to stick when it’s collaborative.
Why This Matters in Therapy
Therapy should feel like the one place you don’t have to defend yourself.
A place where you can say:
“This is what I’m actually dealing with.”
“This is the part I’m embarrassed about.”
“This is what I haven’t told anyone.”
Without bracing for judgment.
Because when shame softens, honesty grows.
And when honesty grows, healing gets possible.
That’s the kind of space I try to create — one grounded in curiosity, dignity, and compassion.
Not perfection.
Not pressure.
Just steady, human support.