Episode
Episode 375: Shame in the Gut: The Neurobiology of Affect Dysregulation and Addiction with Dr. Alexandra Katehakis
- Podcast
- The Addicted Mind Podcast
- Published
- Mar 9, 2026
- Duration seconds
- 2372
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Summary
In this episode, Duane Osterlind sits down with Dr. Alexandra Katehakis, founder of the Center for Healthy Sex, to explore the complex relationship between shame, affect dysregulation, and addiction. Dr. Katehakis breaks down why shame isn’t just a "bad feeling" but a survival-based biological process rooted in our nervous system and early childhood development. Key Highlights 1. What is Shame? (The Gut Connection) Shame is a pro-social function embedded in the human organism from birth. Unlike many other emotions, shame is primarily located in the enteric nervous system (the gut) . The Biology: When we experience shame, we feel a visceral "drop." This is a rapid shift from a high-dopamine state (joy or excitement) to a low-dopamine state (collapse). The "No" Moment: Around 18 months, a child experiences the "genesis of shame" when a parent must use a firm "No" to protect them. In a healthy relationship, this is a temporary state. 2. Rupture and Repair: The Building Blocks of Resilience Healthy Dyad: A parent shames a child (rupture) but immediately follows up with soothing and "motherese" (repair). This teaches the child’s nervous system how to regulate itself. Toxic Shame: When shaming is chronic and unrepaired, "states become traits." The child remains in a collapsed, shame-based state, leading to pathological dissociation or chronic depression. 3. Addiction as "Auto-Regulation" Dr. Katehakis posits that addiction is often a result of affect dysregulation . If a person lacks the internal capacity to regulate their emotions (due to a lack of interactive regulation in childhood), they turn to external sources to "auto-regulate." The Cycle: People use substances or behaviors (sex, gambling, shopping) to escape the painful, "dead" feeling of a shame-based core. The Body…