Guilt and shame are two of the four stressors behind the Symptoms of Sobriety. Every Silver Lining Has a Cloud, compares the two in the segue between chapters dedicated to each. Here's a brief excerpt.
"One of the first TV newsrooms in which I worked had an old-school assignment editor who had above his desk a framed photo from his reporter days. He was on the Patty Hearst story in California. In the 1970s, the newspaper heiress was kidnapped by a violent left-wing activist group that forced the 19-year-old into a role in a series of crimes for which she was put on trial in ’79. The photo shows her outside the court in a t-shirt that read, “Being kidnapped is always having to say you’re sorry.” Drop kidnapped and insert Alcoholic and that shirt could communicate how it sometimes feels when you’re working toward recovery. First, a violent abduction from your day-to-day life makes you a hostage, then your guilt and shame subject you to years of feeling as though you won’t ever be able to atone for it.
Guilt and shame are different. Psychiatrist Helen Block Lewis points out, “Shame and guilt often occur together. They’re frequently fused and therefore confused with each other.” (The Role of Shame in Symptom Formation, Lawrence Erlbaum Inc., Hillside, NJ 1987) Shame is the feeling we get from others that we are wrong . . . guilt is the feeling we give ourselves when we do wrong. In guilt, you’re reviewing your own irrational beliefs and telling yourself you didn’t do enough and you punish yourself for it . . . in shame, someone else is saying you didn’t do enough based on their own irrational beliefs. The former is caused by your values . . . the latter is caused by others imposing their values on you. The gap between your performance and your expectations of yourself is guilt . . . the gap between your performance and others’ expectations of you is shame. When you feel guilt over being Alcoholic, you feel the disease has made you a monster . . . when you feel shame, other people behave as if you are a monster.
As for their impact on cortisol, guilt and shame have the same outcome even though their origins are so different. The cortisol doesn’t make a distinction between whether others are judging you or you are judging yourself. The judgment is that Alcoholism is not “normal.”
These words that can derail sobriety more than any others are: You’re Not Normal. Shame carries that kind of whallop."
--from Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety, pgs. 49-50