Emotions: To Avoid or to Heal

I was, and still plan to, do a post for therapists on handling strong attachment, but some recent experiences make me want to share some thoughts. (Photo, tetsuya yamamoto, Flickr, Lic. CC BY 2.0).

It isn’t new news that humans do many things to distance from painful, uncomfortable, or overwhelming feelings. In fact, that is the basis of the Affect Avoidance Model, which is the conceptual framework I use to make sense of the kinds of problems where psychotherapy can help. On the other hand, it is easy to lose track of how consistently we tend to avoid feelings and how serious the consequences are each time we do.

Imagine that every time a painful feeling shows up at the door to consciousness there is a fork in the road, a choice to be made about what to do. One choice is to do something to make the pain go away. The other is to face it. What is critical is that this choice has consequences. If you choose to avoid the feeling then no healing or growth takes place. The feeling is simply put aside till next time and sick patterns remain unchanged. Meanwhile, the things that have been done to make the feeling go away have their consequences, which play out in the real adult world. Think of acting out in some way like cutting or obsessing or picking a fight with someone, etc. It is easy to be distracted by the consequences and dealing with them, and soon the original feeling is far away.

On the other hand, if you take the other fork and face the feeling, holding it for a few seconds, then permanent healing can take place. This is what I have referred to as “catharsis,” in honor of Freud’s original description in 1893. By doing this over and over, the pain will lose its power and no longer dominate life.

Here’s the important point: People who come to therapy for serious emotional problems and trauma, come with a history of taking the avoidance fork about 99.9999% of the time. This is entirely natural. Once you develop patterns of avoidance and practice them, it is no surprise that each time there is stress, the impulse to avoid is acted upon. What that means is that suffering people have almost no experience whatsoever with healing. All their experience is with acting out and dealing with the consequences of their acting out. The result is an increasing sense of hopelessness about ever escaping from a life of problem after problem.

Once again, I want to honor Freud, who started out as a trauma therapist, and quite a good one. Very early in his discovery of psychotherapy, he found that people generally prefer to act out their feelings instead of feeling them. He was so right, but why? Imagine a child who experiences the stresses of parental expectations. When we have to perform, we all naturally want someone to hold our hand. Demands and stresses trigger neediness. As children (and adults, too), we need more love, nurturing, holding, etc. at times when we are having trouble coping emotionally. When emotional support is not adequate or some other factor (such as a sibling with major needs) makes attention seeking unacceptable, then the child in us does without, but experiences intense yearnings for love and support. This is not only very painful, but when brought into adulthood, it is embarrassing and unacceptable. The availability of emotional support when needed is a necessity many people have not had available. So what choice is left? They do things to minimize the pain…and no healing takes place.

Now let’s turn to the good fork in the road. What I try to do in therapy is to help my patient be in direct contact with the painful yearning and to share that consciousness with me. I use words to make sure I understand the feeling precisely and with the compassion that should have been there in the first place. I try to make sure that the feeling stays in the room for at least 30 seconds, which is harder than you think. The necessary elements are that the painful feeing has to be experienced consciously with its visceral component. You have to actually feel it. Simultaneously, as I have described elsewhere, the patient (and their neural networks) are exposed to the witness’s understanding and compassion. This is soothing, and healing. It doesn’t take away the pain, but makes it less distressing and compelling. Importantly it takes away the feeling’s power to make avoidant acting out seem necessary.

At the same time, I look for the patient to become a parent to his or her own inner child, not the impatient, used-up parent from the past, but a compassionate, understanding parent from today. As this new attitude towards the self is internalized, the processing of feelings and healing becomes easier. It is not as necessary to wait for an outside witness to provide compassion, one can learn to have compassion for oneself.

Why do patients resist the good fork in the road? 1. They don’t feel confident that it can “contain” their pain. They are afraid the pain will be too much to bear and will never heal. 2. They are afraid to trust that healing will work and if it does, that it will ever work again. They protect themselves from future painful disappointment by turning away from the feeling instead of towards it. 3. Acting out has its own satisfactions and payoffs. There are righteous satisfactions in being a victim and showing that the other person was bad. There is excitement in the emotional storm and others’ reactions to it. There is distraction from the original feeling and distancing from its pain.

So the point of this post is to underline how rare and important are moments of healing where we feel our childlike pain in a safe and compassionate context. It is to emphasize how precious each healing experience is, and how taking the good fork in the road is the only way to bring permanent healing to the inner child. Let me say it a different way:

At points of stress, deep inner feelings push up from our past and present a fork in the road. You can go towards the feeling or away from it. When you start to go towards the feeling and do so in a context of connection and compassion (your own compassion or another’s), then the rare and crucial phenomenon of healing takes place and you are a step closer to no longer needing to be symptomatic.

How many of these encounters does it take to change? My best metaphor is paying a mortgage. At first all you pay is interest and it seems interminable. Very gradually, your payments start going more towards principle. At the end, there is little interest left and much principle being paid off each month. With therapy, the first experiences of healing are rare and don’t seem to make a big difference. As they become more familiar, then the need to take the avoidant fork decreases and the number of healing encounters increases. As healing moments become more common, their effect accumulates. Eventually, acting out seems unnecessary and wasteful, a thing of the past. Of course at moments of stress, the old fork will present itself. That is why some ongoing recovery activities or vigilance are still necessary.

So the take-home is to focus much more of the energy and attention in therapy on tuning in to the inner child’s original pain and going towards those feelings as opposed to going away from them and dealing with consequences of acting out.

As I put up this post, I’m closing comment on the previous one, “Working With the Inner Child.” Please continue the discussion here. I think the discussion and comments on the last post have been extraordinary, and I’m leaving room to continue that discussion here, but I believe it is time to focus on the feelings that underlie attachment to the therapist. I hope you agree.

Jeffery Smith


  • It’s been quite sometime since I was here on Dr. Smith’s blog. This must be a very old news, but I like the new domain and fresh look of the website!

    Paying down the mortgage analogy rings true to me. After finish reading “Body Keeps the Score”, I started to practice mindfulness more even though what I had been experiencing was only the pain of paying down the “interests” at the time. I trusted the science and evidence behind it from reading Dr. Van der Kolk’s book only to realize later that I was doing it all wrong when I watched this TEDx Talk on self-compassion and mindfulness. https://youtu.be/IeblJdB2-Vo

    As Dr. Smith mentioned in this blog, “when we start to go towards the feeling and do so in a context of connection and compassion (our own compassion or another’s), then the rare and crucial phenomenon of healing takes place…”. Self-compassion was the missing ingredient.

    It’s been a long road connecting all of the dots – I started out by searching for an answer to phobia of attachment to therapist, which lead me to this blog, then fell flat on my face with the issue of shame, swept up by the storm of the mind-body connection. Finally, they all became clear to me when I discovered Self-Compassionate Mindfulness practice, or sometimes translated as the “loving-kindness meditation” in English. I even found a practice that incorporates parts work. It has been tremendous.

    My moments of change started here, discovering Dr. Smith’s blog. I am happy to report back that I am finally on the right path 😀

  • What timing!
    I’ve been with the same therapist for nearly 4 years dealing with physical, sexual and psychological child abuse which I became aware of after “work issues” caused panic attacks, depression ….. Anyway, for the past 3 years, my therapist has sent me a birthday card that would arrive a eeek before my actual birhday. This year, the card arrived today and my birthday is tomorrow. You can imagine how I felt…
    In my last session (Monday), she wished me an early HBD and asked me if there were any triggers around my birthday and I said “no.” She said the reason she was asking is because she knows that my mother purposely ignored my birthday when I was younger as well as when I was an adult in order to hurt me and watch me cry and she wondered if I was having any feelings in regards to my mother’s dismissal “of the day you were born an innocent , sweet child deserving of love and deserving of being taken care of and yet your mother didn’t love you or care for you?” I immediately answered “no. I know my mother never loved me and never wanted me. I haven’t spoken or seen her in over 3 years, it doesn’t bother me and I’ve accepted it.” She said she believed me about 80% and I said “whatever!”
    Ha! So all week I spent waiting for that birthday card from her and all week I felt on edge, anxious, mad and believing she didn’t really care about me “I’m just another client…” I caught the negative talk and told myself that it was the old voices and there has to be a reason why she didn’t send the card this year. I also reminded myself that each time I thought the worst of her, thought she was playing mind games with me, thought she was attempting to get a rise out of me, I would lash out her in an angry and belligerent way that she would accept and never yell back. I learned over the years that the angry, hurt, sad and fearful feelings I had towards her were really a mirror of the feelings I had towards my mother as a child when my feelings were not permitted to be expressed. So, I paused to feel what I was feeling in regards to not receiving a card from her. I felt the pain and fear of being rejected, abandoned and tossed aside by her. I felt the fear that she may have never really cared about me. I felt my inner child’s rage, fear, anger, pain, sadness, rejection and abandonment by her mother. I cried for hours. I still cry when I think about it and I’m allowing it.
    Yes, I was happy to receive the card and believe that maybe this year she was bogged down and didn’t get it out early as in previous years. However, there’s still a lot of work to be done because there’s that voice in the back of my head that pops up and says “Hm?! Do you think she knew you weren’t really as over your mother as you thought and her knowing she’s a mirror to that attachment, she purposely delayed the card to bring up those feelings???” Obviously, I’m still paying off the mortgage :/

    • Dear Justbreeth and Echo, It’s good to see you back, and both having made important progress. Your stories give hope which is what many new readers need most. Thanks. JS

  • Jeffery,

    Thank you for writing this post. More than anything else this describes my situation. For me, I have a compulsion to repeat past trauma over and over and over again. Even though it is painful, it is what I know. For someone with fearful-avoidant attachment style therapy is very difficult. Hard to take that healing fork because the attachment brings up even more painful feelings which at times feels completely overwhelming. The “come here, no go away” is exhausting. The acting out for me is a little different. I get “too” close and I run for the hills. You have these feelings and you just want them gone you don’t care how but you want them gone. It is tough to take the healing fork if you are too busy pushing your therapist away. It is reflex.

    How does a person’s attachment style change how this plays out? I could never depend on anyone but myself so depending on my therapist is a very tough go at time. When I allow myself to depend and get my needs met it feels great but inside there seems like a constant war going on.

    Thanks again, your time on this post couldn’t have been better.

    • Doug, My best answer is still the same, that getting over mistrust and reluctance to lean on someone is a “Ok, here goes nothing” kind of gesture. Think of a child who has a choice between being left alone in a scary place and going into the arms of a stranger. You choose the stranger. As in my previous answer to you on the previous post, what makes this possible is a lowering of the “stakes.” In other words, with time in therapy and growing trust, even though you would rather not risk it, the level of fear has gradually decreased. This is a black and white decision superimposed on a shifting background of gray. Let me know if this helps.

      By the way, I like the simplicity of attachment styles, but see them more as potentially infinite variations on how children instinctively protect themselves against the pain of being alone. JS

  • Jeffery,
    I was nodding so much reading this that I looked like a bobble-head doll. 🙂 It was a perfect description. I especially liked the mortgage analogy. It amazes me how much energy is freed up when you can walk towards your feelings instead of fleeing them. Your insight and ability to explain the process so lucidly is really priceless.


  • These posts have been life changing for me. I have struggled with feelings about my therapist for 8 years. Each week when I leave his office I sink and revert to old obsessive behaviors and became so ashamed. These articles have helped me understand what is happening to me and have taken away so much of the shame. I hope to discuss this with him and hope I can express it in a a way that makes sense. He is a kind caring man and I know that he cares about me too. That almost has made going there so terrible at times. Now I understand why. Thank you so much for the insight

  • Hi Jeffrey.

    I have posted before on this blog about my severe problem with attachment to a therapist. My problem is that I stopped going to therapy last November after I got really sick going off my meds, and I felt like the therapist did not understand and could no longer help me. I went back once a few months later after I was stabilized and when I said I wasn’t coming back, he wanted me to leave. I still don’t think he can understand or help me any more, but my problem is that I still write him emails when I get stressed and I still think of talking to him and I’m constantly coming up with reasons to go talk to him. My husband is threatened by him because of how I went off my meds when I was seeing him and got so sick, yet I still want to talk to him even though I don’t think he could help me any more. He said he will always be my therapist and refuses to close my case, and this kind of makes me feel better but kind of makes me a little angry or upset because usually therapists stop working with me because I get too attached. What do you think is going on, that I don’t think he can help me anymore, but I want to talk to him? I kind of want to pick a fight with him about real stuff, and make him close my case so I can’t go see him any more, and then I could grieve and get over him and move on. I do not think he can help me because he will not nurture me, and when I told him that I loved him, he just sat there and did not respond or say anything acknowledging. And when I told him how it felt to be off meds, that it felt like when I was a child, he just said, “You want me to nurture you”. I doubt his ability to respond if I tell him what I think about him negatively and how it relates to what someone did to me once. Sometimes I really want to have this out with him, and sometimes I tell myself that I am just creating drama and he can’t help me anymore. My husband would not like if I went to see him because I feel more attached to him than to my husband, because my husband has a lot of his own emotional problems. As it is, I don’t talk to anyone, and I manage pretty well. So is that as good as it gets? Am I right to stay away from him and not try to talk to him if I want to pick a fight because I think he can’t handle talking to me, and because it triggers attachment and dependency feelings, and I want him to just close the case and go away? Thanks, I appreciate your thoughts.

    • Dear Beth, I’m glad you commented on this post. The post is really about the principle that our inner child wants the therapist to fix the pain, not make us go through it. On the other hand, it is when we go thru out pain that it can heal for good. That’s what I mean by going towards the feeling. Having someone “make it better” means going away from the feelings, because if the problem is solved, then there is no more pain.

      In effect, what our child-self does is to re-create our unfinished problems from the past and impose them on the therapy relationship. When we are able to feel safe enough that “having it out with him” is possible, that is when the old problems can be understood, felt and healed. I know this is not easy, and that the child-self really doesn’t want to work it out, but feels safer cycling trough the old bad feelings, hoping for a different outcome that can’t happen. Sometimes out of the box alternatives may be possible. One thought would be to use the communication route that does exist with the therapist to try to put into words what the inner chid is trying to do. When we write or talk about our own inner child, it is hard to do so without feeling some (adult) understanding and compassion for that part of the self, and that dual consciousness of feeling the childlike feelings and having adult compassion is when healing takes place.

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