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

68 Comments

  • 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.

    AG

  • 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.

  • I’ve posted here before, like others. As with the majority, I’m an avoidant (fearful subset) when it comes to platonic relationships and I’m attached to my therapist.

    We’ve hit our ups and downs over the past two months and during the past three weeks, I’ve really questioned whether she is capable handling these issues. I feel in this short amount of time, she’s wearing down. Although she said she could handle my avoidant tendencies, I don’t believe she can.

    Our last session was scheduled for this past Friday. On Thursday night, she text messaged me that she experienced a loss in the family and was leaving out of town right then and there.

    In nearly 1.5 years of going to therapy, I’ve never run into her in real life. On Friday morning, I was leaving a gas station and saw her walking into a breakfast spot in our town at 9:30 am (our appointment was scheduled for two hours later). My trust already waned in her, but as soon as I saw her, I became doubtful. Still, I know plans can change. On Saturday evening, I was going to meet someone to hit some golf balls and I walked up and saw her and her family golfing. I left, abruptly.

    Our sessions had lagged. It felt like a slog. She didn’t seem to understand my needs and we went in circles. When I finally had the courage to tell her I thought she was too rough in my previous session, she admitted to being defensive because she was anxious. She had wanted to “keep me” not “lose me” she said and disclosed that she was having to discuss our relationship in her own therapy sessions.

    I almost feel like she wanted this ending as much as I did. I had lost faith in her because moments of connection that would have cemented the relationship, escaped her.

    I feel jaded by the therapy process. I feel I became too much for her. What was very friendly and amiable became difficult and laborsome. And I am at a loss.

    • Dear And, I’m sorry it has taken a few days to get to your comment. I have been in transit. Repairing ruptures in the therapeutic connection is one of the most important things that go on. What seems to work the best in my experience is open conversation between therapist and patient about what happened. Therapists don’t have to be perfect. For a therapist, being open about a failure raises a tricky issue. As far as I can tell, it always helps to admit to the failure, but only to a degree does it sometimes help to give an explanation. Too much personal information is distracting and can make the conversation more about the therapist than the patient. On the other hand, no information at all can be bewildering.
      Those issues, too, can be talked about openly.

      I do think it is important to work very hard at distinguishing the voice and logic of the inner child from adult thinking. It is very easy to believe that there could only be one possible explanation for a therapist’s behavior. All-or-nothing thinking (I’m talking in general, not about your specifics) might suggest a child’s way of thinking. Every time the inner child shows up, it is a chance to get to know him or her better and for therapist and adult part of patient to bring understanding and compassion. Inner children often have fears about the strength and adequacy of a therapist. A robust therapist is one who can admit to mistakes and work with the aftermath. A sign of therapist brittleness is difficulty admitting to being fallible and imperfect.

      Hope that is of some help. JS

  • Your ideas on attachment are more patient and healing than most advice I’ve heard. I’m a early trauma patient with serious attachment, negative transference problems. I must say, though that the idea of being my own good parent is the most horrible idea I can imagine. Even Julius Caesar didn’t try to say he was his own mother. That says all I have to do is create an imaginary fantasy world of wonderful I, me, and myself, then I won’t need anything or anybody else. I can be a better hermit than ever. But I agree with you, Jeffrey, that a healing relationship with a therapist is the answer, while not escaping into my own psycho Inner Kingdom that made me sick in the first place.

    • In my experience, self parenting is not indulgent or unrealistic. It might be not allowing oneself to act out in destructive ways or talking back to a childlike idea such as having to be perfect to be lovable. Often that kind of compassionate but firm self-management comes late in therapy and may be modeled in part on substantial experience with healthy actions and attitudes of the therapist. JS

    • “Even Julius Caesar didn’t try to say he was his own mother. ”

      That made me laugh, thank you for that. I do see your point. I am also concerned about the re-parenting bit, when I know my wounds are so deep and all-pervading (I was abandoned twice as an infant, not to mention the rest), and seeing how my survival strategy has completely estranged me from my own needs and feelings and all.

      What I know, though, is that when I first heard about the concept or self (re) parenting and got some advice from self-help readings, it was enlightening. I did not know I was self-abandoning myself until then but it became obvious. So from these readings onwards, whenever I wake up in the morning in a bad, disoriented, anxious or depressed mood, at least after a few minutes I am often able to stop blaming and hating myself for not being a happy energetic successful youngster, like anyone else in the ads (yep, how fake!), and I try to be more compassionate and attuned. I try.

      It’s said “Fake it and you’ll become it” (google it!). It does work, because within split seconds I quickly don’t fake it, and gradually, morning after mornings, months, years, I’ve come to know the needy baby inside, a bit. I still neglect and forget her too often and it’s only when she screams and brings the hell up that I remember to soothe her and be with her, but still, it makes a huge difference. I am there, then when she suffers and calls, and I am genuinely concerned, because we are together anyway. There is some development occurring. And because I became concerned, fake or not, I’ve been looking for help, for her, for us. (The “Inner child” is a wonderful concept to help us be more self attuned, though it does require a lot of inner learning, discovery and work).

      Then, getting a good therapist is the key. It is said, from a neurological or meotional point of view, that “self-regulation (what a balanced adult does) tracks back to co-regulation” Co-regulation is what is normally happening in the initial relationship with caring, attuned and supportive parents. Getting help from the outside, we were supposed to experience co-regulation and learn to do it on your own –that’s the only way we learn self-regulation. (see “the myth of self-regulation”).

      We have amazing brains and bodies designed to always learn and to always heal, and they know how to do it if the conditions don’t forbid. Our traumatized nervous systems may have missed the attuned parents and therefore are now disregulated (emotional disfonction, nervous chaos, whatever), but a good therapist can help, because through co-regulation we are back on the track we are naturally designed to be as human beings.

      Self-regulation, once learned, is so automatic (it is designed to be automatic) that you don’t even need to claim you are your own mother. You are simply whole, attuned to yourself, which is just the natural way human adults are designed to be.

      Thank you for the opportunity to share 2 grains of salt, from a bit of neuroscience readings, and for the laughter. I am not Caesar and I claim I am my mother, though for now far from the “good mother”! Learning, by mirroring what my therapist does with me: attuning to my inner child.

      Life IS magic. I would just complain that it took way too much time before I learned this stuff, and may end up being only a good grand-mother rather than a mother to my inner child. But that’s still good, if grandma is a very good one. After all, grand-mothers have skills mothers don’t have. They know more magical trick, learned the hard way throughout their long lives. That’s why they have all these curious wrinkles on there faces, and all these curious cauldrons boiling in the background and the brooms that can fly.

      Worth it.

  • Dear Jeffery
    I love this forum, your posts and comments are so insightful and full of your experience and wisdom. I remain hopelessly attached to my therapist and live in daily terror of her impending summer break. But I do try to take the fork that leads to the feelings, painful as it is. So I am facing the terror of abandonment and the grief that brings and talking to her about it before she goes, and also the anger that she is going no matter how much I need her. She is so patient with my endless neediness and so generous in allowing me to have email and mobile contact between sessions. But she also challenges me to face the things I don’t want to feel and to recognise that life is imperfect and it’s important to understand all the parts of myself. Whilst I am still finding it really really painful I do trust her and the process and believe that by facing and talking about the feelings head on, frequently over several sessions, that I will eventually be able to care for myself and my inner child’s terrors.

  • Hi Jeffrey.

    Thank you for letting me know your thoughts. A couple of days ago, I did email a letter to this therapist. I wrote what had been the major thing I learned in therapy about relating to my thoughts and feelings and that I wasn’t sure but I felt like it would help me to come talk to him again about the therapy relationship. When I quit therapy, we were having an issue about boundaries. I had told him that I loved him (which I imagine is the same as a need feeling that a child has for an adult who cares about them) and I wanted to hug him. (This desire for physical contact has always been an issue for me in therapy settings and has generally gotten so intense that the therapist ends the therapy.) Anyway he said he does not hug people and that is his boundary. I kept talking to him about it and he said that I did not respect his boundary, even though all I did was express my wish for physical contact over and over. Not once did I make a move to do so. I got sick and quit therapy. Now I think of talking to him. So I wrote him a letter asking him if I could come talk about the relationship, but he hasn’t written back and I really don’t think he is going to. He does not seem to handle this in a very therapeutic way.

    I spent the day feeling mercilessly upset. It was horrible. I found out two things:

    1. It was very hard to be mindful of the visual or hearing world. But if I focused on touch and breathing, I felt much more grounded. I did some hard physical work in the yard, slowly, while focusing on my breath, and this helped, though I still felt much panic and anxiety and even depression.

    2. It has been very hard to be mindful because I kept imaging hugging him and that if I could, this would make the feeling go away. This blog is about going into the feeling, I know that. I felt so bad, it was really hard to tolerate. I had finally got some material, burlap, which is as close to the suits he wore that I could find, and has a lot of texture, and sewed a piece of softer cloth on one side, and I could hold this and feel it and rub it lightly against my cheek. Rather than being triggering of my imagination, this was actually very soothing and grounding. It brought me into the present.

    Today, I extended this idea and made a “Texture Box” for myself. It’s a little box and has a few objects in it that I find soothing and calming to touch and feel the texture of. Mine has a ribbon, a feather, the burlap piece, a smooth rock, and a wooden bead with a loop of wire through it (I no longer have problems with self-harm). This was the best idea I have had in a long time, because it really is calming. I still wish he would write back, but I get that if he did, it would “fix” my problem for a while and then I would want more. It’s still frustrating not to have his attention and be able to talk to someone but this focus on texture really works for me, so I wanted to share it. Some of your other readers might find that it is a useful tool.

    I know that desire is a hindrance to mindfulness. Even if you get what you want, you still want more. So desiring the therapist’s attention and not getting it is painful. I wish that he could make up for what I did not get in childhood. I wish he could be there when someone was not. For a long time, this would drive me crazy. However my insight today that when I cannot be mindful to visual and hearing senses because I am too distressed, that focusing on my breathing and on the textures of things is another route for grounding was really freeing.

    I think -it seems- that I will always want (desire) a therapist to soothe me in ways they cannot, when I am stressed or depressed. But learning today how to soothe myself in the midst of this struggle by focusing on breathing and texture worked as an alternative to getting so worked up over someone who is not going to physically be there, ever.

    • Beth, Wow, this is such an amazing description of a path to healing. What healing requires is simultaneously feeling the pain/longing/anger or whatever feelings, and at the same time, having access to a state of safety and groundedness. Not everyone can access such a place of safety and centeredness as you have. In some cases, there has to be the presence of another person who has perspective and compassion. But most of us have at least a degree of a safe relationship internalized, which is what you were able to contact in yourself. That is how mindfulness works. It is a method (like your texture box) for contacting an inner sense of being connected, seen, and lovable. But that inner sense is not always accessible, especially in the context of trauma. For me, that is why trauma work is often not possible without an actual therapist. I believe the work you describe should create a bit of healing each time. Thank you for giving us all such a detailed glimpse of your healing process. JS

    • This is great! I got some scraps of leather and glued them as a cover onto my journal. Inside the journal are the words he has spoken, and the therapy sessions. I find it soothing and comforting.

  • I had to come back to this piece on 5 separate occasions before I got what the heck it was saying and how it related to the attachment to my therapist. In fact I was really kind of ticked that the other piece was closed for comments. But finally after rereading it twice this morning, I get it. And then Beth’s comments…wow. Those just cemented it for me. Thank you Beth for being so detailed.
    I’d still rather have my therapist (or some other grown-up remarkable guy) actually BE my dad, but I finally get what you are saying about me, myself needing to act in that role. Now to actually do it.
    Thanks.
    PS: Dr. Jeff– I’d love to see your thoughts sometime about Complex PTSD, or direct me to where you’ve already written on this.

    • TLC, I’m very glad it finally clicked for you. I do think I have things to say about complex PTSD. Do you have a reference to something representing mainstream thinking on the subject? Jeffery

  • Dear Jeffery,

    I have been to a lot of different counsellors, and become attached to most of them. I also became really attached to some school teachers, and currently lecturers. I am really sick of this because I can’t develop proper relationships with people, and getting help from therapists/ uni counsellors is also hard and hey get scared of me of I tell them and worry they are making me to attached!
    I also constantly feel ashamed around people and like there is something wrong with me because of this.
    If I do what you suggest is there a chance that these feelings can completely get better and I can feel normal? Please help.

    I am really sick of this and it is ruining my life 🙁

    I was also wondering if this type of obsession is a type of OCD? When I become attched to people I can’t stop thinking about them.

    Thanks in advance.

    • Dear J.

      Essentially everyone who becomes strongly attached to therapists (and serial others as well) is dealing with an unmet childhood need that got stuck long ago. If there are exceptions, I have not encountered them, though many people are unaware, as adults, that they have truly suffered as children. Furthermore, as adults, we very often rationalize our childhood to reassure ourselves that things were really OK, or that no one has a perfect childhood. This can cover up a truly painful reality that has become stuck at an earlier time of thinking and experiencing.

      In order to understand what has happened and to heal, what I believe helps the most is to picture oneself as having an inner child who is still looking for a solution to the shortfall. When we look closely at the nature and experience of the attachment, it is usually very reminiscent of how children attach to parents and parent substitutes. Children love their parents. Their attachment is real and giving, but it is also an expression of need and yearning. When a child reunites with a parent, the words might be “I love you so much and I need you to hold me and pay total attention to me, right now!”

      There is nothing shameful in this for a child. We expect children to have strong needs. For them, abandonment means death. This is a need for what I call “PRIMAL LOVE.” Depending on the age when one became stuck, it can take somewhat different forms, but it is often a 24/7 total, all encompassing love that may be in the form of touching, holding, attention, and many other forms. When children are exposed to sexuality prematurely, it can also become mixed up with sexuality, even though the basic need is for a parental kind of love.

      By picturing a child inside, we can get rid of much of the shame that is often mis-associated with attachments that don’t belong to adult life or that go beyond usual adult limitations.

      As I have written in many places, the child’s solution to the problem is finding an adult who will finally give PRIMAL LOVE. This is a wish that even a willing adult can’t fully satisfy. It is the special domain of healthy parents, or caregivers, and small children. So what therapy is for is to help the child let go of at least the part of the wish that can’t be fulfilled, which means experiencing a lot of scary pain and anger and coming to realize that there is joy and happiness in becoming free of those feelings. Emotional healing leads, at last, to being able to accept the kinds of love and attention that are available (from people who are capable of giving) in the adult world.

      To return to your question, unfortunately many therapists are not trained or comfortable with the childlike parts of their patients. In this blog, we have had reports of therapists who abruptly terminated patients who disclosed their attachment. On the other hand, there are therapists who, by training, experience, and personal makeup, are able to recognize what is happening and to handle the situation with respect and understanding.

      As described in quite a few comments in this blog, the winning formula is this: Ideally, people with an inner child who is perpetually looking for PRIMAL LOVE need a therapist who can help them recognize and let go of shame and disapproval for their inner child and childlike feelings. Next the therapist needs to help them let go of mechanisms for avoiding the anger and sadness. These often include addictions, compulsive behaviors, self criticism and self destructiveness, as well as rages and depression. As this happens, feelings of anger and/or sadness will intensify. The therapist needs to make a place for those feelings and help the patient realize that they are driven by disappointment from long ago, even though they may be focused on present issues. Often there is a repetitive pattern of attachment, then painful disappointment. These strong feelings need to be contained by the therapy, so that they can heal. It turns out that the anger is not endless, but eventually peters out, and the sadness is not, in fact, the bottomless pit it seems to be at first. Eventually those feelings can give way to a positive interest in the adult world and what it has to offer. That is the goal of therapy, and it does work.

      The things that slow a therapy down are, first, a therapist who is not prepared to handle these intense feelings and potentially dangerous acting out, and second, the many many things patients do to avoid facing the feelings.

      I hope that gives you some ideas you can follow. I have occasionally seen a situation where someone other than a therapist has played the role of the rock on the shore, weathering storm after storm of emotion, but a therapist who is trained and experienced at doing that job is much safer and more reliable because, like a healthy parent, the therapist doesn’t have to have his or her needs met from the relationship. In that way, the therapy can represent the one-way relationship that needs to play out.

      I am also happy to field questions from therapists who want to learn to do this work safely and effectively.

  • Returning to Beth’s post of Aug 3, I noticed that Beth’s therapist not only reminded of the touching boundary but wouldn’t discuss her wishes either. It just seems to me a main focus in trauma therapy is for the patient to feel free to discuss wishes and sorrows even if they aren’t fulfilled just as wished for. That seems to be the key of good therapy, to be safe to talk about all the feelings, not just the “proper” ones, for as long as it takes to work it through.

    • There is an important distinction. I fully agree that exploring the nature and details of wishes towards the therapist is critical for discovering their origin and original meaning. On the other hand, asking for something can go beyond communication and merge into a kind of acting out. The therapist’s job would be to turn repetition of the same thing into exploration of the intricacies and details. JS

    • The therapist’s job is indeed to explore in detail the specifics of wishes and yearnings. That is how we gain perspective on them and where they come from. There is an important distinction. Talk can be communication, but it can also be acting out. Repetitively asking for something can become more like pressuring than communicating. The therapist’s job in that case is to turn the conversation into an exploration of the interaction as well as the details of the wish. JS

  • hi to dr smith & all,
    i’m someone who has commented briefly here at dr smith’s blog before, a long-time therapy client who finally left that behind over 10 years ago, it seemed that even therapy with a kind & thoughtful therapist somehow always left me in a very self-destructive place. i still deal with the old attachment leftover from that therapy, it never went away & i have my reservations & difficulty with trust around this whole issue & even ran a support forum for a couple of years self-help style for myself & other adults, we all identified ourselves as AD or attachment disordered in some way & tried to support each other daily with insecure attachment & therapy issues. i also deal with the whole constellation of problems i think of as CEN or childhood emotional neglect. because my childhood didn’t allow for me to feel feelings i didn’t start out knowing much about them, & the chaotic environment i grew up in also left me with a very traumatized nervous system, as others here have mentioned. as a reader & creative type i have had to self-help myself & find my own way, discovering the whole inner child concept early on by reading john bradshaw & listening to his lectures, which was a critical starting point. i eventually wrote a book about my childhood, which was incredibly cathartic & helpful for me. journaling has been continually helpful as well. but what brings me to comment today is the whole idea of healing & grounding yourself, self-soothing, self-calming when there is no one else to help you. beth’s ‘texture box’ idea made me wonder if my own gallery might be helpful to anyone else as well. i’ve used my art to express everything i could not exactly verbalize for so many years, often for some of the most painful expressions, like the almost indescribeable experience of childhood dissociation, or the tension of self-harm urges & how to contain them safely. anyway, i thought i’d link it up here, maybe someone will find my images & installations therapeutic. creating them has helped me immeasurably, & i have felt ‘safe’ within my own skin now for many years now without the old self-destructive tendencies.
    take care all,

    http://brensgumbyland.com/warning1.htm

    there are 3 connected hallways, the last ‘quarantine area’ is potentially triggering so keep yourself safe.. somewhat chronological, the later installations & ‘dollscapes’ there become more positive & even ‘happy’ at times, which i consider a great success.. thanks to any who visit..

  • Hi Jeffery,

    My therapist doesn’t like framing things in terms of the inner child. He said the concept was popular thirty years ago as a way of teaching patients how to parent themselves and provide for themselves what they didn’t get from their parents. But therapists eventually discovered that this framing was problematic because it impeded integration. The goal is to integrate the child and adult selves, but viewing the unconscious, emotional self as a “child” (and therefore different and separate from the adult self) promotes continued separation of the two selves.

    On one level, I totally get his point, but, on another level, I don’t completely agree with him. First of all, I’m not sure if the inner child is necessarily the same thing as the unconscious. Secondly, the most valuable thing about conceptualizing this part of myself that has all these age-inappropriate feelings and yearnings as a child is that it makes these feelings more acceptable to my adult self.

    I understand that it may be counter-productive to “otherize” these feelings, instead of owning and accepting them as my own feelings. But can’t I have a stepping stone on the path to accepting these shameful feelings?

    I didn’t raise my objections during the session. (They were not well-formed at the time. I think I expend so much energy managing my feelings during sessions that my cognitive capacity suffers, and ideas often don’t become coherent until after the session.) I told him I understood what he was getting at.

    What do you think about this? Should I fight him on it?

    • Thanks, Kayla for bringing up this objection. Any approach or technique can lose its subtlety when it is popularized, including both the idea of transference and the notion of an inner child. The reason why working with the inner child should not be “otherizing” is that as healing proceeds, the inner child actually grows up, that is, comes to accept that things are not black and white and that unmet needs do not always have to be fulfilled. As this happens, the separation diminishes and what is left is a healthy adult. This is a regular part of working with people with dissociative identity disorder or multiple personalities. The younger ones do grow as therapy progresses and cannot integrate until they do.

      I also see clinically that patients often carry both kinds of thinking and tend, more at first, to switch back and forth. This separation is real. It can be described as switching ego states, but to deny that there is a switch is inaccurate. Often patients try to rationalize their young ways of thinking, which makes it much harder to help them identify precisely what is going on. For example, where the underlying childlike idea is that you have to be perfect to be lovable, the patient might insist that looking great really does improve your social life. That might be true, but it distorts the fact that humanness is really what makes adults and children lovable, and mixes it up with the childhood notion. Untangling the two ways of looking at what makes people lovable is really helpful for a patient who has been struggling in this area.

      Actually adults can be thought of as made up of childlike energy and emotion and adult judgment. Most of the motivation that drives us in life comes from long ago and continues to have childlike qualities. What drives great careers is something very deep and irrational. It derives from early life, modified over time. I find it very useful to think of healthy adults as having both qualities and being able to enter into ego states that emphasize one or the other. On vacation, healthy adults enter their childlike state to a much greater extent, and if they can’t, that’s unfortunate.

      Comparing the disadvantages of the concept of “transference distortion” with those of the inner child, I prefer to work with an inner child. I think that reducing shame is far more important and useful than identifying distortions. Actually, I would love to hear how your therapist approaches integrating distorted thinking. It is true that the inner child had wild popularity some years ago, led by John Bradshaw. However, Richard Schwartz has developed a more contemporary and evidence based “Internal Family Systems Therapy,” based on multiple inner “parts.” This is heavily researched, though I think it may put too much emphasis on stereotyped inner personalities, as opposed to understanding each patient in their own terms.

      Another modern trend is to look more for the positive. In Freud’s time, Victorians emphasized self-deprivation, renunciation and control. They were eager to suppress anything excessive or uncontrolled. In the 21st century, we are discovering the advantages of focusing on the positive. Embracing an inner child and encouraging growth is a more positive approach. JS

      • Hi Jeffery,

        Thanks for responding. I’ll bring up these points with my therapist at our next session.

        My therapist practices ISTDP (intensive short-term dynamic psychotherapy), and he seems strangely attached to that method, given that he wasn’t originally trained in it and his academic and clinical interests seem broad and wide-ranging. I’m ambivalent about the approach (even though I picked an ISTDP therapist intentionally after reading about it). At the end of the day, I don’t think the method or content of therapy matters that much. It’s the process–the therapeutic relationship–that matters. (I’ve been heavily influenced by Irvin Yalom.)

        So at the end of the day it’s how I really feel about his refusing to acknowledge the existence of my inner child. Because isn’t that what he’s doing? After he gave me the whole speech about why he didn’t want to frame things in terms of the inner child, he told me he didn’t want me to take anything he said as a rejection. My “good patient” persona nodded and said, “I understand what you mean.”

        But a part of me totally did take it as a rejection. And another part really did understand what he was saying. It’s really very hard for me to accept the part of myself that is irrational. I can tell that my therapist is trying very hard to show me that he cares, but a part of me irrationally makes up stories about how he must really dislike having to see me.

        • Dear Kayla, I’m sorry to hear about the difficulty you are having. I think therapists are generally intellectuals, and sometimes get over-invested in ideas. Marvin Goldfried, a senior psychologist gave a great speech at the last conference of the Society For the Exploration of Psychotherapy Integration (http://www.sepiweb.org). He pointed out that there are people on the right side and the wrong side in every “camp” in the field. The right side is supporting and encouraging patients, and the wrong side is shaming and criticizing. There’s a write up about his talk in the Society’s latest Newsletter (JS, Editor). I still think the inner child is the very best way to understand our irrationality in a compassionate and accurate way. When we switch into the irrational, we are really not our adult selves. In my way of thinking, the inner child is often ready to interpret the therapist’s words in whatever way was expected. Call it transference if you want, but it’s a strong and natural tendency that strengthens shame and bad feeling. I still think that understanding is a better way to help the irrational self outgrow that kind of thinking and see the therapist in presumably more accurate terms as a really caring person who is trying hard to reconcile his training and thinking with what he observes and feels.

          PS: I’m working on a video, working title, “An Alternative to Multiple Schools of Therapy.”

  • Hi Jeffery, I’ve just come across your blog and feel so grateful. It has given me a greater understanding of what I am experiencing. I’ve been seeing my therapist for about 18 months and I have just told her how I feel about her (I want a closer relationship with her/I think about her all the time and I want her to love me beyond the therapeutic relationship). I know that she cannot give me the love that I want from her and this makes me incredibly sad and angry. Should I tell her that I’m angry at her? My adult self is a bit more rational and knows that she wouldn’t be doing her job if she did reciprocate these feelings. I don’t want to let go of the small amount of hope I have (that maybe we can have a relationship outside of therapy) but most of me knows what the end result will be (loss/rejection/grief) and therefore I am thinking about ending therapy. Since telling her how I felt and not getting the response I wanted (it was a professional kind and validating response), my eating disorder has got worse. Perhaps I’m trying to avoid the pain I feel? I know true healing cannot occur If I use avoidant behaviours however the ‘addiction’ is just so powerful. Many thanks for sharing your knowledge and wisdom Jeffery.

    • Dear Kate, Sounds like you do understand a lot. I think the most important thing I could say is that the goal of therapy is to process those feelings of sadness and anger so that they no longer have the power to drive symptoms and avoidance mechanisms. To me there is hope in leaning into the feelings, because, as I have said many times, they do heal. They do lose their steam, especially when shared in a context of connection and safety. It is always possible to talk about feelings, rather than expressing them directly, and sometimes that is a safer way to ease into a difficult subject. “I’m experiencing some angry feelings.” instead of “I hate you right now for…” JS

      • Hi Jeffrey, I have had therapy in the past but it is only since seeing my current psychologist that I have began to understand what it is all about. It has always been a struggle for me to honestly express my feelings and it has only been in the last couple of sessions that I have been a little more open. I want people to like me you see, and expressing true feelings/being vulnerable is frightening. You’re right though, leaning into these feelings is what I need to do. Every time I see my psychologist I feel more attached and this makes it even harder. She is such a wonderful, honest and compassionate person which is why I am angry – angry that I cannot access her all of the time. Anyway, I will talk about these feelings with her and hope that one day they will heal. Thank you for your comment, your advice is much appreciated. Best, Kate

      • Hi Jeffrey, I hope you are well.

        I wanted to share a recent experience in the hope that you and/or other readers may be able to offer some insight.

        I told my psychologist that I was experiencing a lot of angry feelings. I am angry for allowing myself to become attached to her. I know that the intense feelings of love (non sexual) I have for my therapist cannot be reciprocated and this brings up a lot of pain and anguish, almost making life intolerable. I think this may be why a part of me wants to leave therapy.

        Midway through our last session I told my psychologist that I won’t be coming back to therapy. After talking a bit more (most of which is a blur), I aggreed on one last sessIon. She has told me that if this is what I have chosen, she must respect my decision.

        I feel so torn because on an intellectual level, I get it. My child self wants to be loved and nurtured by her but my adult self knows that my psychologist can’t fill the void of childhood. I have been hanging on to the hope that perhaps if I’m nice enough, perfect enough and an overall ‘good patient’ then maybe she’ll agree to or perhaps even want a loving relationship outside of therapy. The more I see her, the more this hope fades and I can’t bear the pain.

        However, the thought of not seeIng her is heart wrenching. There would be nothing to look forward to, no warm fuzzy feelings. Yet, this is exactly what I am ‘choosing’ to do.

        I am really unsure why I told her that I am ending therapy but it appears I am battling an internal conflict between my adult and child self. Is it because I am scared that my psychologist will confirm what I already know/feel about myself (I am unlovable)? Am I afraid that she will eventually tell me that she no longer wants to see me? Am I trying to avoid this rejection?

        Should I tell my psychologist how I feel – essentially what I’ve written here? I REALLY want to get better. I want to find a partner and experience happiness. I want to live without an eating disorder and without bouts of depression. I want to feel comfortable with who I am. BUT I also want to feel the love and warmth from my psychologist and I want to cling onto our relationship. Leaning into the feelings of anger, hurt and sadness means having to grieve our relationship which will be incredibly hard.

        I’m a bit confused and would love to know if you’ve come across this before.

        Cheers, Kate.

        • Dear Kate, There is a saying in 12-step programs that “Honesty will save your life.” Your honesty with yourself and with Moments of Change is super important. The principle stands that sharing the whole thing with your therapist is the most positive thing one can do. Giving partial information, such as just the part of you wanting to quit therapy, leaves the therapist’s hands tied. She is there to help you experience and heal the whole knot of intense and mixed feelings, and that is how the work gets done. Jeffery

        • Hi Kate
          I feel exactly like you. I have such deep feelings for my therapist, I long for very session, find separation unbearable and have often thought that the pain of therapy is too much to bear. It makes me full of anger and grief that my therapist will never give me the love that I long for from her. Or at least she gives me therapy love but it will never go beyond the therapeutic relationship. My worst fear is that she will get sick or die and I will never see her again, I really don’t think I could survive that. Jeffery always says that the way to deal with it is to lean in to the feelings and talk to your therapist so this is what I have done. She knows exactly how I feel, she knows how I dread the end of each session and the breaks, how I would like to be with her 24/7, how I envy the people around her who have a claim on her love in ‘real life’ and my terror of separation through death or illness. So how does her knowing all these really difficult feelings change things for me? We talk about it a lot, she helps me to see associations and repititions from childhood, we talk some more and around we go. What I think I need from her is some honest feedback about how I make her feel, both positive and negative. In other words I think the only way the relationship can work towards real healing is by being open about transference AND countertranference. If my actions, feelings, talk make her feel something then we should bring that in to the dialectic so that I can understand the impact of my feelings on the other, the very thing that terrifies me. She knows that my tendency is to blame myself so on occasions when I think I have irritated her or upset her with my needin tess and blame myself it would be healthier for her to say something about how her feelings are actually affected by mine so that I can learn how to respond as an adult. She is so empathetic that intuitively I know when she is slightly off with me and she even gets it wrong occasionally, nobody is perfect. But the mirror goes both ways, and whilst I don’t need or expect to know about her private relationships I do need to know how my feelings and outpourings make her feel, Jeffery what do think about countertransference and how it can be used openly as part of the therapy?

          • Dear Chimp, This is a really great question. Would the therapist’s revealing her counter transferential feelings help with healing. It’s worthy of a post. I’ll try to do one soon. My first reaction is to think that a log-jam might be that for now, you seem to take it as real that your neediness must be offensive, and that that issue has to be resolved with her by her telling. There’s a lot there to think about. JS

          • Hi Chimp,

            I have only just seen this message.

            Love for a therapist is a wonderful feeling but in the same breath, it feels like a tease. I cannot imagine getting ‘over it’. I have lots of beautiful friends but I’ve never felt this way about anyone else in my life.

            It’s an interesting point you raise about countertransference. My Therapist is open about her feelings for me and shares information about her own life. I find knowing a little about her incredibly beneficial – I have a hard time trusting and opening up to people so having her open up to me (even if it’s only a little) has really allowed us to build a trusting honest relationship.

          • Dear Kate, I know that with many therapists it is heresy to point out the similarities between parenting and therapy, but I’ll say it anyway because it is true. Being a therapist is a lot like being a parent. There comes a time when children don’t want to depend totally on their parents, and want to engage with their own outside world. That seems to me a better way to describe the evolution of a therapy relationship than “termination.” Teachers experience the same thing, and welcome old students who write or visit after the class is over. It’s not that the relationship needs to end or be broken, but that the limitations on the therapy relationship make it less than ideal to remain the center of a person’s life forever. Those limitations are not the same ones that limit the role of parents in adult life (in individualistic cultures). At the same time, the limitations are also the things that make the therapeutic relationship useful. For example, the relatively one-way quality. This makes it possible to express anger or disappointment with a therapist without being threatened or punished. That is extraordinarily valuable, where relationships in the world have to nourish both parties, and that can block growth when it comes to healing problems from the past. Jeffery

  • Hi Jeffery,
    A great article and one which has brought me some inspiration for the next few weeks. As I head into the last 3 sessions with my current therapist (see comment on a previous post), I think that instead of waiting for her lead on what will be a painful time (whilst consciously/subconsciously practising my avoidance skills mastered over 30 years!), maybe I can write a bit of the script? We often get waylaid by current goings on in the sessions due to my complicated current circumstances but I think from what you’ve said it could be far better to just focus on us parting and park the rest of it. As I become more articulate and trusting, there are things which I want to say so I don’t want to regret all that is left unsaid such that it will become yet another bad ending (either ones I’ve myself ended badly or have had ended for me, badly) or at the very least, unfinished. I sense that as much as this will be difficult and challenging, it is also an opportunity to start addressing the attachment issues which have thwarted me for years. Thanks for providing the motivation.

  • Well I finally told my therapist last night (well I wrote him an email) about my feelings toward him i.e. that he feels very “dad-like”. I was pretty direct about it all, without being creepy. Then this morning I tried desperately to retract it. FYI- you can’t.
    So we will see what happens on our next meeting on Wednesday– feeling a little sick just thinking about seeing him. Maybe I’ll just cancel… Feeling very “cringy” about it right now.

    • Wow! Let’s hope your therapist focuses on how it feels and what it means instead of worrying about feelings being acted upon. JS

      • It went well tonight. Very well. My therapist handled my email with complete grace and did not make me feel ashamed at all– which is what I completely felt. I nearly cancelled my appointment, I was 15 minutes late and I couldn’t even look at him when I walked into his office. Thankfully he said he was noticing my feelings as well and was looking for a good time to address them. He also assured me that after what I had experienced as a child, my feelings were completely normal and even expected.
        I feel so much better knowing the “elephant in the room” is out in the open– he took up so much room. So even though I completely doubted you, Dr. Jeffery, it was good advice after all.
        Most importantly, my therapist did not tell me I needed to find a new therapist. Someday I know I will need to move on, but it did not have to be tonight.
        Wondering what the next steps will be now.

  • I was reading a comment on another blog geared towards attachment trauma that asserts that nearly 50% of therapists are NOT qualified to deal with this type of issue. Would you agree with this?

    I was thinking about it and if I was an alcoholic, I certainly wouldn’t go to someone for help who was still drinking. How does this apply to attachment issues? Can someone with attachment trauma get help from a therapist who is insecurely attached (in some way) themselves? Can they help us meet that part of ourselves if they haven’t met themselves, in that arena?
    I’m starting to sincerely doubt it. Sadly, how do you find this out without going through it? I found myself re-traumatized and re-enactment occurred. I have to start over again. I don’t know what I could have done to prevent this, if anything.

    • Ang, This is such a troubling and recurrent issue. Even narrowing the search to therapists who claim to be “attachment therapists” is not necessarily a guarantee. I recall one therapist who identified herself as a “trauma therapist” and had extensive credentials, but practiced in a doctrinaire way that completely missed how trauma heals. So far, my best thought is to listen to one’s instinctive reaction. People who have been traumatized often override their inner signals, but those signals are often very accurate. This is another reason to raise issues of attachment to a therapist early, so as to test if he or she handles the issue in a therapeutic way. Readers, do you have any other ideas?

  • Hi Jeffrey,

    How would you tell the difference between trying to satisfy unmet childhood needs through a therapist (and thus avoiding painful feelings) and moving through childhood trauma? Neglect can be viewed as a trauma of sorts, but it leaves one with severely lacking emotional needs. Is the proper path to face the desire to talk to the therapist as an avoidance of facing the pain of feeling invisible in childhood? It is such a searing pain that when I feel it, I write him email, though I don’t go see him, or I reach out, as I am doing with this comment.

    Thanks for your thoughts.

    • Dear Beth, You raise a very important distinction that I may not have made clear. Sharing feelings with an empathically connected therapist is totally healthy and positive. It creates the conditions for healing, namely, experiencing difficult emotions in a context of empathic connection. I think of this kind of understanding (the result of feeling and sharing with someone who has an empathic connection) as the gold standard of what therapists provide. It also happens to be an important component of what healthy mothers give. What I have described as avoidance is when patients move away from this kind of communication and towards seeking what I think of more as “tokens” of love, that is extra time, physical contact, relationship outside therapy, etc. I’m not saying that these things are bad, but they tend to lead eventually to wishes that the therapist can’t fulfill. It is seeking to fill needs that no contemporary adult can actually satisfy that begins to look like avoidance. The disappointment and anger that patients experience when they run into healthy boundaries are often the same feelings that could not be expressed long ago with the disappointing parent. These are the emotions that most need to be understood and processed. That processing happens when the therapist has clear boundaries, whatever they may be. Often the seeking of “tokens” of love comes as an alternative to sharing real and deep feelings of longing and disappointment. The “young” hope is that receiving those tokens will make it unnecessary to experience disappointment and anger. In that way, seeking those things can be an avoidance of doing important emotional work. On the other hand, talking about having such wishes and feelings does lead to doing the work and to healing of the original disappointment.

      Regarding your last sentence, my thought is that if written communication is all that seems possible, it may still be a way to test the therapist and open a door leading to sharing with the feelings present in the room.

      Also, please note, as one reader did recently, that long before being aware of anger at a therapist who does not give, many patients experience self-criticism and shame at their own wishes, which makes them reluctant to talk about them, and also inhibits doing the work.

      I hope this is clarifying. Jeffery

  • Hi Jeffrey,

    I had to read that several times, but it is making more sense.

    1. If I say in words to the therapist what I am feeling (disappointment, rejection, anger, invisibility) and allow myself to feel those feelings and work for a positive feeling, whether I am with the therapist or not, that is a path towards healing.

    2. If I expect the therapist to “do something” to “make” me feel better, that is a path of avoidance.

    It seems that working through some of the negative feelings really amounts to a change in perspective sometimes. For example, instead of chronically being angry about my past, I look for something I can be grateful for in the present. It takes practice to do this!

    Having a conversation about feelings without wanting/expecting the therapist to “do” something feels hard. Taking responsibility for my feelings feels hard. I like to think of it as I “get to” take responsibility for my feelings.

    I used to go to therapy and feel that if only he would hug me, everything would be OK. You are right that this was essentially a way of not respecting his boundary and avoiding some of my childhood pain. My Texture Box really helps with bringing me into the present when I think a hug from him would eliminate the pain of the past. The other thing that really helped me a lot was getting a workbook on DBT (Dialectical Behavior Training). It actually has instructions for distress tolerance and self-soothing.

    I feel that maybe I have progressed to the point where I can share feelings rather than expect the other person to do some specific thing to “make them better”. It means that I can listen to the other person more, too.

    I feel that because I write to this therapist when I get stressed, even though he does not answer, that I have more innerwork to do. My inner child SO wants to be seen, to connect. I realize that, though the therapy room may be a place to initially feel safe, that ultimately I have to find another place and another way to satisfy that.

    I have not been to see this therapist in almost a year. What keeps coming up is my feelings of invisibility. I don’t know if leaning into those feelings means I have to come to terms with feeling invisible, or if it is OK to feel seen by a therapist, if they can. I am really scared of those feelings of disconnect, because they hurt a lot. Maybe it is both. But I know I want to learn a new way of handling them than writing to someone that I don’t talk to or relate to. I do feel ashamed of wanting attention. I feel ashamed of all I have done to try to get attention, instead of being able to talk about it. I did make an appointment for a couple of months away. To try to talk, and listen too. I realize that listening will help me feel the presence of the therapist, when before I was convinced that I had to have a hug in order to feel connected.

    I appreciate the other people who comment here. In some way, I feel connected in our struggle to feel OK.

    • Dear Beth, As I said explicitly in my early response to you, the gold standard is being seen and understood by your therapist. This is what makes the room safe and healing, and in my view, this is only good. Empathic understanding is the amazing healing medicine that has no dose limit and no side-effects. I do think that “doing things to make the patient feel better” is not therapeutic, but serves avoidance. I don’t want to discuss exceptions here, right now. Suffice it to say that a lot of avoidance does take place along the way to healing. No one starts out fully ready to face all feelings in pure form. Jeffery

  • This post has made me realize that although I have never wanted to truly admit it, my relationship with my father has impacted me greatly. I realize now that no “normal”woman looks around constantly for a man to fulfil that father void– not even a husband. Although, I have tried to get my husband to take on that role, he just cannot and probably should not. My need, though, is so very great.

    So now, however, I am now left wondering how in the world does one finally, really get over their deep feelings for their therapist? When does that step come? Right now it seems completely cruel to me to expect me to stop meeting with him and thinking about him and move on. When something good or bad happens right now I think about sharing it with him first. If our session gets cancelled, I’m kind of ticked. I’m in deep. He is the first “father figure” who has taken an interest in me and my well-being, in a non-perverse way. Granted I pay him to listen to me (and that pains me greatly), but I still feel like he cares beyond pay. He is my first ever therapist and I am really struggling. It sucks to think about moving on. I now totally understand how people could keep seeing a therapist for years or decades. I really wish I would have known this could happen– it may have prevented me from attaching to him.
    How does it all come to an end? I feel like I want to go into the rest of my sessions with my eyes far more open. I’m a pretty sensitive person and if the end is going to be really painful I want to know. Maybe this all just indicates that the time isn’t right yet to end. But nor do I wish to get even more attached, ya know? I also still am not understanding why the attachment is actually a good sign, because it is supposed to be good, right? It still just feels really embarrassing. I have shared it with no one in real life and even though I told my therapist, when I think about it now I still cringe. Just when I think I’ve figured it out, I don’t really think I do. I think I am panicking a little– not sure why.

  • Dear TLC,

    You write that you are in a lot of pain over your attachment. Because you love your therapist (the way a child loves an adult that they need, I assume), but the pain of your childhood is not going to go away no matter what they do. Sharing that pain with your therapist – the details of what you wish for, could help. I went through a similar thing, but on the “mother” side. I was extremely attached to a female doctor, and I practically lived for the time I got to spend with her. However, I kept wanting her to soothe me, which, as you know, just is not possible. As Jeffrey says, no contemporary adult can actually soothe the pain of the past. Sharing it in words with a therapist or someone else can be helpful. But for me at least, I had to learn to “grieve what never was” with my own mother. This did not happen rapidly. When I became so emotionally dependent on that doctor, she felt she could no longer help me, and she stopped treating me. I cried frequently, was angry, and just in emotional pain in general for maybe 6 months or even a year. One thing that helped me work through some of my pain is an exercise in Sonia Connolly’s book, “Wellspring of Compassion: Self Care for Sensitive People Healing from Trauma”. She suggests that you “invite your longing to tea”. You set aside a couple of hours for yourself, and choose a favorite tea, for yourself, and the longing. You get to know your longing – what it looks like, where it lives in your body, things like that. I can’t describe it here well in a brief space – it is described in much more detail in the book.

    These exercises so not make the emotional pain “magically” go away. Rather, I found that they were ways of helping me through the pain. I still have times when the old pain gets triggered. But it no longer dominates my life. It is through a combination of therapy and learning how to soothe myself that I have made emotional progress. The pain is very real, but so are the coping skills you can learn to use to deal with it.

    Beth

  • Hi Jeffery,
    Thanks so much for your wonderful blog. It helps bring some clarity so much of the crazy stuff that I’m feeling/experiencing since starting therapy 2 years ago. Before therapy, I would have thought of myself and a relatively well-functioning adult whereas now I seem to be a bit of a mess (inside at least).

    I am so deeply attached to my therapist, I long for the weekly session with her and think about her all the time. I am finding the intensity of the feelings of love both sexual and non-sexual more and more difficult to cope with. I have shared this with her and she responded amazingly and been nothing but empathetic and understanding. She has always maintained good boundaries although I have never really tested them I know they will remain intact. She has never shied away from whatever I have brought to her. I 100% know that there will never be more to our relationship than the 1-hour therapeutic relationship that we have once a week. She has done everything ‘right’ according to your previous post on ‘the inner child’. I truly ‘believe’ that the reason that she cannot give me the things that I want (e.g a hug or outside of therapy care) isn’t because she is withholding on purpose but because she is keeping me safe and does care. I also do ‘believe’ deep down that emotional healing is possible. Based on this it appears all is going well for me… but right now I can’t seem to see past the pain and longing I am feeling. …..I wonder where someone goes from here? My feelings for her seem to be getting even more intense not less. I struggle to find my ‘inner child’ or even know what it is she wants. My conscious mind and logical thinking take over all the time and I feel like it’s inhibiting my progess but I am not sure how to move forward from here. Am I just to keep plodding along with this intense pain week after week and hoping for the best?

    Thanks again for your work

      • Dear Jeffery, Chloe, TLC
        The post has moved back to attachment to therapist I think because this brings so much pain. As TLC says it feels kind of cruel, and there are so many of us it seems,
        agonising over this person who becomes central to our lives, causes us such grief and longing, that it does deserve the space given to it here. I have asked my therapist so many times why she couldn’t give me a health warning about attachment, therapists must experience this all the time. a bit of upfront prior talk about it would at least help those of us who feel so deeply and painfully to know that it’s ‘normal’. Like Chloe and TLC I can’t see an end to my perpetual longing and need to be with my therapist, if we ended I really don’t know what I would do and that can’t be safe. It really makes me think how many others are there trying to function in the real world whilst their inner self is torn apart with this constant pain, as I am. It never goes away or feels any easier.

        • Dear Chimp, What I often see is that the interaction comes to focus on something that the therapist could do but doesn’t seem to be willing. In my language, that is the inner child reenacting an interaction with the parent who was unwilling. As long as the therapist remains unwilling to bend, then nothing happens and the pain goes on unresolved. I can only see two ways out. One is that the child goes through the pain and anger and lets go of something that feels like a life and death need. I’m not so sure that is even possible, but it doesn’t feel very good at all. The other one is that the therapist’s unwillingness becomes an active issue to be resolved between the two. The problem with the therapist just agreeing is that the issue still doesn’t get resolved because it this outcome is so radically different from the original refusal. Then the child is liable to come up with another requirement and it starts all over again. I think there has to be some real give and take around the issue. If both parties are able to see both sides and work out a solution that works for both, then I see the best avenue to resolution. The big picture is that this is the resolution of the original refusal, but this time, using an adult perspective side-by-side with the original black and white point of view. I hope I’m clear and that this way of looking at it gives some room for you and therapist to think more about what isn’t getting resolved. JS

  • Dear Chimp and Dr. Jeffery,
    Couple of questions and comments. First, Chimp– when you ask your therapist about why she didn’t warn you, at least a little, what does she say? It is clear to me that you are much further ahead on this journey than am I. I don’t even “dare” to have that conversation with my therapist. I feel so uncomfortable– it just all feels so wrong still. Since revealing my attachment to my therapist a few weeks ago, his initial reaction was not shaming at all– in fact he was encouraged by it. However, he has not talked to me about it at all. I now feel kind of weird about it again.
    Second, Dr. Jeffery, what do you mean in the part where you say, ” The problem with the therapist just agreeing is that the issue still doesn’t get resolved because this outcome is so radically different from the original refusal”? What do you mean by the “just agreeing” part? Just agree to what exactly? The fact that there is an attachment? A need/wish that the client sets out there and asks the therapist to fulfill? Or am I completely missing the boat.
    I guess I am not getting it… Although I am very attached to my therapist as a father-figure, I guess i am not a very demanding “child”. I don’t push him to give me hugs, take more of an interest in me, take phone calls, nor do I schedule excess sessions (although I would love all of these things!) I do email him (which he never returns– although he does acknowledge at our sessions). Honestly, I would not dare to demand more. I keep all of my wishes for more to myself.
    Again, I am also stuck on why this attachment could ever indicate something positive. Like I said, my therapist was encouraged by it. I don’t get that. I spent so long trying to get any kind of attention from my actual father and instead got either anger or indifference. I just don’t know how to bear this one ending.
    Sorry to be such a whiner about this, but like I explained earlier, I feel so blindsided by all of these emotions. And although I really do appreciate Beth’s genuine response (I really do)I don’t want to work through this on my own, with a book in hand. I don’t want to have to leave this therapy where, for the first time in my life, I actually feel valued by a father-figure But on the flip-side, will this attachment just get worse as time goes by, if I don’t cut it off now. Blah! I am so angry with myself for allowing this to happen!

    TLC

    • Dear TLC, I am sorry to be ambiguous. In fact I’m somewhat thinking out loud. It’s hard to describe in a general way just what actions on the part of the therapist bring the old, unfinished business and feelings into a realm where the patient can feel the feelings from back then, (anger, longing, etc), while looking at them from a compassionate but adult perspective at the same time. Those are the conditions for healing.

      I was thinking that a therapist who simply accepts the role of fulfilling wishes to step outside boundaries, colludes with the patient in helping the patient not to feel the original feelings of disappointment, anger, etc. Somewhere between a rigid refusal and a too-easy gratification lies the territory where the therapeutic work gets done. JS

  • Dear Jeffery and TLC
    I think I get what you are saying and for TLC it may appear I am a bit further on but what I am wondering is my therapist too giving? For example I am working away from home and she encourages email, Skype, even whatsapp. At first I was the reluctant one but now I find the connection so helpful and containing when I am 1000s of miles away. She offers me extra sessions, I have rarely asked. She gave me a transitional object when she was on her summer break over August. She holds an object of mine that symbolises all my pain. She does not do physical touch, hugs etc and she does not reveal very much about herself. Of course I take up all her offers, my child will take all the loving attention she can to make up for the separation and losses in my childhood. But maybe she is giving too much? I have wondered and posted before about countertransference. If we need a side by side adult resolution of my attachment/transference then I think it should include in the analysis how she feels/responds to me otherwise I cannot fully understand about my inner self and how I need to change. So TLC when I ask her why she didn’t tell me I would experience all the pain of attachment her response is that of course I can feel angry about it, that my default is always to blame myself and why do I feel that way, and that everyone is an individual so she can’t predict anything until we are really in relationship. My demand on her now is to make her feel what I feel, really know my pain and desolation around separation and loss. I see her/connect with her 3 or occasionally 4 times a week. We have a very deep relationship and I trust her totally to help me to a resolution. But I still have all these questions that I think are unknown until you are actually in therapy, no one can prepare you for the pain it brings and no one around you can understand why you’re not “getting better”. And whilst I find it very helpful to share and be part of these online conversations with Jeffery I also feel as though I am betraying her in some way, that it undermines the trust I have in her. So even as I write I feel guilty. There are so many complexities in therapy that I sometimes wish I could just stop thinking about it and just feel.

    • Oh, my, You are pushing me to go deeper into this very subtle subject. I, too have been known to give easily and a lot, but at the same time, I expect an expanding engagement with the outside world and other people. If that weren’t happening, I would worry that my giving is creating an alternative to life rather than a pathway towards mainstream life. There are times when giving less or demanding more would simply block the inner child from choosing connection over safety. I think that is the key issue, but each person is different and the array of defenses against danger are different in every case. But there is another factor, and that is the conversation with the adult. When adult parts understand what is happening, they can internalize the attitudes of mothering and take on more of the job of being the mother who is warm and compassionate, but also ready to push a bit for growth when it is possible but the inner child is reluctant. These skills may be learned through the therapy relationship or remembered from somewhere or found in outside relationships. Whatever the route, it is a big help to have a strong partnership between the adult and the therapist to help the young one find hope, motivation and sometimes a push to grow.

      Regarding betrayal, I think the antidote to betrayal is that this part of the therapy should not be hidden or secret. Therapists are professionals, and if they can handle an intense relationship, they should be able to handle an educated consumer who is exposed to broader thinking.

  • Interesting, because my therapist consistently encourages me to share with others some of the things he and I talk about. I’m guessing, like you said, he’s checking in on my engagement with the outside world. That’s probably an important part to being able to move apart from him. (Still don’t like that though 🙂 )

    This part you wrote also makes sense:
    “When adult parts understand what is happening, they can internalize the attitudes of mothering and take on more of the job of being the mother who is warm and compassionate, but also ready to push a bit for growth when it is possible but the inner child is reluctant.”

    I’m thinking this could help me move away from the harsh judgement I often have about others who don’t measure up to my many expectations and the self-hatred I constantly have for myself.

    I think I am understanding this process a little more. When I understand the why of something I can feel more comfortable with some of the attachment happening.
    One last querie:
    Who is the one who usually decides if the work of therapy is done for good? Do most people usually just stop going altogether one day or do they gradually just see their therapist once every two weeks, then once a month and then once every other month, etc. Even just the idea of not seeing my therapist ever again just sucks. He’s just such an awesome guy– can’t stop wishing he really was my dad or at least could always just be a small part of my life.

    • TLC, Glad to see this is making sense. Regarding the end of therapy, it is quite variable. My thinking is that it is best done as a mutual decision. I don’t see the value of imposing termination, because it is more important for the patient to feel ready and want to let go of regular sessions. I also don’t close the door. The idea of ending does often bring up issues that have not been addressed before, and this is important. I don’t think that a definitive closing of the door to future contact brings out issues that are not already there. Plus, that emotional brutality adds something negative that I don’t think is needed. So I think the important part is a mutual concern for making sure the patient does develop and grow a life outside of therapy. JS

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