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Monday, October 17, 2016

Psychotherapy: Overcoming the Urge for a "Flight Into Health"

In a prior article, When Clients Leave Therapy Prematurely,  I wrote about clients leaving therapy before they've completed the work.  In this article, I'm focusing on a particular dynamic called a "flight into health" where a client avoids any further exploration of his or her problems out of fear with a temporary cessation of symptoms that brought the client into therapy in the first place.

Psychotherapy: Overcoming the Urge for a "Flight to Health"

Often, this "flight into health" is unconscious.  It is based on a fear of further in-depth work on the presenting problem.  At the time, the client is convinced that s/he is feeling better and no longer needs to come to therapy.

S/he is usually unaware that what's really happening is that s/he has convinced him or herself that everything is fine now.  But, usually, s/he is suppressing the symptoms, and the suppression of these symptoms can only be maintained for so long before they come to the surface again.

There are some clients who go through this time after time with different therapists and they are unaware of what they're doing, so they can be in and out of therapy many times.

In many cases, these clients haven't developed the necessary internal resources and coping skills to do the work (see my article:  Developing Internal Resources and Coping Skills).

Let's take a look at a fictional vignette, based on many different cases, to understand how this plays out:

Lynn:
Lynn had been in therapy several times as an adult.  Each time she started therapy, she came for the same reason:  to deal with a history of physical abuse by her mother when she was a child.

Psychotherapy: Overcoming the Urge For a "Flight Into Health"

Her pattern was that she would remain in therapy for several sessions, and when she and her therapist began to speak about how angry and sad she felt about the physical abuse, she would suddenly "feel better" and decide that she no longer needed to be in therapy.

Against her therapist's advice, she would leave, feeling somewhat relieved to have talked about the abuse.  But within a few months, she would begin feeling depressed and anxious about her childhood abuse and decide to try a different therapist.

From her perspective, the prior therapies "didn't work" because she began feeling anxious and depressed again.  She didn't realize that she had fooled herself each time into thinking her problem was resolved when, in fact, it wasn't.

Instead, on an unconscious level, she suppressed her anxiety and depression, and covered it over with a lot of activity to mask her feelings.  She would plan many trips, outings, and social events to keep herself distracted and exhausted.

But after a while, this defensive behavior no longer worked for her and she felt disappointed that her old feelings were back.

When she talked about her prior attempts to get help in therapy with her latest therapist, she expressed her sadness and disappointment that prior therapists were unable to help her.

When the therapist discerned what was happening, she explained the concept of "flight into health" to Lynn as a way to help Lynn to understand her history in therapy.  Somewhat skeptical, Lynn listened, but she didn't feel it applied to her.

She wanted to begin immediately by delving into her traumatic history.

But suspecting that Lynn might be having problems with containing difficult emotions, her therapist told her that it was important to start with building the internal resources to do the work.

Her therapist explained that, without the internal resources and the necessary coping skills, Lynn could become easily overwhelmed and want to leave therapy by convincing herself that she was "feeling better" when, in fact, not much had changed.

Her therapist spent several sessions teaching Lynn how to calm herself with a breathing exercise, the Safe Place exercise, and certain mindfulness exercises.

She also helped Lynn with various containment exercises, including a visualization exercise where Lynn imagined that, before she left each session, she could place her uncomfortable feelings and reactions into an imaginary box with a lid on it that was kept in the therapist's office ready and waiting for the next time that Lynn came to therapy.

Initially, Lynn felt impatient with this preparation phase of therapy.  But when they began working on a memory about the early childhood physical abuse, using EMDR (Eye Movement Desensitization and Reprocessing) and Lynn began to feel overwhelmed, her therapist reminded her to use her internal resources, including the breathing, internal resources and visualizations.

By using her internal resources, Lynn was able to calm herself and contain difficult emotions.  She also made good use of the imaginary box with the lid that allowed her to imagine that she was leaving this traumatic memory and the difficult emotions associate with it with her therapist.  In other words, she didn't have to take it with her.

By the Lynn completed therapy, she felt the difference between her usual "flight into health," which was a defense against completing the work and actually overcoming the trauma.  In hindsight, she realized that whenever she thought she was "feeling better" before, it was only temporary.

Psychotherapy: Overcoming the Urge For a "Flight Into Health"

Lynn and her therapist went back to the traumatic early childhood memories again and Lynn no longer felt upset by them.  She felt compassion for herself as a child, but she no longer felt anxious or depressed.

Her therapist followed up with Lynn several months later, and Lynn told her that their work was holding.

Conclusion
While it's understandable that no one wants to dwell on traumatic memories, the reason why people come to therapy is that these memories are getting in the way of their leading the life that they want.

Emotional trauma doesn't resolve itself on its own (see my article:  ).

Without working through the trauma in therapy, it continues to have a strong impact on your current life.

A "flight into health" is an unconscious defense mechanism that clients use when their fear becomes  too much for them.  They convince themselves that they're "better" when, in fact, "feeling better" is a self generated feeling and only temporary.  Sooner or later, the problem makes itself felt again.

Preparation to do trauma work is essential to help the client to deal with the difficult emotions that can come up.  When clients have developed the necessary internal resources and tools beforehand, the trauma work is usually tolerable.

Rather than going from one therapy to the next, clients can complete the work and go on to lead more fulfilling lives without the affect of the earlier trauma.

Getting Help in Therapy
If you recognize yourself in this article, you owe it to yourself and your loved ones to get help with a therapist who can assist you with the necessary initial preparation.   The time spent doing on preparation before trauma work is well spent in the long run (see my article: The Benefits of Therapy).

Rather than spending the rest of your life carry the burden of your emotional trauma and having it get in the way of leading a happy life, you can learn to contain and tolerate the emotions that arise so that you can resolve the trauma (see my article: How to Choose a Therapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.



















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