I Want to Heal But Also I Don’t: Why Do Many Feel Averse to Therapy and Trauma Work?
Anti-Healing Parts Can Complicate Therapeutic Work and They Are Often Sneaky Liars
If this article feels difficult for you to read and you feel like not finishing it, it might be helpful to feel into why that is — could it be caused by the anti-healing parts that it discusses?
Note: This article discusses the aversion to trauma healing and psychotherapy arising from the nature of trauma itself. Obviously, there are also very concrete barriers related to the accessibility and quality of therapy, from cost to physical health constraints. There are people traumatized by past therapists or who fear, often entirely understandably, that a mental health professional would not understand their neurodivergence, chronic illness, gender identity or other types of core lived experience.
This piece is in no way intended to minimize these challenges and concerns. It is, however, sometimes possible to surpass these problems by working by yourself or with the help of a peer by teaching yourself effective modalities of trauma therapy, though in cases of very severe trauma this is not always advisable. It is also not my intention to judge or criticize anyone having the kind of difficulties discussed in the article, they are incredibly common.
Also, parts may have concerns about therapy that are based on misunderstandings. A common one is the idea that trauma work is based on thinking and talking about your most awful experiences. Luckily, effective trauma therapy is mostly not concerned with the original traumatizing situations, as that has a tendency to only strengthen the involved memory pathways. Instead it focuses on the effects the trauma has on the person’s experience in the now, such as on the level of the body and the autonomic nervous system, as well as limiting beliefs caused by it, rather than the narrative of what happened in the past.
What Are Parts and How Do They Affect Our Lives?
According to the theory in Internal Family Systems (IFS), our mind is made up of parts, kinds of subpersonalities, which make us the incredibly complex and fascinating beings we are. IFS and other parts-based frameworks are quite compatible with the current understanding of neuroscience. Parts are why we sometimes act in ways “uncharacteristic” to us, feel torn in multiple directions, do things we don’t want to do (like with addictions, bad habits and bouts of rage) or don’t do the things we want to do (like going to the gym or expressing our boundaries).
Most parts have developed in our childhood and may be mentally stuck there. They commonly harbor black-and-white views of the world, e.g. one part believing that something is completely awful and unacceptable, while another part has an opposite view. This tends to lead to a polarization between these parts, which often acts like a tug of war and explains why one can hold contradictory ideas or preferences at the same time.
Quite a few people want to hit the gym, yet struggle to actually pull it off, at least in the long term. Similarly, many would like to seek therapy, but never do or quickly give up on it. From the point of view of therapists, often also of the person’s loved ones, this can be frustrating, but it is very understandable when you look at it as a protective mechanism.
Healing Can Feel Unsafe
Trauma is all about the feeling of unsafety, whether it’s more about concrete lack of safety, such as the fear that someone will physically attack you, or more social and emotional unsafety, like that others will reject and abandon you. (For childhood trauma, these are in fact largely the same thing, as a child cannot survive if they are abandoned by their caretakers.) Some people with severe trauma feel this on a tangible level all the time, while for others, the sense of not being safe is more implicit and might only become obvious when they are triggered.
Trauma is awful. Yet peculiarly, it tends to feel much safer than the idea of not having trauma. The current situation, even if in many ways unpleasant or unsatisfactory, is familiar. We know what it’s like and that appears safer than something unknown, which may come off as a trick or a trap — parts may believe real safety cannot exist, so anything promising such a thing is inherently suspicious.
Typically, the current, traumatized state is closed off from many things. There may be patterns of social, emotional and romantic withdrawal and detachment, with the frightening implication that healing would mean opening up, being vulnerable and letting people in. Yet there may be such a disconnect from even your own self and your own body that the idea of re-establishing a connection to who you are may feel unbearable.
Parts may be aware that not only healing would change you as a person, it might result in concrete changes to your life. Reasons related to trauma make many people stick to romantic relationships, friendships, communities, toxic workplaces and fields that don’t feel quite right to them. It is also common for those coming from a family with severe abuse or neglect to hold a belief that their parents did not do anything wrong, allowing the maintenance of a relationship, while the subconscious likely knows this is not true.
Shame and Dissociation Make Us Go Into Hiding
Another factor complicating pursuits of healing is shame, a typical component of trauma, which may or may not be consciously experienced. “In fact, it has been demonstrated that shame is a ‘potent treatment barrier’ for trauma survivors, leading to outright avoidance, and to dropping out and attrition once engaged with care and services.” (Dolezal et al, 2022.) Parts illustrate the way the human experience is often rife with conflicting beliefs. A survivor may believe that they do not feel embarrassed about past sexual abuse since they know it was not their fault, yet parts can carry shame on a less conscious level.
“[C]hronic shame is commonly characterised by the nagging and persistent possibility of shame, where, for the most part, shame itself is not necessarily realised in experience. Instead, what comes to dominate experience is a pernicious form of anticipated shame, or a persistent and heightened ‘shame anxiety,’ of which an individual may, or may not, be aware. […] It is important to note that shame anxiety may not be experienced as shame. Instead, it may be dominated by shame avoidance and, as such, characterised by emotions such as fear, anxiety, self-consciousness, stress or powerful impulses to hide, avoid or escape.” (ibid)
Dissociation is also an important part of the puzzle. (For more about dissociation, see this article of mine.) The term refers to several mechanisms that exist to push horrible experiences out of consciousness to prevent them from overwhelming us. For many, it feels much more comfortable than the idea of healing. Why tear open old wounds when there is something in-built in humans that helps us turn away from pain and cushion us from its impact? Sadly, there are major trade-offs: dissociation also prevents us from fully engaging with life.
According to structural dissociation theory, which deals with the way severe trauma can fragment the personality, many people with severe childhood trauma have a strong apparently normal part or ANP (a term that curiously goes as far back as studies of WW1 veterans). They may appear highly dysfunctional, potentially struggling with such issues as psychosis, addiction, suicidal thoughts and violence, making it seem obvious to others that professional help could be valuable. Yet when the person is operating from an ANP, they may barely remember such struggles, more focused on basic functioning than experiences like joy or aliveness.
Why Do People Drop out of Therapy?
Normally when I make controversial claims in my writing, I try to back them up with research, but anti-healing parts seem very tricky to study. People who don’t ever seek therapy are not recorded in any data. Even among those who do, how could we accurately study the experience of someone who states they dropped out because they didn’t like their therapist or because they were too busy with their studies, even if the actual reason was apprehensive parts?
Of course, in the field of psychotherapy, clients quitting therapy early is a well-known phenomenon, referred to with terms such as attrition or premature termination. There is plenty of research on its potential causes, though I believe it fails to delve into the deeper motivations.
“Studies vary, but we now know that between 20 and 57 percent of therapy clients don’t return after an initial session. Of those who do come back, another 37 to 45 percent will stay for only two more sessions.
Why? There’s a slew of potential reasons: people change jobs, run out of money, reconcile with their romantic partners, and so on.” (Psychotherapist Networker)
Other reasons listed in that article and elsewhere include the client not clicking with the therapist, not trusting their methods, or feeling like the therapist is not empathetic enough, low motivation and stigma attached to therapy. Socioeconomic factors also appear to play a role. Labels like “low motivation” may not say much, though, as I believe that for most people, the motivation system is largely controlled by trauma-based parts. For reasons detailed later in this article, I also suspect viewing the practitioner as strongly empathetic can actually be more triggering than perceived low empathy, obviously depending on the extent of such deficit.
Possible Deeper Causes for Premature Termination
No doubt these reasons can play a role in “therapy drop-out”. Yet none of these purported causes of really explain some factors associated with it, such as how commonly it occurs right after an apparent big breakthrough or major insight. One could suggest an explanation like the client not feeling adequately supported with such a big shift, as they can be unnerving and destabilizing, but I suspect parts triggered by the idea of healing play a big role.
Also, anti-healing parts may make the person start forgetting therapy appointments. When someone is inexplicably forgetting something, the reason is typically parts that are actively trying not to remember. Other clients begin to regularly cancel appointments, perhaps for seemingly minor reasons. These can both help strengthen the person’s belief that they really are too busy for this or otherwise aren’t cut for therapy at this point in their life.
The more effective therapy is, the more triggering it tends to be. Some people manage to stay in supportive psychotherapy or modalities with low efficacy for years, yet trying out a more powerful technique has them quit quickly. (There is a common belief that all schools of therapy have equal efficacy, based on research with questionable methodology, which I attempt to debunk in my free book Loving Awakening.)
Others are quite happy to work on more “cerebral” concerns such as productivity or stress, either by themselves or with a counselor. They might even boast how adept and keen they are on inner work, yet stay clear from anything that dives too close to their attachment trauma or other core wounding.
I suspect anti-healing parts often also oppose couples therapy. A common pattern is that one partner wishes to attend couples counseling while the other party does not see a need, though still wants to stay together. Again, there are multiple potential reasons for such apprehension, both related to relational dynamics and attitudes towards counseling in general, but I strongly suspect fearful parts can play a role, too. Being stuck in unhealthy roles in a relationship feels safer and more familiar than potential change.
In general, there may be parts that feel like it’s unfair you should be the one in the therapist’s chair when people who have hurt you, neglected you or perhaps even abused you just shrug off their problems. And in a sense, it is very unfair. Had they dealt with their issues, they would not have behaved in ways that traumatized you. That is really painful. The unfortunate truth is that you can’t make others heal. You can’t make them confront their apprehensive parts, you can only try to confront your own ones.
Aversion to Healing Outside of Therapy
Parts can also be triggered by books related to trauma or healing. Some trauma literature features material with an obvious potential to be triggering, such as descriptions of abuse. Yet curiously, I’ve found that one particularly common culprit is Jay Earley’s IFS guidebook Self-Therapy, which contains none of that. Quite a few people have told me they could not finish the book, because of how strongly it posited healing being accessible and possible.
Parts may even get revved up when they hear mentions of trauma or parts, things they interpret as therapy language, claims that trauma is extremely common, or someone insisting that you personally have trauma. They might interpret those things as blame or pathologizing even when that is not the intention. Obviously, sometimes such talk actually is patronizing, coming from parts trying to fix other people.
On the other hand, some people with anti-healing parts are very keen on self-help books. The genre promises change and healing — typically without any obvious mention of trauma. Consuming such titles makes you feel like you are doing something, while the reader stays in charge and can avoid delving too deep. I’ve known people who spent years devouring self-help and swore it had changed their lives, yet an external observer struggled to notice any difference.
Parts’ suspicions may not be limited to just therapy-adjacent things, either. Anything that holds the promise of change can seem terrifying. Rejection and abandonment frighten most people and it really hurts to feel misunderstood and unseen. Yet at least there tends to be a familiarity to those experiences, which may not be the case with love and acceptance. Even feeling understood can feel triggering, as can the prospect of things like joy, ease or excitement. For some with insecure attachment, even securely attached people appear to pose a sense of danger.
Typically, the main factor is whether parts believe something poses a risk of dealing with core trauma. As such, a therapist who doesn’t prod too deep could provoke less alarm than the promise of a healthy, loving relationship or even a warm and compassionate friend or mentor. There is often an apparent tendency in trauma survivors to seek out unhealthy, even abusive relationships. This is typically explained by re-enactment of trauma, but I suspect it can also relate to avoiding people who come off as too safe.
Dealing With Anti-Healing Parts
You can’t force parts into anything, but parts that oppose healing can be worked with like any other — with the obvious caveat that they might not be very fond of the idea. Yet like all parts, they do value being heard and their contribution appreciated, being treated with curiosity and compassion. The IFS motto is that all parts are welcome, because they are all trying to help.
The most important thing to understand about anti-healing parts is that they exist, you might well have them and that they often lie. If they try to convince you “this isn’t going to work”, a common reason is their fear that the approach is going to help. They might be telling you now is not the right time to do therapy, you are too busy, that the practitioner or the therapeutic modality isn’t the right fit for you, or that you aren’t doing the work properly, when it’s really about fear.
These objections can obviously be true, or they might be ideas stemming from parts that are terrified of change. It is probably worth thorough consideration to see if the concerns can be related to real issues, e.g. that the therapist really does not listen or seems inferior to someone you worked with in the past, or whether they could be distorted ideas coming from parts. If the practitioner feels off, might someone else be a better fit? Can you sense any panic or anger related to the situation? Something coming off as merely useless would generally not be expected to stir up such emotions.
I believe optimally, anti-healing parts should be something discussed both in therapy and in the wider conversation about healing and mental health, though this requires considerable nuance. Many trauma survivors have experienced gaslighting both related to their original source of trauma and when trying to seek professional help for it.
It is tricky to talk about something that easily sounds like “you might believe this, but it’s actually wrong, and if you think your therapist is bad, it can’t possibly be true” without the potential for feeling invalidated. On the other hand, it is well-known that trauma can spark distorted beliefs about the world that feel very real and it’s good to be aware of that possibility.
If you have trauma, accepting that is an important yet typically a highly challenging first step. Alas, I believe that paralyzing fear stops most of severely wounded people from ever getting that far, or their acceptance wavers depending on which part currently holds the reins. Accepting the presence of trauma means accepting there are things that could be very differently — that authentic connection to both yourself and the external world is possible.
