The Burial and Resurrection of Sigmund Freud—The Impact of Ignoring Emotional Repression in Therapy
Emotional repression has been increasingly recognized as a significant factor contributing to various forms of suffering, including mental health issues and chronic physical conditions. Freud's fundamental conclusion was that emotional repression produces suffering. He posited that unresolved conflicts from childhood could manifest in various psychological issues. While many evidence-based therapies have successfully helped individuals manage specific conditions, a critical question arises: How do we define "helping" someone? If a therapy provides temporary relief from anxiety, for instance, it might be measured as a successful outcome. However, if that relief only addresses conscious thoughts, feelings, or behaviors without delving deeper into the underlying emotional conflicts, then the effectiveness of that therapy can be called into question.
After much criticism of Freud's work, modern science confirms his basic conclusion regarding emotional repression being a major contributing factor to many forms of suffering. Research supports the notion that buried emotions can create anxiety and other mental health challenges. Studies, such as Gratz and Roemer's work on emotion regulation, highlight how difficulties in processing emotions can lead to substance use disorders and other psychological issues. Similarly, Gatchel demonstrated that emotional factors play a crucial role in the development of chronic pain, indicating that unresolved emotional conflicts can manifest physically over time. These findings underscore the importance of exploring deeper emotional issues rather than merely treating surface symptoms, reinforcing the need for therapies that address the root causes of suffering, which often lie in emotional repression.
The importance of depth work in therapy is becoming increasingly recognized. For example, Martin reviewed the therapeutic alliance's role in treating depression, emphasizing that understanding and processing emotions within the therapeutic relationship can lead to better outcomes. This suggests that therapies incorporating depth work can provide more comprehensive relief, addressing not just the symptoms of anxiety but also the root causes stemming from repressed emotions. Moreover, the connection between emotional repression and addiction illustrates the broader implications of neglecting to address underlying emotional issues. Miller and Smith found that individuals with higher levels of emotional repression were at greater risk for substance use problems, reinforcing the idea that surface-level interventions may overlook deeper issues contributing to a range of mental health struggles. Aldao further supported this by summarizing evidence linking repressive coping strategies to various health problems, including both mental health disorders and chronic physical conditions, highlighting the critical need for thorough emotional processing in therapeutic settings.
The history of therapies following Freud is rich and varied, often responding to or critiquing his ideas. Behavior therapy, emerging between the 1920s and 1950s, was shaped by pioneers like B.F. Skinner and Ivan Pavlov. This approach focused on observable behaviors, emphasizing that actions could be learned and modified through rewards and punishments, thus shifting attention from internal thoughts to measurable external behaviors. While this method offered practical techniques for behavior modification, it often sidestepped the deeper emotional issues highlighted by Freud, neglecting the emotional repression that underlies not only mental health challenges but many other forms of suffering.
Humanistic therapy, developed in the 1940s to 1960s by figures such as Carl Rogers and Abraham Maslow, sought to promote personal growth and self-acceptance, reacting against Freud's more negative view of human nature. It created a safe environment for clients to explore their emotions, valuing personal experience and feelings. However, even this approach sometimes fell short of fully addressing the root causes of emotional distress by focusing primarily on personal growth without adequately processing underlying repressed feelings.
Cognitive therapy, which gained prominence in the 1960s and 1970s through the work of Aaron Beck, taught individuals to change negative thought patterns that lead to distress. This approach marked a shift from examining unconscious drives to focusing on conscious thoughts, offering a structured and practical method for improving mental health. While cognitive therapy has proven effective, it, too, may neglect the deeper emotional processing necessary for lasting healing, leaving many unresolved issues that contribute to ongoing suffering.
Meanwhile, psychodynamic therapy, which evolved from Freud's original theories, has continued to adapt since the 1960s by focusing on relationships and social factors rather than solely on sexual repression. This modern adaptation retains some core Freudian ideas while broadening the emotional landscape explored in therapy; yet it still risks becoming too focused on surface-level dynamics without addressing the underlying repression that Freud emphasized.
In recent years, trauma-informed therapy has emerged as a critical approach, particularly since the 2010s, with contributions from figures like Bessel van der Kolk. Highlighted in his influential book The Body Keeps the Score, this therapy emphasizes the impact of trauma on mental health, recognizing that unresolved emotional issues, including repression, often stem from traumatic experiences. It addresses the limitations of Freud's focus on the unconscious by providing evidence that trauma can manifest in both physical and emotional symptoms, reinforcing the need for therapies that explore buried emotions to foster recovery and healing. Certain techniques within trauma-informed therapy specifically target these buried emotions, making them distinct from other approaches.
Currently, a trend toward integrative approaches is evident, combining various methods to address emotional regulation and nervous system health. There is a growing recognition of the importance of mindfulness and somatic practices alongside traditional talk therapies. Evidence-based practices are increasingly prioritized, with a focus on measurable outcomes and scientific validation. Cognitive Behavioral Therapy (CBT), supported by over 1,000 studies, and Dialectical Behavior Therapy (DBT), particularly effective for borderline personality disorder, are notable examples of therapies grounded in research. Trauma-informed approaches are also gaining traction, especially concerning PTSD and anxiety, bolstered by a strong evidence base.
In conclusion, while many evidence-based therapies that emerged after Freud have proven effective in providing relief from specific conditions, they often operate at a conscious level, addressing thoughts, feelings, and behaviors without adequately processing the deeper emotional repression that underlies not only mental health challenges but many other forms of suffering. This oversight risks leaving individuals with only temporary fixes rather than truly resolving the root causes of their distress. What stops someone from developing chronic pain or even cancer later in their life from the same emotional repression that created the anxiety? The very anxiety that the therapist helped them address may leave them with a false sense of resolution, as they may have only managed the symptoms of their emotional repression rather than achieving a true and lasting resolution. This underscores the critical need for therapeutic practices that prioritize deeper emotional processing, enabling individuals to confront and heal from the buried emotions that are essential to achieving lasting well-being and comprehensive mental health.
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Scott Kiloby is the author of seven books on non-dual awakening, an attorney, and a former registered California addiction specialist, as well as the co-developer of KI Emotional Repression Inquiry, a transformative spiritual practice that addresses emotional repression within an awareness-based context. To learn more about KI, visit kiloby.com.
Scott Kiloby trains therapists and other licensed health care professionals in KI. To be mentored/trained in KI or to collaborate with the co-developers of KI, email support@kiloby.com.
Disclaimer:
Scott Kiloby is not a therapist, doctor, or current licensed healthcare professional. KI Emotional Repression Inquiry is not therapy or medicine. The mentors and trainers of KI do not diagnose or treat any health conditions.
Some citations or references in this blog may have been generated with the assistance of AI tools. While we strive for accuracy and integrity in all our content, we encourage readers to verify sources independently when needed. If you spot anything that seems off or requires clarification, feel free to reach out.
References
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–23771.
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133(4), 581–624. https://doi.org/10.1037/0033-2909.133.4.581
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41-54 1 3.
Martin, D.J., Garske, J.P. and Davis, M.K. (2000). 'Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review', Journal of Consulting and Clinical Psychology, 68(3), pp. 438–450.
Miller, P. M., Smith, G.T., &Goldman, M. S. (1990). Emergence of alcohol expectancies in childhood. Journal of Studies on Alcohol, 51, 343-349.
Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking 24.
