How emotional pain is transformed into psychological injury and expressed as symptomology

1. Demetrios Peratsakis, LPC, ACS

2. “Anxiety, and its many expressions of fear –dread, panic, worry, hesitation, and depression, including such states as sadness, remorse,
grief, despair, and despondency, are affective conditions fueled by guilt and shame. Because guilt and shame are rooted in the opinion of
others, a corresponding sense of anger and resentment occurs at the perceived injustice or critique; Guilt, Anger and Shame (GASh)
corkscrew into a repetitive cycle called rumination. This may deepen into unexpressed rage, manifested as depression or anxiety --chronic
or pervasive sorrow or distress.
The root cause of emotional pain is the hurt caused by various forms of Trauma, Loss or Betrayal. Unresolved, the ensuing damage, or
psychological injury, is a degree of harm to one’s sense of self in relation to others --their self-esteem, trust, intimacy, power and feelings
of worth. Symptoms may develop as a means to gain or re-gain control, to stabilize and reorganize the individual and their relationships.
As such, they accumulate meaning and power, the ability to influence outcome toward one’s favor. Over time, the behaviors may concretize
into established transactional patterns or habits (symptoms) that become rigid and resistant to change. As psychotherapists, we are
concerned when these become problematic and serve as a means of controlling, perhaps even punishing others, or as a method, often
socially acceptable, of excusing or avoiding responsibility for change.”
– Demetrios Peratsakis, LPC, ACS, 2017

3. Emotional Pain
Trauma
(fear)
Loss
(sorrow)
Betrayal
(anger)
Psychological Injury
Injury to self-esteem, trust, intimacy, power and worth
Guilt
(I am bad/wrong)
Anger
(I resent them)
Shame
(I am less than)
Primary Symptoms
Adaptive protection against further injury
Depression
(Unexpressed Rage)
Anxiety
(Unexpressed Rage)
Demetrios Peratsakis, LPC, ACS © 2016