A flight to health: When defence mechanisms take hold

A complicating factor of therapy is that often what brings you to therapy are the very same things that make you not want to be in therapy. Whether you’re at the beginning of your journey or have been engaged in therapy for some time, the process naturally involves ambivalence and moments of resistance. This article explores one of these phenomena: the flight to health.

Ambivalence is Part of Therapy

Therapy involves coming into contact with painful emotional states such as anxiety, shame, sadness, vulnerability, anger, uncertainty and conflict. While you are working through these feelings in therapy, defence mechanisms may be operating in the background and, unbeknownst to you, are trying to get rid of your unwanted feelings. The nature of therapy is therefore conflicted, it naturally involves ambivalence and some of the time (or even all of the time) you may have one foot in the consulting room and one foot out the door.

What is a Flight to Health?

A flight to health refers to a phenomenon in therapy that occurs when defence mechanisms have taken hold and you experience a spontaneous recovery. In this state, the problems that brought you to therapy appear to vanish, issues seemingly resolve, you may be convinced you feel better, you’re thankful therapy has worked, you believe you no longer need your therapist anymore and life is good now. By seizing recovery, any further contact with uncomfortable emotions can be put out of mind.

When a Flight to Health is Likely

Certain situations can make a flight to health more likely. These include:

• Periods of celebration or relief: Holidays, the arrival of pleasant weather or the end of a crisis can make it seem as though problems are resolved.

• Early stages of therapy: When the realities of addressing problems set in, the resulting anxiety might feel intolerable.

• Overwhelming sessions or phases in therapy: Working through a trauma or experiencing intense feelings (i.e., too positive or too negative) toward your therapist can bring about a retreat into apparent recovery.

• Breaks in therapy: When you or your therapist take a break, the disruption can stir up mixed feelings and create space for defences to creep in.

Bringing Unconscious Process to Awareness in Therapy

Defence mechanisms operate beyond conscious awareness, making them hard to navigate alone. Therapy helps you safely engage with the uncomfortable emotions these defences mask. When ambivalence arises, discussing it with your therapist allows it to be thought about and understood, making it a meaningful part of your therapeutic work.

December 2024