When I see clients in my practice, more often than not, they are looking to eliminate something painful in their lives – anxiety, depression, conflict, rage, physical and emotional pain, shame. Understandably, they want to be rid of things in their inner emotional world and in their relationships that leave them feeling discomfort and cause suffering for themselves and those in their lives. It’s a wish that makes sense – to want to be rid of something that we experience as painful and harmful.

Unfortunately, eradicating deeply entrenched patterns in our psyche and bodies is extremely challenging. We have years of practicing cycles and patterns that don’t help us. And while most of us entered into these patterns honestly – that is, we are products of our upbringing, environment, and nervous systems, things we did not choose for ourselves and cannot change – it does not mean we are sentenced to a lifetime of these patterns having power over us.

So, what leads to meaningful change? What is the path to healing?

I cannot underscore enough how individualized and personal each person’s healing journey is – I do not believe there is a one-size-fits-all approach. But I do believe there are two core factors that can profoundly shift our relationship to our pain and promote true healing.

1. Expansion and addition
Instead of seeking to rid yourself of your problem, ask what can be added that offers a more helpful outlet. It rarely works to say, “I’m just going to not be anxious,” when you’ve lived years with anxiety. But can you add compassion and mindfulness practices, yoga or meditation, journaling, mantras, or a regimented plan to sit with what leads to the anxiety?

When we add something new—when we gently expand into unfamiliar but supportive territory—we widen our menu of choices. In challenging moments, we can move into the anxiety, the rage, the pain, or we now have other go-tos. It’s not pathological to return to old routes of soothing when they are the only map we’ve had. Most people do not want to engage in painful behaviors; they just feel hopeless, and the pattern has become automatic. To interrupt automatic patterns, our brains and bodies need more healthy, effective options.

2. Address the shame
Shame is universal, but when we get stuck in it, it immobilizes us. When we become consumed with shame about our shortcomings, we move further away from doing the very work that could help us heal.

(Side bar – it’s really obnoxious when your therapist says things you already know to be true and literally spend your career identifying with others… but alas, turning inward and applying to ourselves the skills we offer others is tough work.)

Shame can be a colossal force. Defensive shame, in particular, keeps others out and restricts our access to our own healing. We cannot and will not heal if we cannot face our shame—our limitations, our errors, our humanness. We cannot make meaningful, authentic repair with others when we are drowning in shame. It simply isn’t possible. So name the shame. Call it out when it’s there. When we name the beast we’re up against, we gain clarity about how to meet it and move through it.

Healing rarely comes from erasure; it comes from expansion.

By adding what nurtures us and by deepening access to the core of who we wish to be in our lives and what we want to cultivate, rather than fixating on what we wish to eliminate, and by facing shame head-on rather than hiding from it, we create the internal space needed for change. This is not a fast process, nor an easy one. But it is a deeply human one—and with solid support, curiosity, and compassion, it is absolutely possible.