Acting Out

Managing emotional pain and conflicts

Rev. Sheri Heller, LCSW, RSW
Invisible Illness
Published in
6 min readMar 20, 2024


“Ego is something that you come to know — something that you befriend by not acting out or by repressing all the feelings that you feel,” ~ Pema Chodrin

Born into a family plagued by mental illness and generational abuse and trauma largely determined my life’s trajectory. That said, adolescence, a typically stormy stage of individuation, was all the more exacerbated by the numerous core injuries that culminated in self-hatred and consuming fears. Needless to say, my hollow nihilistic persona did not yield positive results. In fact, I was rapidly going down a rabbit hole of addiction and dissociation.

Having few life skills and beset by insatiable unmet needs and complex trauma was a sure formula for destructive acting out, a psychological concept descriptive of expressing unconscious emotional conflicts or feelings through behavior, rather than through conscious reflection or verbal communication.

Many years later when the dark forces of despair and alienation diminished and I was emotionally regulated and safely ensconced in a relatively satisfying mainstream life, I took a position as a treatment supervisor at an alternative high school for at-risk youth. I knew full well that even stable teenagers experienced intense physical, emotional and social changes, struggle with identity formation and pressures to conform to social norms while asserting autonomy. That being the case, I correctly presumed that this naturally turbulent developmental stage would be exponentially magnified for these teens who were plagued by systemic abuse and devoid of essential familial supports.

Witnessing their aggressive defiance, lawlessness and unrestrained drug and alcohol use underscored the psychological distress and unresolved issues I grappled with in adolescence. My awakened identification and familiarity evoked memories of wandering the streets of NYC at all hours, promiscuous escapades, and drugs. Lots of drugs, along with dancing the night away at new wave punk clubs. Like myself, these kids were acting out their desperate need for love and help.

Similar to toddlers who epitomize the moniker ‘the terrible twos’, adolescents and adults who struggle with managing their frustrations and disappointments are prone to acting out their emotional conflicts. When life’s unfairness ignites profound feelings of dissatisfaction and unbearable conditions are exacerbated by the absence of agency, a loss of control foments righteous rebellion and indignation. Within this framework the need for healthy containment and the task of individuation is often perceived as antithetical to the quest for freedom and power. Likewise, decorum and mores are regarded as oppressive boundaries and despotic discipline.

When one’s will is squelched, condemned, or unrestricted due to lack of appropriate discipline and life skills, dealing with turmoil through acting out is bound to happen.

Founder of psychoanalysis Sigmund Freud, wrote an essay (1914) Remembering, Repeating & Working-Through in which he elaborated on the concept of acting out as a behavioral form of resistance in a therapy patient (Dora). Freud clarified, rather than verbally communicating dissent, the client dramatizes conflict through sundry forms of noncompliance, such as memory blocks, defiance or abruptly terminating treatment. This limited interpretation eventually became reformulated as enactment ; nonverbal behaviors aroused by a dynamic interplay between a patient and therapist.

In the real world outside of the therapeutic container, discharging emotions fraught with unconscious strife through unruly behavior is a common occurrence. No one is exempt from behaving in impulsive, disruptive, or aggressive ways. However, when these behaviors obfuscate the emotional or psychological issues underlying one’s conduct, acting out has set in.

Instances of acting out can vary widely depending on the individual and the specific circumstances. Openly defying authority may be an indirect expression of feeling unfairly subjugated. Those who are highly sensitive to rejection might act out their relational fears by deliberately pushing others away. For folks afflicted with traumatic histories, acting out unexpressed sexual abuse or dissociative numbness through cutting can offer a temporary release from unbearable emotional states.

As a survivor and clinician of complex trauma, I’m familiar with an elaborate form of acting out known as the repetition compulsion. Simply put, the repetition compulsion involves repeatedly re-enacting unresolved traumatic material from earlier life experiences. Symbolically or literally enacting a detrimental event from the past is subconsciously fueled by the wish to master the original trauma in the present.

Unfortunately, this psychological pattern is a set-up for disaster, as the survivor of traumatic abuse cannot ‘fix’ or nullify victimization. Nevertheless, the trauma survivor who is stuck in time is subconsciously driven to gain a sense of control over heinous brutality, by exposing oneself to people and situations reminiscent of past traumas.

Dismantling the repetition compulsion and curtailing cyclical enactments involves a massive re-wiring of deeply imprinted patterns and beliefs. Challenged to differentiate the past from the present so as to sufficiently process and reframe a history of systemic victimization is a complicated and arduous task. It requires confronting a level of despair that would have shattered the victim in childhood. It also necessitates coming to terms with what the traumas led the survivor to do under extreme circumstances.

As psychiatrist and pioneer of trauma disorder studies Judith Herman, imparted, “trauma resolves only when the survivor develops a new mental ‘schema’ for understanding what has happened.”

Photo by Kyle Cleveland on Unsplash

Ultimately, persistent acting out puts a strain on relationships, career and academic ambitions, self-esteem, mental and physical health and even safety. Acting out through severe risk taking and impulsivity such as reckless driving, substance abuse, or impulsive spending can incur calamitous consequences. Likewise, acting out through lawless behavior such as theft or violence, can result in incarceration.

Since acting out behaviors such as physical or verbal violence, vandalism, aggressive opposition, attention seeking behaviors, self-harm, substance abuse and sexual compulsivity, stem from underlying emotional issues, such as unresolved trauma, anxiety, depression, or difficulty regulating emotions, it’s imperative to address and understand the underlying root causes of acting out behaviors in order to promote healthier coping strategies and emotional well-being.

Exhuming the unconscious motivations and mindfully articulating a comprehensive understanding of these complex urges can lead to cultivating constructive expression that is purposeful and creative. By identifying meaningful outlets for expressing underlying emotions and issues in a safe and controlled manner, mature and beneficial ways of channeling powerful impulses can result.

Referred to as sublimation, the transferring of problematic primitive urges into life affirming pursuits allows individuals to find socially acceptable ways to deal with their impulses, rather than repressing them or acting on them in destructive ways. For example, someone with aggressive tendencies might channel their aggression into competitive sports, while another person with sexual compulsivity might express themselves through artistic endeavors or intellectual pursuits and problem-solving. A person struggling with loneliness might divert their energy from self medicating with substances to engaging in community service or volunteer work. By helping others, they can satisfy their underlying impulses in a way that benefits society.

Redirecting inner conflicts, harmful behaviors and challenging emotions and desires through sublimation assists with attaining optimal functioning. Harnessing the energy of one’s inner state and conflictual emotional material into elevated pursuits transmutes destructive primal urges into activities and ventures that enhance one’s life and benefits others.

Thinking back to when I was steeped in acting out the tyranny of my existence is rife with sadness and regret. Yet who I was beyond the garish hollow personae I embodied, eluded me. Still, I knew this much. I wasn’t ready to die, nor could I live the way I was. In an attempt to save myself, I eventually committed to getting a job, enrolling in a city university, and finding a therapist.

Now, what I used to judge as recklessly perilous choices, in hindsight I view as glimmers of determination. One such glimmer morphed into a life-changing event. At sixteen I came upon an opportunity to convince a Rabbi to scholarship me to visit Israel for the summer. I seized it with zeal. Naturally, I was exiled from the yeshiva and kibbutzim for being ‘irreverent’. Hence, I spent two months backpacking with a fellow troubled teen. That initiation into travel ignited a wanderlust that would be reawakened in the unforeseen future.

Siphoning my damaging impulses and behaviors into positive academic endeavors, travel and trauma informed treatment proffered hope and a pathway towards healing and growth. It affirmed that although it is inevitable in life that sadness, anger and loss are aroused when desires and expectations clash with harsh reality, how we choose to respond can make or break us.



Rev. Sheri Heller, LCSW, RSW
Invisible Illness

Complex trauma clinician and writer. Survivor turned thriver, with a love for world travel, the arts and nature. I think outside the box.