The answer can be understood as follows: when a person receives support, a sense of unworthiness may awaken within them, triggered by an inner voice that reminds them of past mistakes or shortcomings.

The Unworthiness Paradox: The Conflict of Love and Guilt

The answer can be understood as follows: when a person receives support, a sense of unworthiness may awaken within them, triggered by an inner voice that reminds them of past mistakes or shortcomings. This leads to an emotional conflict: on one hand, the person feels the love and kindness of those around them, and on the other, they internally believe they do not deserve such care. As a result, they not only fail to reciprocate with gratitude, but often even push away the help they receive.

As described in one of the sources:
"If a person has done something bad and concealed it from their parents, some part of their being feels that they are unworthy of parental love. Even if the parents love the child, admire them, support them, and acknowledge their successes, the faint inner voice tells the child: 'Yes, yes, however, if you knew what I did, you wouldn't say that.' This feeling of being unworthy of good treatment leads the child to repel the love and support their parents offer." (source: link txt)

Thus, an internal conflict arises when positive external stimuli (support, love) clash with an inner feeling of guilt or unworthiness, which complicates the proper expression of gratitude.

Supporting citation(s):
"If a person has done something bad and concealed it from their parents, some part of their being feels that they are unworthy of parental love. Even if the parents love the child, admire them, support them, and acknowledge their successes, the faint inner voice tells the child: 'Yes, yes, however, if you knew what I did, you wouldn't say that.' This feeling of being unworthy of good treatment leads the child to repel the love and support their parents offer." (source: link txt)