Hi Healme:
I can certainly relate to the feeling of stuff in my life being good and going well and yet my feeling not good or well inside. I have felt guilt too, for not enjoying life and being happy, when I *should* (because others are certainly suffering in the world and what right do I have to feel sad...kind of thinking).
It didn't feel like dying inside to me but sort of like I was infected. And it's big work to pick out all the slimey puss and flush my insides clean. (

ooooooooo. that was a bit too graphic maybe?)
The good news is.......there are antibiotics!! I don't take meds but I think of sharing here and reading and learning as a kind of medication. So is therapy (wonderful that you are going!! ).......which comes in many forms. And the puss is similar to bad thinking and feeling awful where the effect of the *antibiotics* stops the infection and kills the bugs that cause it (which are for me......thoughts and the feelings that surface from those thoughts).
I hope you T and the people here will be your *antibiotics* and that soon you will be healing well.
As to running away from intimacy? I think it's a way of avoiding loss. If you don't get too close it won't hurt when that closeness is withdrawn (and the loss will be very little, if any). Also, feeling worthless predicts that the person we are intimate with will withdraw once they discover how worthless we are (which I bet is all unconscious belief). Also, uncovering stuff is a scary and painful process which does not feel usual and thus stimulates that instinctive fear and desire to protect ourselves by getting away from the danger (get away from exposing our deepest stuff.......which brings us closer to whoever we're exposing it to.........which again........requires the risk of losing that closeness and thus......the usual way to cope is to run away and avoid all that potential pain).
Am I soundling all know it ally yet?
For me.......that's what's it like. For you....it may be similar or quite different. Just thought I'd post my thoughts for you to ponder or discard.
If people you've trusted and become close to have withdrawn from you......or even if you have an unconscious belief that that will likely happen (because you feel worthless......and may not be aware of that either)..........then you might run away from intimacy quick as can be.
So maybe.......the way to change might be to destroy those feelings of worthlessness (which have to be uncovered first) and next, replace them with a pricetag that cannot be marked down, which begins by thinking and deciding to believe in one's own value?
The good news is.......it can happen. (((((((((Healme))))))))))
Hope this helps a little.

Sela