The # 1 Reason My Clients Seek Therapy

Updated: Sep 5

Typically, when a client reaches out for therapy, they want to address things like anxiety, depression, and relationship challenges. A therapist agrees to see the client, and they begin to address and treat the symptoms. This is all good and fine, and yet, often times, the root cause of those symptoms goes unnoticed and unspoken. As a licensed psychotherapist, a large percentage of my clients are having breakthroughs both in their understanding of why they feel this way, but how to go about addressing it, and healing that root cause.


The root cause? Core needs. What happens when a child doesn't get their core needs met? Do healthy adults relationships also require these needs to be met (answer: yes)? What are these core needs?


As early as six months, the right hemisphere of the brain begins the threat vs. safety wiring that will be hardwired into adulthood. If core needs are met, safety is wired. If these needs aren't met, the right hemisphere will be wired to be on the constant lookout for threat, relationships won't feel safe, and a confident/authentic self may not develop. Read on.



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1) The first need is Safety. This is in many ways a proximity thing. Are my caregivers (parents) nearby? Are they consistently around? Are they reliably monitoring me? If the child senses that the answer is yes, we develop what Bowlby called 'a secure base.' This means feeling the freedom to venture away from out parent's watchful eye, to go explore, and take risks, knowing we have a secure base to return to. This leads to what we often call a 'secure attachment style' which is a vital ingredient for healthy relationships and a healthy sense of self. As an adult, the person with a secure attachment style can self-soothe, process difficult emotions, and identify/express their needs.


If the secure base is not established, the child may develop an 'anxious' or 'avoidant' attachment style. The anxious become preoccupied with the parents whereabouts and feels nervous the parent may leave, and when the parent does eventually leave, and returns, the anxious child doesn't feel soothed and comforted upon their return. This is because the consistency and reliability hasn't been established and the threat of being left or abandoned is always there. In adult relationships, this is acted out in the same ways with their partner.


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The avoidant child learns to disconnect or numb him/herself from the core need, because it's not effective or safe to have that need. So instead the child gets lost in toys and becomes uninterested in the parents. This child grows up to be fiercely independent, afraid to ask for help, not connected to his/her body and emotions, and is not comfortable with being vulnerable. Intimacy can feel threatening and because they had to disconnect from difficult emotions, they may also not be connected to pleasant emotions, which can result in anhedonia or depression.


2) The second need is Empathy/Understanding. This means being seen and understood by a parent. They mirror back our emotions to us. This let's us know that it's ok not only to have this emotion, but it's safe/normal to have it, and also, this is what we can do with the emotion to heal it/feel better.


The opposite of having this need met is the parent who is stressed, or emotionally not available in whatever way, or is just simply not capable of attending to one or all of a child's difficult emotions. If a parent doesn't have the ability to be present with and tolerate their child's emotions (or even certain parts of the child's personality), then the child must repress, swallow, and disconnect from that emotions, because it's not safe to have it! Imagine being a spontaneous, excited or creative child, expressing that, and then being shamed for it. Do you think the child stays connected to that part of themselves? Or would it make more sense for them to repress and disconnect from it, so that they can feel safe with that parent?





3) Soothed. This is less done by language and more done with attunement and compassion. When a child is distressed, they need to be soothed! A gentle touch on their thigh, an arm around their shoulder. Anything that lets that little one know you feel them, and you're here for them. This settles the nervous system, and deactivates Cortisol, a stress hormone. When a little kid doesn't get consistently soothed, Cortisol doesn't deactivate, the nervous system doesn't settle, and the foundation for anxiety has been laid.


4) Lastly, we need to feel Appreciated: the parent recognizes and validates our inner world and our struggles. They normalize our challenges and validate our experience. They also celebrate our successes! Even minor wins are appreciated. They delight in the child's accomplishments.



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So what does all this mean? As little people, when these needs aren't met, the message that the child internalizes is: There must be something wrong with me. Of course, this message doesn't take the shape of an actual thought in the child. It's a felt experience:


If my mom/dad doesn't want to soothe, appreciate, and be there for me, there must be something wrong with me.


If they get angry when I express creativity and spontaneity, there must be something wrong with creativity and spontaneity, so I should bury that impulse.


If they can't tolerate my sadness or excitement, I better repress that, as it's not safe to express it.

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In order to survive (feel safe in the relationship), the child disconnects from these needs, swallows feelings that aren't approved of, and learns to jump through hoops. We call this abandoning authenticity for attachment (the relationship).


Core shame results when authenticity is buried and emotions haven't been integrated (we didn't learn how to have a difficult emotion, feel safe having it, and knowing how to work with it).


A false self may emerge which can look like people pleasing, avoiding conflict, a lack of boundaries, and not expressing one's needs.


Lastly, the sympathetic (flight/fight) branch of the nervous system, and Cortisol and other stress hormones get turn on and stuck in 'on' mode.


So the anxiety or depression that you have grown up with, the relationship drama, the shame, the lack of boundaries, and the feeling of just not being good enough all can be connected to some of these core needs not being met.


The good news is there is path toward healing, reconnecting with your authenticity, and feeling whole again.


For a deeper dive, check out this article on attachment wounds.


I'm a licensed psychotherapist (similar to a psychologist) in Vietnam and I'm happy to provide free, valuable content.


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Nervous System 2.0