Sometimes people come in with some awareness of these experiences and sometimes the impact is under appreciated or even out of awareness. The goal is not to dwell on the past but to empathically understand it in order to grow beyond it. Early experiences become deeply embedded in our psyche and even in our brain structure. What we may have experienced as traumatic or depriving when we were at our most vulnerable has had an impact on our self-esteem, on our perception of self and others, and how we approach and maintain relationships. Basic interpersonal dynamics such as trust, love, dependency, anger and sexuality become shaped by these contexts. We learn to adapt and survive by unknowingly developing coping mechanisms that become part of our personalities, both for better and for worse. On the one hand, we might become keenly sensitive to others, which can make us excellent friends, lovers and workers. On the other hand, that same dynamic when taken too far can make us self-doubtful,  self-neglecting, afraid, even withdrawn and resentful.

The work of psychotherapy is the understanding and working through these patterns that were once adaptive but have gone too far and are now interfering in life in one way or another. It is these maladaptive patterns that can make us avoid, push away, escape, blow up, underachieve, develop addictions, or self-sabotage in one manner or another. These dynamics come alive in the therapeutic relationship, allowing for greater insight, compassion, and understanding. In addition to exposing these patterns for greater understanding, the therapeutic relationship becomes a vehicle in which new and healthier patterns can emerge and be tested out in order to expand and add greater flexibility to how we handle situations that may trigger what was formerly a traumatic situation (e.g. feeling vulnerable). This can lead to a greater sense of happiness and fulfillment in all areas of life.