People often tell me during our initial conversation that ‘nothing terrible happened’. Their childhood wasn’t obviously abusive. They weren’t physically harmed. Their parents probably did the best they could with what they knew. From the outside, their family seemed perfectly ordinary.
Yet, despite growing up in what looked like a loving family, something has never felt quite right. If this feels familiar, perhaps you’ve carried a persistent sense that you’re somehow too much, or not enough. Maybe you find it difficult to trust people, even those who’ve given you no reason to doubt them. You might exhaust yourself trying to meet everyone else’s needs while remaining strangely disconnected from your own. Or perhaps you find yourself feeling anxious, hypervigilant, ashamed or emotionally overwhelmed in situations that don’t seem, objectively, to warrant such a strong reaction. From the outside, you may look entirely capable, even enviably successful: the one who always delivers, who everyone assumes has it all together.
You may have wondered whether you’re simply too sensitive, or whether you’re making a mountain out of a molehill. Neither of those conclusions is likely to be true. Sometimes what shapes us most isn’t what happened on one particular day. It’s what happened, or failed to happen, over thousands of ordinary days.
One of the assumptions that underpins my work as a relational integrative psychotherapist is that people make sense. Even the patterns that now cause suffering usually began as intelligent and resourceful adaptations to relationships over which we had very little control.
How early relationships shape who we become
We arrive in the world entirely dependent upon other people. Long before we have language, our nervous system is learning what relationships feel like, what it’s like to be us, and what to expect from the world. Allan Schore’s (2021) work in relational neuroscience has demonstrated that our earliest relationships don’t simply influence what we think about ourselves; they help shape how we experience ourselves in the first place.
Psychologists sometimes describe these experiences in terms of attachment. Whether our earliest relationships feel consistently safe, responsive and emotionally available has a profound influence on how we later experience ourselves and other people.
Children don’t simply remember relationships. They are formed by them. As children, our inner world is shaped by what happens when we need comfort, when we express anger, when we’re joyful, when we disappoint someone, when we’re frightened, or when we need help. These countless interactions gradually become embodied expectations about our selves, about other people, and about what relationships are like.
When you were distressed, did someone come? If you were frightened, was there someone who helped you to feel safe? When you were excited or curious, was there someone who delighted in sharing that experience with you? Could you freely express your feelings, or did you learn that some emotions were welcome while others needed to be hidden? Was it safe to be fully yourself?
Of course, these aren’t questions a baby consciously asks. You may not even know how to answer them now. But over time, our nervous systems develop patterns of response to whether our fundamental relational needs, as Richard Erskine (1998) describes them, are met. We begin to anticipate how other people are likely to respond to us and, just as importantly, who we’re allowed to be in relationship with them.
Why good enough parenting is enough
When our earliest relationships are sufficiently attuned and responsive, we gradually develop an internal sense that our feelings make sense, that our needs matter, and that other people can generally be trusted.
Note that I said sufficiently, not perfectly, attuned. None of us experiences perfect parenting. Nor do we need to. Donald Winnicott’s (1971) idea of the good enough parent remains influential because it recognises that healthy development doesn’t require perfection. Children don’t need perfect parents. They need relationships that are sufficiently safe, responsive and emotionally attuned for healthy development, and which offer opportunities for repair after inevitable misunderstandings.
Sometimes, however, those experiences are repeatedly missing. This is not necessarily because our caregivers intended harm or didn’t care about us, but because they themselves were overwhelmed, emotionally unavailable, struggling with unresolved trauma, mental ill-health, chronic stress, neurodivergence, addiction, poverty, or simply because nobody had ever met those needs for them either.
Children adapt to the relationships they have, not the relationships they need. Those adaptations are often extraordinarily intelligent.
We become who we needed to become
Children cannot choose different parents. Nor can they simply decide to stop needing them. Instead, they adapt in whatever ways allow them to preserve the relationships upon which their survival depends. Those adaptations made perfect sense at the time.
A child who learns not to ask for comfort may become fiercely independent. A child who constantly monitors the emotional atmosphere at home may grow into an adult who is exceptionally perceptive and caring, or one who remains permanently alert to signs that something is about to go wrong. A child whose feelings are repeatedly dismissed may gradually lose touch with them altogether or learn that only certain emotions are safe to express. These strategies weren’t mistakes. They were creative, resourceful responses to the emotional world available to you.
The difficulty is that adaptations developed in childhood rarely disappear simply because childhood ends. What once protected you may now leave you exhausted, disconnected from yourself, unable to trust others, or repeatedly drawn into relationships that somehow feel familiar despite causing pain. The very thing that once enabled you to survive has become something that now limits your freedom. Something similar often happens when adults receive a late ADHD diagnosis, and recognise, often with real grief, that years of exhausting effort were adaptations to a world that was never quite built for how their brain works.
From this perspective, anxiety, perfectionism, emotional withdrawal, people-pleasing, chronic self-criticism or difficulty trusting others stop looking like evidence that something is fundamentally wrong with you. Many adults who seek therapy don’t identify with stories of abuse. Instead, they recognise something subtler: experiences that today are often described as childhood emotional neglect or unmet emotional needs.
Is early relational trauma a formal diagnosis?
Early relational trauma is not itself a formal diagnosis in the way that, say, post-traumatic stress disorder (PTSD) is. Early relational trauma is a clinical framework, not a diagnostic category. It draws on attachment and development theory and on relational neuroscience, particularly Schore’s (2021) work on how early attunement and misattunement shape the developing nervous system, to describe a real and well-evidenced pattern rather than to assign a label.
However, there is a related diagnosis worth knowing about. The World Health Organization’s ICD-11 recognises Complex Post-Traumatic Stress Disorder (C-PTSD), which sits alongside PTSD but includes additional difficulties often seen after prolonged or repeated relational trauma, particularly in childhood: problems with emotional regulation, a persistently negative sense of self, and difficulty in relationships (Brewin, 2020). Not everyone whose early relationships shaped them this way would meet criteria for C-PTSD, and you don’t need to meet those criteria for the psychotherapeutic work to matter. But if you’ve come across the term and wondered whether it applies to you, this is where the two overlap.
Indeed, therapists might use various terms to describe this: as well as early relational trauma and complex PTSD, they might refer simply to complex trauma, or to attachment wounds or developmental trauma. Whatever terms are used, you don’t need any diagnosis, formal or otherwise, for what you’ve lived through and its continued impact on you to be worth understanding.
Why early relational trauma feels confusing
One of the most painful aspects of early relational trauma is that, without a clear ‘before’ and ‘after’ as there is with a single dramatic event, there’s often no obvious story to tell. It was simply the emotional environment in which you grew up. You may know people who experienced violence, neglect or abuse that seems far worse. You may even feel guilty using the word trauma at all.
But trauma isn’t a competition. Many people worry that they’re exaggerating or ‘making it up’. Others question whether therapy is justified because they know people whose childhoods were far more obviously traumatic. The question isn’t whether someone else’s childhood was more painful. The question is whether your early relationships shaped the way you came to understand yourself, your emotions and other people in ways that continue to affect your life today. If they did, they deserve to be understood.
The body remembers what words cannot
Because so much early relational experience develops before language, it’s not always available to us as an autobiographical memory. More often, it emerges in patterns of feeling, bodily responses, impulses, expectations and ways of relating. That’s why I don’t just work with the stories clients tell. I also pay attention to what their bodies are communicating. Sometimes I notice someone holding their breath while describing an apparently mundane event. I become curious about the moment a person’s shoulders soften, or when they sigh, or when they suddenly seem further away despite continuing to speak. Sometimes we notice together that an emotion is present in the room before words can be found for it. These phenomena often tell us something that language, on its own, cannot.
You may already have heard that trauma is trapped, stored, or frozen in the body and nervous system. This idea has been popularised by well known figures in the psychological professions like Bessel van der Kolk (2014) and Peter Levine (1997). You may not, however, have known what that actually feels like for you, in your own body. That’s something we can explore together.
What relational integrative psychotherapy can offer
People sometimes imagine psychotherapy means talking about the past until it finally stops hurting. But the past itself cannot be changed. The things that happened can’t be erased, and nothing either of us says in a therapy room can alter that.
What can change, however, is the impact that those experiences continue to have on your life now. Therapy offers an opportunity to become curious about the ways you protect yourself, the expectations you carry into relationships, the beliefs you’ve come to hold about yourself, and the automatic responses your body and mind have learned. Our aim is to arrive at a place where you have some choice.
In practice, I might draw on several ways of working, depending on what you bring. EMDR can help when a particular memory or experience still carries a charge that talking alone hasn’t shifted. Somatic and body-based approaches matter here too, since so much of what we’re exploring together was never stored as a narrative in the first place. As so many of these ways of being began as ways of protecting a particular part of yourself – from disappointment, from feeling too much, from not being wanted, or from something else – some of our work together might involve getting to know those ‘parts’ directly rather than only talking about them. None of this is applied as a fixed formula. It’s shaped by what you need, session by session.
Understanding yourself and how you came to be you is rarely a purely intellectual exercise. Because we’re referring to adaptations that were developed in relationship, they’re often revised in relationship too. Over time, the therapeutic relationship has the potential to become one through which you can discover, perhaps for the first time, that your experience can be received without judgement, that difficult emotions need not threaten connection, and that you needn’t respond in the old and familiar ways to remain accepted.
This doesn’t arrive all at once. Most people notice change gradually. You might begin to notice old patterns being played out while they’re happening rather than afterwards. You might discover that you can remain present with an emotion you would once have avoided. You might find yourself responding differently to someone you love without consciously forcing yourself to do so. Often these changes appear almost incidentally before we fully recognise their significance. To work safely, this process also has to proceed at a pace your nervous system can tolerate. That is as true when I integrate EMDR into our work as when I don’t. Lasting change is rarely accelerated by becoming overwhelmed.
The hope that underpins psychotherapy isn’t that we can undo childhood. We can’t. The hope lies elsewhere: our development doesn’t end with childhood. Throughout our lives our brains remain capable of forming new connections. Our nervous systems continue to adapt. New relational experiences continue to influence how we understand ourselves and other people. We cannot become the person we might have been had our early years been different. But we can continue becoming who we are.
If you’ve spent years believing that nothing significant happened to you, while carrying a persistent sense that you’re broken or defective, I hope this article has offered another way of understanding that experience. If you recognise yourself in these pages, perhaps that’s enough to begin.
Who is this for?
This work tends to suit people who are willing to be curious about ways of being that no longer serve them: ways you protect yourself, relationships that feel familiar despite the cost, the sense that you’re never quite enough. This tends to be slower, more exploratory work rather than a short course of structured sessions, so it’s a good fit for people who are ready for that pace, even if they arrive unsure of exactly what they’re looking for.
I offer a free 20 to 30-minute initial conversation so you can get a sense of whether this way of working might suit you, with no obligation to proceed beyond that.
Garthine Walker is a UKCP-registered psychotherapist based in Cardiff, offering online therapy across the UK. She specialises in trauma, attachment wounds, neurodivergence, burnout and maladaptive daydreaming.
REFERENCES
Chris R. Brewin (2020). ‘Complex Post-Traumatic Stress Disorder: A New Diagnosis in ICD-11’, BJPsych Advances, 26:3, 145–152. DOI: 10.1192/bja.2019.48.
Richard G. Erskine (1998). ‘Attunement and involvement: therapeutic responses to relational needs’, International Journal of Psychotherapy, 3:3, 235–244. DOI: 10.4324/9780429479519-3.
Peter A. Levine with Anne Frederick (1997), Waking the Tiger: Healing Trauma. North Atlantic Books.
Allan N. Schore (2021). ‘The Interpersonal Neurobiology of Intersubjectivity’, Frontiers in Psychology, 20:12. DOI: 10.3389/fpsyg.2021.648616.
Bessel van der Kolk (2014), When the Body Keeps the Score. Penguin.
Winnicott, D. W. (1971). Playing and Reality. Tavistock Publications.