In the course of healthy development, a child learns that he or she is loved, lovable and worthwhile when responded to by capable caretakers.  Children require caregivers who can identify and nurture needs as well as recognize intention.  In this optimal environment children develop confidence, a positive sense of self, become securely attached and capable of forming healthy relationships. 

When the environment is less than optimal, when it is fraught with trauma, abuse or neglect, development is impaired.  Children grow up feeling like they are not worthwhile, being unaware of their own needs, feeling ashamed of and unable to attend to their own needs, and they have difficulties finding or sustaining positive relationships.

The process of psychotherapy aims to create an environment where unmet needs are discovered and understood from the patient's point of view.  It is a process of creating a healthy relationship.  When we are responded to with empathy, understanding and acceptance, we become empathic, understanding and accepting towards ourselves and others.