Camille is a 38-year-old attorney who runs a litigation team of twelve. On paper, she is exactly as formidable as her reputation suggests. But she describes her inner life to me like this: “I can be completely fine — centered, even — and then my senior partner sends one flat email and I’m convinced I’m about to be fired. I’ll spend the next four hours mentally rehearsing the conversation where I have to defend myself. And nothing has actually happened.” Camille grew up with a mother whose approval was the barometer for everything — warmth one afternoon, cold silence the next, and no way to predict which version would be there when Camille walked in the door. Her nervous system learned a very specific skill: scan constantly, because the ground can shift at any moment. It’s a skill she didn’t need in a courtroom. It followed her there anyway.

2 ) You have challenges making, keeping, and sustaining good relationships.

With a romantic partner, with friends, with mentors and colleagues, and even the neighbor down the hallway in your apartment building who keeps making overtures for friendship. You struggle to make and keep good, healthy relationships in your life. At least in the way that you want.

And/or, you may have plenty of relationships in your life, but they don’t feel healthy. They don’t treat you well and honor your dignity and personhood. You think that the good decent partners always seem taken. You experience major ruptures with girlfriends time after time. And you always seem to end up with toxic, narcissistic bosses who remind you of your father.

It’s not uncommon for those who grow up in dysfunctional, chaotic, neglectful, or outright abusive homes to have challenges seeking out and keeping healthy, functional relationships.

After all, if you don’t grow up in a home where healthy, functional relationships were modeled and lived out, how are you supposed to magically know how to find and keep good healthy relationships in your own life once you outgrow that home?

What I see consistently in my work is that relational patterns from childhood don’t just quietly fade once you leave home. They travel with you, embedded in how your nervous system reads safety and danger in other people. John Bowlby’s attachment theory, later expanded by Mary Ainsworth’s research into secure, anxious, avoidant, and disorganized attachment styles, helps explain why this happens. If you didn’t get consistent, attuned caregiving early on, you likely developed an insecure attachment style — a relational blueprint that shapes who you’re drawn to, how much closeness you can tolerate, and what you do when conflict arrives. (PMID: 517843) (PMID: 13803480)

This is why you can know, intellectually, that a partner is treating you poorly and still find yourself unable to leave. Or why you can want closeness desperately and simultaneously push people away the moment they get too near. Or why you feel inexplicably relieved when a potential friendship doesn’t pan out — even though you’re lonely. These aren’t personality flaws. They’re attachment adaptations.

Often, as part of relational trauma recovery work, we have to unlearn and relearn what a healthy, functional relationship looks like and feels like. We have to learn, sometimes for the very first time, that conflict doesn’t have to mean abandonment, that closeness doesn’t have to mean loss of self, and that someone staying isn’t a fluke that will eventually be corrected.

3 ) You move through the world masking your lack of esteem, feeling like you’re “faking it” and like you’re about to be found out all the time.

Call it imposter syndrome. Call it faking being a grown-up. The experience of feeling like your inside experience doesn’t match up with your external actions is, to a certain extent, normal and natural.

You launch a company, or plunge into new parenthood, or find yourself in charge of managing a huge team of staff, many of whom are more seasoned and older than you… in each of these scenarios, it’s somewhat normal and natural (especially in the beginning!) to feel like you’re faking it, figuring it out as you go.

What I’m talking about is different. It’s feeling like everyone else got handed the Guidebook to Life. Except you. It’s feeling like if people really knew you and your past, they’d run away. It’s feeling like you’re never really up for what life requires and you wear a mask of confidence. But inside you feel like you’re holding it all together with proverbial paperclips and tape. Constantly belittling yourself and your abilities. Feeling like you’re not up for it, feeling like it’s all going to crumble and fall apart at any moment.

What I see underneath this, again and again, is a child who was given conditional worth — whose value was tied to performance, compliance, achievement, or emotional caretaking of adults in the household. When love and approval were contingent on being a certain way, you learned that your intrinsic self wasn’t quite enough. The “real you” had to be hidden, polished, or improved upon before it could be acceptable. That belief doesn’t automatically update when you grow up and start winning awards and running organizations.

The driven, ambitious women I work with are often the most accomplished people in the room — and the most privately convinced they don’t belong there. What looks like confidence from the outside is often a very well-rehearsed performance. And the gap between the performance and the interior experience is exhausting to maintain, year after year.

Low self-esteem, impaired self-perception, and feeling like you’re moving through the world faking everything and simply not up for what life requires can be another hallmark that you were negatively impacted by your past. If this resonates, you might also find it useful to read about childhood emotional neglect — a pattern that maps almost exactly onto this kind of invisible fraudulence.

4 ) You feel the need to escape. Often. Repeatedly.

Life feels like too much and, to take care of yourself, you developed ways of coping. Of escaping.

You escape the boredom, stress, overwhelm, strain, and emotional pain of your daily life through repetitive actions or substances, sometimes compulsively.

Binge eating and purging. Gaming for hours. Disappearing into Netflix. Three, four glasses of wine a night. Or, and here’s a slippery one: you work. A lot. Like all the time.

Whatever the escape looks like. You do it. You find yourself counting the hours until you can just escape, zone out, relax, disappear.

Again, while a certain amount of escapism is normal and natural (really, who doesn’t love Netflix?!), a telltale that this is, perhaps, indicative of unresolved issues is the degree of severity and compulsivity of the escaping.

In other words, if you feel like you don’t have choice over it, it’s a problem.

This is worth sitting with. Because many of the ambitious women I work with have a specific blind spot here — they don’t identify as someone who escapes, because their escape looks productive. They don’t drink too much; they work too much. They don’t disappear into gaming; they disappear into a packed calendar that leaves no room for stillness, for feeling, for the uncomfortable truths that would surface if they ever stopped moving. Workaholism and busyness-as-coping are socially rewarded forms of escape, which makes them especially hard to identify and address.

What all forms of escape have in common is that they serve the same function: they lower the volume on feelings that feel too big, too formless, or too dangerous to sit with. And if you grew up in a home where big feelings were unsafe — where your emotions were punished, dismissed, or simply met with no response at all — you learned, correctly, that feelings needed to be managed. Suppressed. Escaped. The coping strategies that kept you functional as a child are now running on autopilot in your adult life, often at considerable cost.

And that – that way you choose to cope with life and all its attendant hard-to-tolerate feelings and the lack of choice you have around it – may be a sign that your childhood negatively impacted you and you need more tools and skills to deepen your emotional capacity and abilities to cope with stressors. You can learn more about how the nervous system drives this in my writing on trauma and the nervous system.

5 ) You don’t know what “normal” is.

Now, let me be clear: normal is a bit of a four-letter word in therapy. There really is no “normal” insomuch as there’s no black and white single way of things being okay or not okay.

But there is a kind of “normal” in terms of what’s healthy and functional versus unhealthy and dysfunctional that folks who come from relational trauma backgrounds often fail to understand.

It’s normal for a father to scream and rage at the kids one minute and then act like nothing happened the next morning, right?

No, it’s not.

It’s normal for me to not tell him I want to be exclusive because I shouldn’t pressure him, right?

What made you think that was normal dating behavior?

It’s normal to feel super depressed at night and wonder what the point is, right?

You get the picture…

So often, when you come from adverse early beginnings, there’s a misunderstanding of what “normal” (e.g.: healthy and functional looks like). With relationships. Life expectations. Self-expectations.

What I find in my clinical work is that this normalized-dysfunction runs deep — deeper than most people realize at first. It’s not just that you tolerate things others might not. It’s that you genuinely can’t always see what you’re tolerating, because the baseline was set so early. You might not recognize that it’s not normal to feel vaguely braced for something terrible even on a good day. You might not know that most people don’t spend Sunday evenings dreading Monday with a specific quality of dread that has nothing to do with the actual workload. You might not realize that the hypervigilance you’ve always described as “just being thorough” or “just being responsible” is actually a stress response that never got to switch off.

Part of this also connects to what Judith Herman, MD, psychiatrist and author of Trauma and Recovery, identified as the fundamental distortion trauma creates: a collapse of the ordinary sense of what is safe, possible, and predictable in the world. When you grow up in a home where the rules were inconsistent, where love was unpredictable, or where chaos was the baseline, you don’t develop a clear internal template for what safety looks like. And without that template, everything can feel either fine when it isn’t, or dangerous when it isn’t either. (PMID: 22729977)

Often in relational trauma recovery work, we unpack all the maladaptive beliefs internalized from childhood and take a closer look at what “normal” actually is. We rewire your expectations and help you develop more functional, adaptive beliefs. About yourself, about others, and about the world.

What is the most important thing to bear in mind if you see yourself in these signs?

Today I shared with you five anecdotal ways that you may have been negatively affected by your childhood.

My hope is that by writing out these examples you might see yourself and your story, your personal history, with a little more clarity.

But here’s the most important thing to bear in mind.

Like I mentioned in the intro to this post, even if you didn’t see yourself in these descriptors in the same way that you don’t see yourself in the questions posed by the Kaiser ACE’s study, it’s important to remember that if even some part of you – even a small part of you – is asking the question, “Did my childhood negatively affect me?” then you already know the answer.

Trust yourself and your perception of your experience. No one else is the expert of you. Not me, not the pop psychologist on TV, not your parents, and not the deity you were told is the expert of you. Only you are the expert of you. Trust your judgment here. You already know the answer.

And knowing the answer — finally letting yourself know it — is not a catastrophe. It’s a beginning. It’s the first honest step toward building something different. Something that actually fits who you are and what you need, rather than what you learned to settle for.

What Does Healing From Childhood Impacts Actually Look Like?

I want to be honest with you about something: healing from the impacts of a difficult childhood is not a linear process, and it’s not fast. I say this not to discourage you but because I think the cultural narrative around trauma healing is often too tidy — a clear arc from wounded to whole, a finite timeline, a moment of resolution. In my work with clients over many years, I’ve found it’s much messier and much more interesting than that.

What healing actually tends to look like is: a gradual widening of your window of tolerance. More capacity to feel the full range of your experience without being flooded or shut down. Relationships that feel incrementally more trustworthy. A loosening of the grip of the inner critic. A growing ability to recognize your own patterns — not just intellectually, but in real time, as they’re happening, which is very different from understanding them in retrospect.

It also looks like grief. Real grief, often, for what you didn’t get — the childhood where someone showed you how to be in the world, the parents who were present and attuned, the adolescence where you got to be young rather than parentified or vigilant. This grief can feel counterintuitive in healing work, because it doesn’t feel like progress. But the ability to grieve what you lost is actually one of the clearest signs that healing is occurring. You can only mourn what you can now see clearly enough to know was missing.

Kira, a 39-year-old surgeon I work with, described it this way: “I spent thirty years telling myself my childhood was fine. When I finally let myself say, out loud in session, that I’d been terrified of my father — not sometimes, but regularly — I felt like the floor had opened up. I cried for a week. And then something shifted. I started being able to set limits at work that I’d never been able to set before. I started sleeping through the night for the first time in years. The grief did something the intellectual understanding never could.”

There are many evidence-based approaches that support this kind of healing. EMDR therapy works directly with the nervous system to process and integrate traumatic memories. Somatic approaches address the embodied aspects of trauma that talk therapy alone often can’t reach. Inner child work helps you access and reparent the parts of yourself that were formed in those early difficult environments. And relational trauma therapy — which addresses the core wound of relational harm through the medium of the therapeutic relationship itself — can offer, for the first time, the experience of being truly seen and held by another person without conditions.

The question isn’t whether healing is possible. In my years of clinical work, I’ve seen it happen again and again — women who came in exhausted, defended, and convinced something was fundamentally unfixable about them, who left with a capacity for their own lives that surprised them. The question is whether you’re willing to take the first step of acknowledging what you’re actually dealing with. Which is, I think, why you’re reading this post in the first place.

How can assessment-based therapy help you recognize your trauma story?

When you sit across from your therapist insisting your childhood “wasn’t that bad” while simultaneously describing emotional chaos, relationship struggles, and compulsive escaping, you’re demonstrating exactly why the question “was my childhood really that bad” needs professional exploration—because trauma survivors consistently minimize their experiences while living with profound impacts they’ve normalized as “just how life is.”

Your trauma-informed therapist understands that recognition is the first crucial step in healing. They know the Kaiser ACE study, while valuable, doesn’t capture the full spectrum of relational trauma—the emotional neglect, the parentification, the conditional love, the thousand small abandonments that don’t fit neat checkboxes but leave you feeling like a Weeble Wobble, constantly destabilized by external forces. They help you see that your struggles aren’t personal failings but predictable responses to inadequate early caregiving.

The assessment process involves exploring those five key areas: your emotional regulation (or lack thereof), your relationship patterns and repetitions, your sense of self-worth and authenticity, your coping mechanisms and their compulsivity, and your internalized beliefs about what’s “normal.” Your therapist isn’t looking for extreme abuse to validate your experience—they’re helping you connect the dots between what you experienced and how you’re struggling now.

Together, you examine specific examples: how a terse email destroys your entire evening, how you always end up with partners who remind you of your critical parent, how you can run a company but feel like a fraud, how you can’t get through an evening without three glasses of wine. Each pattern gets traced back to its origin—not to blame but to understand, not to dwell but to recognize what needs healing.

One of the most powerful aspects of this process is the naming. There’s something that shifts, neurologically and emotionally, when you move from “I’m just anxious, that’s just how I am” to “this anxiety makes complete sense given what I experienced, and it’s something I can work with.” The story changes. And when the story changes, so does your relationship to yourself.

Most importantly, therapy validates what you’ve always suspected but been afraid to claim: that your childhood did impact you, that your struggles make perfect sense given your history, and that recognizing this truth isn’t weakness or self-pity but the beginning of genuine healing. You’re not crazy for thinking something was wrong—you’re finally seeing clearly.

Here’s to healing relational trauma and creating thriving lives on solid foundations.

Warmly,

Annie

Both/And: Holding the Complexity of Your Experience

In my work with clients, I find that the most important breakthroughs happen not when someone chooses one truth over another, but when they learn to hold two seemingly contradictory truths at the same time.

You can be grateful for what you have and grieve what you didn’t get. You can love someone and acknowledge the harm they caused. You can be strong and still need help. These aren’t contradictions — they’re the texture of a fully lived life.

The driven, ambitious women I work with often struggle with this because they’ve been trained to solve problems, not sit with paradox. But healing isn’t a problem to solve. It’s a process to inhabit. And the both/and is always where the deepest growth lives.

I want to be specific about what the both/and looks like in this context, because it can feel very abstract until you hear it applied to something real. You can acknowledge that your mother was doing her best and that her best caused you harm. Both of those things can be true simultaneously, and you don’t have to choose one to invalidate the other. You can have had a materially comfortable childhood and still have been emotionally neglected in ways that shaped you profoundly. You can love your family deeply and recognize that you learned some deeply dysfunctional patterns inside of it.

What I notice is that many clients feel they have to pick. They either defend their parents — “it wasn’t that bad, they did their best” — or they condemn them, in a way that feels disloyal and wrong. The both/and offers a third path. It allows you to tell the full truth without having to flatten the complexity. And the full truth, it turns out, is almost always where healing lives. Not in the edited version that protects everyone, including you from your own grief. If you’re finding this particular reframe difficult, my post on whether privilege cancels out childhood trauma might be useful reading alongside this one.

Let me give you a concrete example of what this reframe actually does in practice. When Priya, a 44-year-old tech executive I work with, first came to see me, she described her childhood this way: “My parents worked incredibly hard. We had everything we needed. I have no right to complain.” That last sentence — I have no right to complain — was doing enormous work. It was flattening a complicated story into a single acceptable narrative. Her parents had worked incredibly hard. She did have what she needed materially. And she had also grown up emotionally parentified, responsible for managing her mother’s moods, never allowed to have needs of her own, and chronically afraid that any sign of difficulty would be a burden. Both things were completely true. And until she could hold both, healing wasn’t accessible to her.

The both/and isn’t weakness or excuse-making. It’s accuracy. It’s a refusal to flatten yourself into either the story that protects everyone or the story that only carries the harm. When you can hold the full complexity of what you lived — the love and the harm, the survival and the cost of it — you finally have access to real grief. And grief, I find in my clinical work, is almost always the doorway to something more spacious.

The Systemic Lens: Seeing Beyond the Individual

When we locate suffering exclusively in the individual — “What’s wrong with me?” — we miss the larger forces at work. Culture, family systems, economic structures, and intergenerational patterns all shape the terrain on which your personal struggle plays out.

This matters because the driven women I work with almost universally blame themselves for pain that was never theirs alone to carry. The anxiety, the perfectionism, the chronic self-doubt — these aren’t character flaws. They’re adaptive responses to systems that asked too much of you while offering too little safety, attunement, and genuine support.

Your parents were shaped by their parents, who were shaped by theirs. The emotional unavailability, the volatility, the perfectionism, the scarcity mindset — these patterns travel across generations, often without anyone consciously choosing to pass them on. What we call intergenerational trauma isn’t a metaphor; it’s a documented psychological and even biological reality. You didn’t inherit a character flaw. You inherited a pattern, and patterns can be interrupted.

There are also broader cultural forces worth naming. Many of the women I work with grew up in families and communities that had very specific, very rigid scripts for what women were allowed to feel, need, express, or ask for. Anger wasn’t acceptable. Ambition made you difficult. Needing something made you a burden. These messages don’t disappear; they go underground and become the inner critic, the one that sounds suspiciously like a parent but is now using your voice.

Healing begins when you stop asking “What’s wrong with me?” and start asking “What happened to me — and what systems made it possible?” That reframe isn’t about avoiding personal accountability. It’s about accurate accounting — seeing the full picture of what shaped you, so that you can make genuinely informed choices about who you want to be now.

There’s also a generational dimension to this that I think is worth naming explicitly. The emotional dysregulation, the perfectionism, the anxiety, the difficulty with relationships — these patterns didn’t originate with you. Research on epigenetics and intergenerational transmission of trauma, including the work of Rachel Yehuda, PhD, professor of psychiatry and neuroscience at the Icahn School of Medicine at Mount Sinai, has shown that trauma can alter gene expression in ways that affect the nervous systems of subsequent generations. You may be carrying fear responses that were first forged in your grandparents’ or great-grandparents’ experiences — of poverty, war, immigration, systemic oppression — and that have been transmitted through both psychological and biological channels. (PMID: 27189040)

None of this removes your agency or your responsibility for the choices you make now. What it does is make the accounting accurate. When you know the full landscape of what shaped you, you can make genuinely informed decisions about what to carry forward and what to set down. That’s not victimhood. That’s wisdom.

If what you’ve read here resonates, I want you to know that individual therapy and executive coaching are available for driven women ready to do this work. You can also explore my self-paced recovery courses or schedule a complimentary consultation to find the right fit.

If you see yourself in any of these signs, I want you to know: you’re not broken. You’re a person who grew up in difficult circumstances and adapted brilliantly to them. Those adaptations made sense then. They may be costing you now. And there’s real, substantive help available — not to fix something wrong with you, but to finally build the internal foundation that every person deserves and that circumstances didn’t give you. You’ve been carrying this a long time. You don’t have to keep carrying it alone.