How to Stop Earning the Love You Should Have Been Given

Family of Origin & Childhood Trauma • May 04, 2026

Article title: How to Stop Earning the Love You Should Have Been Given Course/client pathway: Primary: Fixing the Foundations — https://anniewright.com/fixing-the-foundations/ Secondary: Enough Without the Effort, Parenting Past the Pattern, Therapy with Annie Suggested SEO title under 60 characters: Stop Earning Love: Healing Childhood Love Deficits Suggested meta description under 155 characters: Learn how to stop earning love and heal childhood wounds with trauma-informed, attachment-focused strategies for lasting relational safety. Suggested slug: stop-earning-love-you-should-have-been-given Suggested focus keyphrase: stop earning love Suggested internal links:

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The scent of freshly brewed coffee mingled with the faint rustle of papers as Paloma sat in her sunlit kitchen, the morning light illuminating her tired eyes.

Already, before the day had truly begun, her mind was racing through the mental checklist of accomplishments she needed to secure—compliments to earn, affections to win, approval to justify her worth. Yet, beneath the surface of her poised exterior, a whisper of exhaustion echoed: Why must love always be earned?

This quiet, aching question is at the heart of so many lives where love was conditional, where the foundational experience of being cherished simply for being—unearned, unqualified—was missing from childhood. For women like Paloma, a senior engineer navigating corporate pressures, or Nina, an attorney balancing courtroom battles with family demands, the invisible burden of “earning love” shapes how they move through relationships and life itself.

Defining the Problem: What Does It Mean to “Earn Love”?

In clinical terms, “earning love” refers to a relational pattern where affection, attention, and acceptance are perceived as conditional, requiring constant achievement, pleasing behaviors, or self-sacrifice to secure. It contrasts with the fundamental human need for secure attachment—a sense of being loved and valued unconditionally, particularly in early caregiving relationships.

When a child grows up in an environment where love is withheld unless certain conditions are met—such as good grades, obedience, or emotional suppression—their nervous system learns to associate safety with performance.

They develop what we call a relational blueprint marked by anxiety, fear of abandonment, and compulsive caretaking or people-pleasing behaviors in adulthood. This blueprint becomes a filter through which all relationships are experienced: love must be earned, never freely given.

Nervous System and Attachment: The Biological Bedrock of Love Patterns

Attachment theory, as pioneered by John Bowlby, MD, and Mary Ainsworth, PhD, illustrates how early relationships with caregivers wire the brain’s threat detection and safety systems. A secure attachment fosters a nervous system that can regulate emotions, tolerate distress, and seek comfort without shame. Conversely, inconsistent or neglectful caregiving activates survival mechanisms in the autonomic nervous system—fight, flight, freeze, and fawn responses—that shape relational strategies later in life.

For individuals conditioned to earn love, fawning—the automatic appeasement response—is particularly prevalent. This survival strategy involves silencing one’s own needs or emotions to pacify others, a behavior rooted in the somatic and procedural memories of early relational threat. The body remembers what the mind might not fully articulate—a nervous system attuned to vigilance, shame, and the compulsion to prove worthiness through achievement or caretaking.

Dr. Bessel van der Kolk, MD, in his seminal work The Body Keeps the Score, elucidates how these somatic memories are stored in the body, not merely the conscious mind, perpetuating patterns of self-neglect and relational strain long after the original trauma has passed.

The Impact of Childhood Neglect and Conditional Love

The Adverse Childhood Experiences (ACE) study by Felitti et al. (1998) revealed profound correlations between childhood abuse, neglect, and adult health outcomes, including mental health challenges intimately tied to attachment wounds and emotional regulation difficulties[1]. More recent research underscores the specific role of emotional neglect—often invisible yet deeply scarring—in fostering adult dysregulation and relational insecurity[2][3].

Paloma’s story reflects this pattern: despite outward success, her inner world is punctuated by loneliness and a persistent fear that she must continually perform to maintain love and belonging. Nina, the attorney, similarly recounts a childhood where affection was doled out only after achievements, creating a nervous system primed for chronic hypervigilance and self-criticism.

Both/And: Loving the Wounds and the Warrior

In the healing journey, it is vital to hold a both/and perspective rather than an either/or. You can honor the resilience and survival skills that “earning love” cultivated—often critical for navigating difficult early environments—while simultaneously recognizing how these strategies limit authentic connection and self-acceptance.

This tension is at the core of trauma-informed healing, as articulated by Judith Herman, MD, in Trauma and Recovery: survivors must mourn their losses while reclaiming agency. The capacities that once protected them can become barriers to fully inhabiting their desires and experiencing unconditional love.

For example, Beatrice, a nonprofit leader and mother, describes her tendency to overextend in caregiving roles as both a source of pride and exhaustion. Her journey involves acknowledging the strength of her caretaking impulse and learning to set boundaries that reflect her intrinsic worth rather than external approval.

The Systemic Lens: Beyond Individual Patterns

Healing from the compulsion to earn love cannot be isolated from the systemic contexts in which these patterns arose. Family systems theorists like Salvador Minuchin, MD, and Ivan Boszormenyi-Nagy, MD, remind us that relational dynamics are embedded in intergenerational legacies, cultural norms, and broader social structures.

For many women, especially those navigating professional spaces historically dominated by patriarchal expectations, the pressure to “earn love” intersects with societal messages about productivity, worth, and femininity. The systemic lens invites us to view these internal patterns not as personal failings but as adaptations to relational and cultural environments that often undervalue vulnerability and authentic presence.

Nina’s experience as an attorney in a male-dominated field amplifies this dynamic—her drive to succeed is both a personal survival mechanism and a response to external pressures that reward performance over personhood.

A Healing Map: Steps to Stop Earning Love and Embrace Relational Safety

Healing is an embodied, gradual process best navigated with trauma-informed, attachment-aware guidance. Here is a practical map aligned with the Fixing the Foundations framework, designed to support those who have done much inner work but find themselves caught in the cycle of earning love:

1. Safety & Stabilization: Cultivate a nervous system baseline of safety through mindfulness, somatic practices, and grounding techniques. This may include breathwork, gentle movement, or sensory awareness to interrupt fight/flight/fawn responses.
2. Explore Your Relational Blueprint: Reflect on early attachment patterns and relational messages about love. Journaling, therapy, or reflective dialogue can help name these templates.
3. Attachment & Nervous System Work: Engage in practices that build the capacity to tolerate vulnerability and seek support without shame. Therapies like Sensorimotor Psychotherapy (Ogden & Fisher) or polyvagal-informed approaches (Stephen Porges) are valuable here.
4. Grief & Mourning: Allow space to mourn the childhood love that was not received. This includes acknowledging feelings of abandonment, loneliness, or sorrow without judgment.
5. Cognitive & Emotional Restructuring: Develop new internal narratives that affirm your inherent worthiness. This may involve challenging beliefs such as “I must earn love” and replacing them with “I am enough as I am.”
6. Relational Skill-Building: Practice setting boundaries, expressing needs, and receiving care in current relationships. This stage often requires intentional experimentation and support.
7. Integration & Forward Movement: Weave these new experiences and identities into daily life, fostering a sense of continuity and resilience.

For those seeking professional support, Therapy with Annie offers trauma-informed, attachment-focused therapy that walks clients through these phases with warmth and rigor.

The Nervous System’s Role: Why “Earning Love” Feels Like Survival

To understand why the pattern of earning love is so tenacious, it helps to explore the nervous system’s role in shaping relational experiences. For driven women like Paloma or Nina, the nervous system operates as an ancient, embodied archive of early relational safety—or its absence.

When love was conditional in childhood, the nervous system learned to read achievement and approval as signals of safety. These learned survival pathways are not mere habits; they are physiological realities that govern how one experiences connection and threat.

Imagine Zara, a marketing executive who, during a tense board meeting, feels her chest tighten and her throat constrict as she anticipates judgment. Her nervous system reacts as if in danger, even though the threat is social, not physical. This somatic response is a residue of early experiences where love was contingent on performance. The autonomic nervous system’s sympathetic branch—the fight/flight response—activates, flooding her with adrenaline and heightening vigilance.

Conversely, the parasympathetic nervous system, particularly the dorsal vagal complex, may trigger freeze or shutdown when perceived rejection feels overwhelming. Beatrice, after a long day of caregiving and overextending herself, might collapse into exhaustion, her nervous system signaling surrender rather than engagement. These physiological states make it challenging to “just be” and receive love freely; instead, they compel action—doing, achieving, pleasing—as strategies to regulate internal distress.

Polyvagal theory, developed by Stephen Porges, sheds light on these processes by emphasizing how feelings of safety are communicated through subtle cues of connection—tone of voice, eye contact, and gentle touch—that engage the social engagement system. When early caregivers failed to provide these cues consistently, the nervous system defaults to defensive modes, compelling the individual to earn love through effort rather than receive it graciously.

For women in demanding careers or caregiving roles, the nervous system’s imprint can manifest as chronic hyperarousal, restlessness, or numbing. Paloma’s relentless pursuit of accolades and Nina’s perfectionism are not signs of weakness or vanity but biological attempts to create safety in an unpredictable relational landscape. Recognizing this shifts the narrative from self-judgment to somatic empathy, opening pathways for healing.

Embodied Vignettes: Moments That Reveal The Pattern

To ground these concepts, let’s return to the lived experiences of our composite clients, whose stories illuminate the subtle, often invisible ways earning love plays out.

Paloma’s Evening Ritual: The Quiet Exhaustion of Doing to Be Loved

After a day of meetings and presentations, Paloma returns home, her body aching but her mind still churning. She prepares dinner for her partner and children, meticulously arranging plates and ensuring every detail is perfect.

As she moves through the kitchen, she notices the tightness in her shoulders and the dull throb behind her eyes. Her partner’s casual “Thank you” feels like both relief and a reminder—a silent ledger of appreciation she must keep tallying.

In this space, love feels transactional, measured in tasks completed rather than presence shared. Paloma’s nervous system is wired to anticipate conditional acceptance, making it difficult to simply rest into the love that is already present. The sensory experience—the clink of dishes, the warmth of the oven, the subtle scent of rosemary—could be a portal to connection, but her mind races ahead, planning the next day’s accomplishments to maintain her worth.

Nina’s Courtroom Pressure: Performing Under the Gaze of Approval

In the courtroom, Nina stands poised, her voice steady but her heart hammering. Each argument, each carefully crafted sentence, is a performance calibrated to win approval from judges, colleagues, and clients. Beneath her legal expertise lies a nervous system primed for hypervigilance, scanning for signs of disapproval or rejection.

After a successful case, instead of relief, Nina feels a surge of anxiety—questions about whether her efforts were enough, whether love and acceptance are secure. This relentless pressure to earn love translates into physical symptoms: jaw clenching, shallow breathing, and a pervasive sense of urgency. The sensory details—echoes of gavel strikes, the rustle of legal pads, the cool sterility of the courtroom—become intertwined with her nervous system’s survival strategies.

Zara’s Parenting Challenge: Navigating Love and Expectations

Zara, a mother of two, often finds herself caught between professional demands and the emotional needs of her children. When her young daughter resists bedtime, Zara’s initial impulse is to soothe and accommodate, fearing that firm boundaries might jeopardize their fragile connection. Yet, when she yields repeatedly, she feels a rising tide of resentment and exhaustion.

Her nervous system is caught in a dance between fawn—appeasing to maintain love—and fight—asserting boundaries to protect herself. The tactile sensations of bedtime stories, the warmth of her daughter’s small hand, and the softness of the blanket are charged with emotional meaning. Zara’s own childhood, marked by emotional distance and conditional affection, informs her parenting responses, highlighting how these patterns perpetuate across generations.

Beatrice’s Leadership: The Caregiver’s Burden in the Workplace

In her nonprofit role, Beatrice is known for her generosity and reliability. She often volunteers for extra projects, anticipating that this will solidify her value to colleagues and leadership. Yet, this overextension leaves her depleted, her body aching from tension and her mind foggy with fatigue.

During a staff meeting, the fluorescent lights feel harsh against her skin, and the hum of conversation becomes overwhelming. She notices a familiar tightness in her chest and a desire to disengage. Her nervous system is signaling overwhelm, but the internalized message—love and acceptance must be earned through self-sacrifice—pushes her to keep going.

These embodied vignettes illuminate how earning love is more than a cognitive pattern; it is a deeply felt, somatic experience that colors daily moments in work, parenting, and relationships. Recognizing these sensory and emotional cues is a crucial step toward interrupting the cycle.

Systemic and Cultural Context: The Intersection of Gender, Culture, and Love

The compulsion to earn love does not develop in a vacuum; it is embedded within cultural narratives and systemic forces that shape women’s experiences of worthiness and belonging. For ambitious women navigating professional landscapes, the intersection of gender expectations, cultural values, and relational conditioning creates complex dynamics.

In many societies, women are socialized to prioritize relational harmony, caretaking, and emotional labor—roles that often demand invisibility and self-sacrifice. The cultural script may valorize achievement while simultaneously demanding emotional availability, creating a paradox where love and approval feel contingent on fulfilling multiple, often conflicting, roles flawlessly.

Nina’s experience in the legal profession exemplifies this tension. The predominantly male environment rewards assertiveness and measurable success but often overlooks the emotional labor women perform to maintain collegiality and mentorship. This dual expectation can deepen the nervous system’s vigilance, reinforcing the need to earn love through ceaseless striving.

Moreover, systemic inequities—such as gender pay gaps, underrepresentation in leadership, and societal minimization of women’s emotional experiences—compound the relational wounds rooted in early attachment. The cultural devaluation of vulnerability and the stigmatization of emotional neediness make it challenging for women to ask for care without shame.

Understanding these systemic layers is empowering. It shifts the narrative from individual blame to collective awareness, inviting a compassionate stance toward oneself and others. It also underscores the importance of creating communities, workplaces, and families that prioritize relational safety and authentic presence over performance.

Repair Practices: Cultivating Embodied Safety and Reclaiming Love

Healing the compulsion to earn love requires intentional, embodied practices that recalibrate the nervous system and nurture the experience of unconditional acceptance. For women like Paloma, Nina, Zara, and Beatrice, integrating these practices into daily life can transform the felt experience of worthiness.

Somatic Grounding: Anchoring in the Present

Somatic grounding techniques help interrupt fight/flight/fawn responses by bringing attention to the body’s sensations in the present moment. Simple practices such as feeling the texture of a soft blanket, noticing the weight of your feet on the floor, or tracing the outline of your hand with your eyes can anchor you in safety.

For instance, Paloma might begin her mornings with a brief ritual of placing her hands on her heart and feeling the rhythm of her breath before diving into the day’s demands. This small sensory pause cultivates a nervous system baseline of safety, reducing the urgency to prove herself.

Mindful Boundary Setting: Saying No as a Form of Self-Love

Learning to set boundaries is a radical act of self-care for those conditioned to earn love through pleasing. It involves recognizing internal limits and communicating them clearly, even when met with discomfort or resistance.

Zara’s parenting journey includes practicing saying no to her daughter with calmness and compassion, reassuring her that love is not contingent on compliance. Similarly, Beatrice experiments with declining extra tasks at work, noticing the relief and the subtle fear of disappointing others.

Internal Dialogue: Rewriting the Script

Transforming the internal narrative that equates love with achievement is crucial. Journaling prompts such as “What would love say to me if it were unconditional?” or “How do I feel in my body when I imagine being loved just as I am?” can foster new relational blueprints.

Nina finds it helpful to speak compassionate affirmations aloud, especially during moments of self-doubt: “I am enough. I am worthy of love without earning it.” This practice rewires neural pathways, gradually softening the grip of old beliefs.

Relational Experiments: Receiving Without Doing

One of the most challenging but healing practices is allowing oneself to receive care, compliments, or affection without immediately reciprocating or qualifying. This might look like accepting a genuine compliment from a colleague without deflecting or resisting, or resting in a partner’s embrace without needing to “earn” it through good behavior.

Beatrice recalls a moment when she allowed herself to simply be held by a close friend during a vulnerable conversation, noticing the nervous system’s initial urge to pull away and then the deep relief that followed surrender.

Grief and Compassion: Honoring What Was Missing

Healing includes mourning the childhood love that was not given. This grief is a sacred process that acknowledges loss without blame, creating space for integration and compassion.

Paloma, in therapy, allows herself to weep for the little girl who longed for unconditional acceptance. This act of tenderness toward her wounded self softens the armor built around the heart, opening pathways to new experiences of love.

Bridging to Fixing the Foundations: Building a Secure Base for Lasting Change

The journey from earning love to receiving love freely is profound and multi-layered. It requires repairing the foundational relational and nervous system patterns established in early life. This is the essence of Fixing the Foundations, a trauma-informed, attachment-focused course designed to guide women through the core phases of healing.

By cultivating nervous system regulation, developing new internal narratives, and practicing relational skills, Fixing the Foundations offers a roadmap to reclaiming inherent worth and relational safety. It supports the integration of the embodied practices described here, amplifying their impact through community, expert guidance, and structured reflection.

For ambitious women balancing career, family, and self-care, this work is not a luxury but a necessity. It transforms the internal experience of love from a laborious performance to a lived reality of belonging. The course gently invites you to rest into the truth that you are, and always have been, enough—no earning required.

If these reflections resonate with your experience, consider exploring the Fixing the Foundations course or connecting for personalized support through Therapy with Annie. Your nervous system, your heart, and your future self will thank you.

Repair Practices: Cultivating Embodied Safety and Reclaiming Love

Healing the pattern of earning love requires more than intellectual insight—it calls for somatic, relational, and emotional repair that recalibrates the nervous system toward genuine safety and connection. For women like Paloma, Nina, Zara, and Beatrice, whose bodies and minds have been conditioned to equate love with achievement, these practices invite a radical shift: learning to receive love without strings attached.

Somatic Grounding: Returning to the Body as a Source of Safety

The nervous system holds the imprints of early relational experiences, often enacted below conscious awareness. Somatic grounding practices help reclaim the body as a safe home rather than a battleground of tension and dysregulation. Techniques such as slow, mindful breathing, gentle stretching, and sensory awareness can interrupt automatic fight/flight/fawn responses and signal to the brain that it is safe to rest.

For example, Paloma might begin her mornings with a simple breath awareness exercise: feeling the rise and fall of her chest, noticing the cool air at the nostrils, or sensing the weight of her feet on the floor. These small acts of embodied presence gently rewire the nervous system to tolerate stillness and presence, reducing the compulsion to “do” to earn care.

Mindfulness of sensations also cultivates interoceptive awareness, the ability to notice subtle bodily cues—which is often dulled in people who learned to suppress their needs. Zara, juggling parenting demands, can use grounding to notice the warmth of her child’s hand or the softness of a blanket without immediately responding to the urge to appease or fix. These moments of sensory attunement become portals to connection rather than anxiety.

Setting Boundaries as an Act of Self-Love

For many women conditioned to earn love, boundaries can feel risky or selfish. Yet boundary-setting is a foundational repair practice—it teaches the nervous system that one’s needs and limits are valid and worthy of respect. Practicing boundaries is not about erecting walls but about cultivating relational integrity and safety.

Beatrice’s pattern of overextending in caregiving roles offers a clear example. She might begin by identifying one situation where she can say “no” or delegate a task, observing the sensations and emotions that arise. This practice is an embodied message to herself and others: “My love and care are not contingent on my sacrifice.” Over time, these experiences build new relational templates that honor her intrinsic worth.

In the workplace, Nina could experiment with asserting her needs, such as requesting clear deadlines or realistic workloads, thereby challenging the implicit contract that her value depends on constant overperformance. These boundary experiments, though sometimes uncomfortable, are crucial steps toward dismantling the compulsion to earn love.

Relational Repair: Practicing Receiving and Asking for Care

Healing earned love patterns is inherently relational. While many women have learned to give care abundantly, receiving care can feel unfamiliar or threatening. Practicing receiving is a radical act of vulnerability and a key step toward rewiring attachment patterns.

Paloma’s partner might offer a simple gesture—holding her hand after a long day or offering a genuine compliment without expectation. Paloma’s task is to receive these gifts without immediately reciprocating or minimizing them. This can be surprisingly difficult for nervous systems attuned to transactional dynamics, but it is a powerful way to experience love as a gift rather than a reward.

Similarly, Zara can practice asking for support from her spouse or community without framing it as a test of worthiness. This might look like requesting help with bedtime routines or sharing feelings of overwhelm. Each successful experience of asking and receiving care gently undermines the internalized belief that love must be earned.

Inner Dialogue and Compassionate Witnessing

Internalized messages such as “I must prove myself” or “I am not enough as I am” often operate beneath conscious awareness. Bringing these beliefs into the light through journaling, therapy, or reflective dialogue allows for compassionate witnessing and cognitive restructuring.

Nina, for example, might journal about the origins of her perfectionism and its connection to childhood expectations. Naming these patterns reduces their unconscious power and creates space for alternative narratives. Affirmations and compassionate self-talk can reinforce new beliefs, such as “My worth is inherent” or “I deserve love without conditions.”

Therapeutic modalities that incorporate compassionate witnessing—such as Internal Family Systems (IFS) or Compassion-Focused Therapy (CFT)—can be especially helpful in addressing the internal critic and nurturing the vulnerable inner child who first learned to earn love.

Repairing the Foundations: A Path Forward

The practices above are integral to the Fixing the Foundations framework, which underscores the importance of addressing both internal neurobiological patterns and external relational contexts. This dual focus is essential for sustainable healing.

Integrating Nervous System Regulation with Relational Safety

The nervous system and relational environment are in constant dialogue. As the nervous system learns new patterns of regulation through somatic and boundary practices, the external world must also provide consistent cues of safety and acceptance. This reciprocity strengthens the capacity to internalize secure attachment.

For Beatrice, this might involve cultivating supportive relationships—whether with partners, friends, or therapists—that affirm her worth without demanding overextension. For Nina, it could mean seeking out mentorship or peer groups that value vulnerability alongside achievement.

Addressing Intergenerational Patterns

Many women carry intergenerational legacies of conditional love and emotional neglect. Recognizing how family histories shape current patterns allows for compassionate inheritance and conscious choice.

Zara, reflecting on her childhood, might notice how her mother’s emotional unavailability influenced her own caretaking style. Through therapy or reflective work, she can begin to differentiate her identity from these legacies, choosing new ways to relate to herself and her children.

Cultivating a Culture of Enough

Beyond individual healing, there is a cultural imperative to challenge narratives that equate worth with productivity and performance. Communities and workplaces that celebrate vulnerability, authenticity, and relational presence create fertile ground for healing.

For women navigating professional spaces, this might mean advocating for policies that support emotional wellbeing, such as flexible schedules or mental health days. It also involves fostering peer cultures that value human connection over competition.

In sum, stopping the cycle of earning love is a profound journey of nervous system recalibration, boundary cultivation, and relational repair. It requires recognizing the biological and cultural roots of these patterns while embracing practices that embody new possibilities. For women like Paloma, Nina, Zara, and Beatrice, this path leads not only to personal freedom but to richer, more authentic connections—and ultimately, to the love they have always deserved.

From here, we naturally move into the next phase of healing: Fixing the Foundations, where these insights and practices coalesce into a comprehensive approach to reclaiming relational safety and embodied worth.

Closing: A Warm Communal Invitation

To all who have felt the quiet ache of having to earn love: your experience is deeply understood, and your yearning for freedom from this cycle is both valid and vital. Healing is neither linear nor solitary. It unfolds in moments of courage—reaching out, setting a boundary, embracing grief, or simply allowing yourself to rest in being rather than doing.

You are not alone on this path. There is a community of seekers, healers, and companions walking alongside you, affirming that love—real love—does not have to be earned. It is your birthright, waiting for you to receive it as the whole, worthy being you are.

If you feel ready, exploring the Fixing the Foundations course or connecting for therapy can be a gentle next step. Remember, the foundation of your life can be rebuilt—stronger, safer, and more loving than ever before.

Related Reading and Research

• Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences Study. American Journal of Preventive Medicine. 1998. PMID: 9635069. DOI: 10.1016/S0749-3797(98)00017-8.
• Simon E, Raats M, Erens B. Neglecting the impact of childhood neglect: A scoping review of the relation between child neglect and emotion regulation in adulthood. Child Abuse & Neglect. 2024. PMID: 38733836. DOI: 10.1016/j.chiabu.2024.106802.
• Lahousen T, Unterrainer HF, Kapfhammer HP. Psychobiology of Attachment and Trauma—Some General Remarks From a Clinical Perspective. Frontiers in Psychiatry. 2019. PMID: 31849787. DOI: 10.3389/fpsyt.2019.00914.
• Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med. 1998;14(4):245-258. PMID: 9635069.

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