Core Unmet Needs
Many of us who have suffered significant childhood trauma experience intense emotional pain as adults; such pain may present itself as severe anxiety, depression or anger, for example.
According to Timulak et al., 2012, three core unmet needs underlie such emotional suffering; these are :
- unmet needs for safety and security
- unmet needs for love and meaningful connection to others
- unmet needs for acceptance, validation and recognition by others
Sadly, such unmet needs frequently stem from growing up in a dysfunctional family. (To read my previously published article : Dysfunctional Families : Types And Effects, click here).
Core Feelings Associated With Core Unmet Needs :
Timulak elaborates on the above by stating that these three core unmet needs are associated with corresponding core feelings as shown below :
- unmet needs for safety and security are associated with feelings of fear and insecurity
- unmet needs for love and meaningful connection to others are associated with feelings of sadness and loneliness
- unmet needs for acceptance, validation and recognition by others are associated with feelings of shame and worthlessness
Secondary Distress And Obscured Core Unmet Needs And Feelings :
Timulak also alerts us to the fact that when individuals suffering from emotional pain present themselves to therapists, their core unmet needs and corresponding core feelings may be obscured and concealed because these are overlayed by surface, ‘secondary distress’ (i.e. distressing, surface feelings that have their roots in the underlying core unmet needs and associated core feelings).
Examples of such ‘secondary distress’ / ‘surface feelings’, Timulak states, include :
- feelings of helplessness
- feelings of hopelessness
- feelings of depression
- feelings of anger
- feelings of anxiety
- somatisation (e.g. insomnia, physical tension, exhaustion, teeth grinding, stomach pains, chest pains, loss of appetite, headaches, dizziness etc.)
It is important for patients and therapists to consider the possible core issues that may lie beneath adverse surface feelings (secondary distress). Often, these core issues will have their roots in childhood trauma.
Can Emotional Pain Be Treated Like Physical Pain ?
It hardly needs stating that emotional pain can feel unbearable; after all, it drives some to suicide. As well as knowing this from a theoretical perspective, I know from personal experience; I spent five days in a coma in intensive care following a suicide attempt, as I have written about previously in other articles that I have published on this site.
[NB. If you are feeling suicidal, you are strongly advised to contact an appropriately qualified professional].
But what is actually going on in the brain, in physiological terms, to cause such excruciating suffering?
Findings Of Recent Study:
A recent study was conducted on volunteers who were shown a photograph of a partner who had recently rejected them. Whilst looking at the photographs, these volunteers (a little cruelly, it could feasibly be argued!) were told to concentrate upon how badly the rejection made them feel.
Brain scans revealed that whilst the volunteers were focusing on the pain of rejection whilst looking at the photographs, the brain regions that were activated were very similar to those known to be activated by physical pain, in particular:
– THE SECONDARY SOMATOSENSORY CORTEX
– THE DORSAL POSTERIOR INSULA
This suggests that both physical and psychological pain have similar neurological underpinnings.
Above : Image thought to show regions in brain activated in response to painful stimuli.
Implications Of The Above Study For The Treatment Of Psychological Pain:
Traditionally, physical pain and psychological pain have been treated in separate ways :
Traditional Treatment Of Physical Pain :
By medications such as paracetomal, aspirin, ibuprofen, Tylenol
Traditional Treatment Of Psychological Pain :
By medications such as antidepressants and sedatives
However, another study (carried out at the University of British Columbia) involved an experiment in which one group of volunteers had symptoms of anxiety treated using a placebo whilst the other group had symptoms of anxiety treated by the administration of 1000 mg Tylenol.
Results showed that those administered Tylenol had significantly reduced anxiety symptoms when compared to those in the placebo treatment group.
Conclusion:
It seems reasonable to conclude, on the basis of the above two studies described above, that not only do physical and psychological pain share common neurological foundations, but that, because of this, some psychological pain (such as that connected with anxiety) may respond to treatments (such as Tylenol, see above) originally intended to combat physical pain.
However, research into this area of study is at an early stage so definitive conclusions must be drawn with caution.
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David Hosier BSc Hons; MSc; PGDE(FAHE)