Alert others to inherited wounds + unawareness

Three Levels of Typical Personal
and Relationship "Problems"

Implications for Effective Clinical Practice

By Peter K. Gerlach, MSW


The Web address of this article is

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        This article is one of a series on effective professional counseling, coaching, and therapy with (a) low-nurturance (dysfunctional) families and with (b) typical survivors of childhood neglect and trauma. These articles for professionals are under construction.

        This series assumes you're familiar with:

        Before continuing, pause and reflect - why are you reading this article? What do you need?

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        This article summarizes three levels of common stressors in typical family systems and other social groups. Most family adults and human-service professionals focus only on the surface "problems" (unmet needs), so the underlying primary problems go unresolved, and surface symptoms recur. Once aware of these levels, co-parents can work together to discern and resolve their primary problems and raise their family's stability, bonding, and nurturance level.

        All adults and kids want stable, safe, satisfying relationships and families. The size and scope of the U.S. counseling, life-coaching, and therapy professions suggest how elusive these prizes are in our culture. Toward improving your clinical effectiveness, this summary article proposes (a) why this is, and (b) what you can  do about it.

        See if you agree with these...


  • all personal and social "problems" are unfilled psychological + spiritual + physical needs - i.e. physical + emotional + spiritual discomforts;

  • needs range between (a) surface, intermediate, and primary; and (b) current to long-term;

  • most people aren't trained or motivated to be self-aware, which includes distinguishing between their surface problems and the unfilled primary needs that cause them. Anyone can learn to make and benefit from this distinction, once aware of the different levels of needs.

  • clinical work is most apt to be effective when professionals (a) accept these premises, and (b) proactively inform clients how to discern and fill their primary needs as family and social teammates, rather than competitors.

  • concurrent unfilled needs combine to cause situational or chronic stress, so "effective stress management" involves identifying, ranking, and preventing or reducing unmet needs. Chronic stress suggests a person is unaware of (a) personal needs, and (b) effective problem-solving (need reduction) strategies. It often also suggests the person is unaware of being dominated by a well-meaning false self.

  • Typical divorcing-families and stepfamilies have three layers of concurrent problems surface, intermediate, and primary:

1) Typical Presenting (Surface) Problems over...

  • unhealthy compulsions (e.g. addictions)

  • problems with "moods," like depression

  • excessive fears, anger, or apathy

  • excessive social isolation

  • a range of psychosomatic illnesses

  • prolonged divorce conflict and stress

  • courtship, weddings, and cohabiting

  • conflicts between co-parents, including re/marital and ex-mate conflicts

  • family membership (inclusion and exclusion)

  • family role (responsibility) definitions

  • inter-home and intra-home rules, boundaries, and consequences

  • asset and debt ownership and management, including child support

  • household geographic moves

  • stepparent-stepchild and stepsibling roles and relations

  • relations between current and ex relatives and in-laws

  • child discipline, visitations, custody, education, and health care

  • family vacations, holidays, and celebrations

  • first and last names, and family-role titles

  • legal parenting agreements

  • stepchild legal adoption

  • stepsibling and half-sibling relations and favoritisms

  • family conflicts over religion, education, and healthcare

  • psychological or legal (re)divorce, and/or related legal suits

   2) Underlying Intermediate Problems

  • adult ignorance of effective communication basics and problem-solving skills - e.g. focusing on surface needs; and...

  • adult ignorance of healthy grief basics, and how to spot and release blocked grief; and...

  • adult ignorance of stepfamily realities, and unrealistic stepfamily expectations; and...

  • adult ignorance on how to evaluate stepfamily information and advice; and...

  • an inability to resolve significant barriers to co-parental cooperation effectively; and...

  • unwise cohabiting and commitment (re/marital) decisions; and...

  • co-parent inability to spot and resolve...

    • stepfamily-identity conflicts,

    • loyalty conflicts,

    • values conflicts - including adult priority clashes, and...

    • relationship triangles; and...

  • lack of informed family, community, and media co-parent support, including uninformed churches and clinicians

  3) Unseen Primary Problems  

  • Co-parents' psychological wounds + denials + unawareness of the above, promoted by...

  • Social unawareness and denials of the pervasive [wounds + unawareness] cycle and its toxic effects. This results in legally approving...

  • unqualified (unwise) child conception,

  • low-nurturance relationships and families, and...

  • widespread child neglect, abuse, and resultant psychological wounding.

        Pause, breathe, and notice your thoughts and feelings. Have you ever seen a proposal about problem-levels like this? Does it seem reasonable? If so, what does it mean to the way you live and work?

Clinical Implications

        Adopting the 3-level concept has implications for your personal life, your clinical assessment and intervention schemes, your client goals and strategies, and your clinical metasystem. If you choose to ignore this 3-level concept in your work, you risk (a) providing inferior or ineffective service, and (b) missing the chance to alert your clients to this concept and improve their problem-solving effectiveness. Ignoring or discounting this concept suggests you may be controlled by a protective false self.

        To benefit from this problem-level concept, you'll need to ...

  • accept (a) the universal reality of normal personality subselves, true Self, false self, and psychological wounds and recovery; and (b) what these realities mean to you, your clients, your co-workers, and your clinical work. Then you'll need to...

  • integrate these terms and concepts into your thinking, clinical planning and practice, and communicating with clients and co-workers.

        If you see value in this 3-level concept, begin to include it in your work by using some new terms with clients and co-workers - e.g. "problem levels," "this is a  level-1 (or 2 or 3) problem," "surface problems and primary problems," "dig down (from level-1)", "the [wounds + unawareness] cycle," and selected terms among those used in level 2 above - e.g. "Your stepfamily loyalty conflict is a symptom of underlying primary problems."

        If you're used to assessing your clients for level 1 or level 2 problems, you'll need to expand that to also assess each client adult for any primary (level 3) problems - e.g.

  • (a) how wounded is this person (how often does a false self control her or his personality), and (b) how aware is s/he of that and what it means?; and...

  • how aware is this person of (a) the core level-2 topics above, and of (b) which subselves govern his or her personality in calm and stressful situations + what that means + real-time self talk, senses, and needs?

        Based on your assessments, you'll then need to expand your set of intervention strategies to include helping clients to...

  • see what topics they need to learn, and motivating them to learn and apply the level-2 topics to reduce their presenting problems; and help clients...

  • (a) become aware of their subselves, and (b) explore which subselves are running their lives and whether they need to do something about that.

Restated - if you fully adopt the 3-level concept above, to provide effective clinical service you'll need to commit to evolving competence at doing strategic inner-family systemic therapy ("parts work") as part of any client-family treatment plan. That means you'll need to want to adopt a multi-modal (intrapsychic + dyadic + family-system) model of clinical work. Notice you reaction to this proposal...

        If you're a clinical supervisor, consultant, trainer, case manager, program director, or policy maker, you'll need to expand your way of thinking, speaking, and acting to integrate this three-level concept with the people you live and work with.

        You'll also need to expand any in-service program in your organization to include the ideas that comprise this 3-level model and your version of these implications. To do these things effectively, you'll need to want to become aware of how often your true Self guides your other subselves.


        If you haven't recently, review these slide presentations on basic ideas that comprise this clinical model. They underlie the three-level concept here.

        Review this article on surface and primary needs, and see if it makes sense. Then imagine your clients' and co-workers' reactions to this concept. Option - share and discuss copies of the article with selected people and see how they react.

        Even if you intuitively agree with the [wounds + unawareness] cycle and the 3-level concepts, your motivation to integrate these ideas into your work depends on your trying the concepts and seeing what happens. Options -

  • Identify several current personal problems in your life. Try "digging down" to define (a) what surface and primary needs are unfilled in you and any other people involved - including kids, and (b) why you think they're unfilled. Then see what happens if you apply the three-level concept in this article to each of your "problems."

  • Adopt the open mind of a student, and pick several current clients, cases, or students. One at a time, review your current assessment of their presenting and actual "problems." Then thoughtfully try applying this three-level scheme to your assessment and treatment plans, and imagine what might result. Option - try this exercise with your supervisor or a in a case-consultation group, once the other person/s are aware of the concept.

        Ask your co-workers' and supervisor's reactions to the need-level and problem-level concepts. As you do, assess whether you feel each person is governed by their true Self or not. If they're ruled by a false self,  expect them to (a) reject, discount, or resist the level concept, or (b) consciously accept and endorse it, but not use it. Double messages indicate false-self dominance.

Status Check

        Clarify where you stand on the key ideas in this article. A = "I agree;" D = "I disagree;" and ? = "I'm not sure yet," or "It depends (on what?)."

I fully accept that the personalities of normal people are comprised of semi-independent subselves.  (A  D  ?) If you disagree or aren't sure, study this memo, and try this safe, interesting exercise.)

I can clearly describe and illustrate the "dig down" relationship-skill described in this non-profit Web site, and (b) I agree typical clients can benefit from learning to apply it.  (A  D  ?)

I fully accept that (a) human personal and family "problems" are unmet needs (discomforts), (b) that "neediness" is normal and inevitable, not "negative," and (c) that human needs range between surface (superficial) and primary.  (A  D  ?)

Typical adults are over-busy, distracted, usually focus on their and others' surface needs, and are unaware of the underlying level-2 or level-3 problems outlined in this article.  (A  D  ?)

When the primary needs causing surface needs aren't discerned and well-filled, related surface needs (symptoms) usually recur in various forms. (A  D  ?)

I feel that (a) effective problem-solving requires all people involved to be (a) guided by their true Selves, (b) clearly aware of their own and the others' current primary (vs. surface) needs, and (c) to value them all equally. (A  D  ?)

I'm motivated now to experiment with integrating the personality-subself and three-level concepts into my clinical work with an open mind and noting the results, over time. If not, I know why. (A  D  ?) 

I know how to judge whether my true Self is responding to this status check or not. If not, I know which subselves are responding, and why.  (A  D  ?)


        This article builds on the idea that human "problems" are unfilled needs - emotional, physical, and spiritual discomforts. It proposes that typical unaware clients seek professional help to resolve surface needs, or symptoms of primary needs. The article proposes two deeper levels of problems that cause the surface (presenting) problems.

        Many of the level-2 problems above are common in typical divorcing families and stepfamilies. Two universal primary (level-3) problems in any typical client adult are (a) being often controlled by a protective false self, and not knowing that or what it means; and (b) being unaware of their present-moment feelings, primary needs, communication dynamics, a group of vital topics, and of their unawareness.

        The article summarizes key clinical implications of this three problem-level concept, and suggests ways of integrating the concept into your professional paradigm and work. The article closes with several key options for learning and applying the ideas that comprise the concept.

        Note these related Web articles for lay people:

  • surface and primary needs,

  • why and how to "dig down" to discern current primary needs,

  • this three problem-level concept; and...

  • this scheme for effectively filling current primary needs - i.e. for win-win problem solving.

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        Pause, breathe, and reflect - what are your subselves thinking and feeling now? Did you get what you needed from reading this article? If so, what do you need to do next? If not, what do you need? 

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Updated March 22, 2014