It’s Not What’s Wrong With You, It’s What Happened to You
Most people come to therapy trying to figure out what’s “wrong” with them. I actually think that’s the wrong question. A more helpful and often more compassionate place to start is: “Why am I the way that I am?”
No judgment. No criticism. Just curiosity.
The brain is the most complex structure we know of, yet when someone struggles with anxiety, emotional regulation, or certain behaviors, we’re quick to label it as something being “wrong.” In reality, many of our current patterns once served an important purpose. They were adaptive responses to past experiences, ones that may no longer work in our current lives.
Take, for example, a young person growing up in an abusive household who engages in self-injury as a way to regain a sense of control. In that environment, the behavior makes sense - it helps them survive emotionally. But years later, long after the danger has passed, the urge may still be there. What was once adaptive has become maladaptive.
Looking at things this way shifts the question from “What’s wrong with me?” to “What happened to me?” And that shift can be profoundly relieving.
What Is the Neurosequential Model of Therapeutics (NMT)?
This core question—what happened to you?—is at the heart of the Neurosequential Model of Therapeutics (NMT). NMT isn’t a specific type of therapy. Instead, it’s a brain-based framework that helps clinicians understand how experiences shape the brain over time and how to choose interventions that actually fit the person in front of them.
While the word neurosequential may sound intimidating, it simply means that therapy is informed by how the brain (neuro) develops in stages (sequential). This lens helps us understand typical brain development and how stress, trauma, and adversity at different points in life can influence emotional regulation, relationships, and behavior.
Why NMT Matters
If insight alone healed trauma, most people would be finished with therapy pretty quickly.
Traditional talk therapy often assumes that the thinking part of the brain is always online and in control, but that’s not how the nervous system works. This is why you can’t simply reason your way out of anxiety or panic. When the brain and body don’t feel safe, insight doesn’t stick.
NMT helps explain why therapy sometimes feels frustrating or slow, especially early on. It reminds us that regulation comes before reflection. If the nervous system is overwhelmed, focusing only on thoughts and insight can feel ineffective, or even exhausting.
How NMT Helps in Therapy
NMT isn’t a therapy modality like CBT, ACT, or DBT (therapy does love its acronyms). Instead, it’s a framework that helps assess your unique history and nervous system to guide which approaches are most helpful at different stages of treatment.
This is why NMT pairs well with an eclectic, individualized approach to therapy. Some sessions may focus more on talking and insight. Others may emphasize grounding, regulation, or mindfulness. The goal is always the same: to meet your nervous system where it is, rather than forcing a one-size-fits-all approach.
Using NMT allows therapy to be tailored to you, not just your diagnosis.
Takeaway
You and your nervous system are not broken. They adapted to your environment in ways that once made sense.
Together, we can work to understand how your nervous system learned to respond to the world and how it can learn newer, safer patterns that better support your life today.
If you’d like to learn more or see whether this approach might be a good fit for you, feel free to schedule a free consultation.
Recommended Readings
For further reading, explore works by the creator of the Neurosequential Model of Therapeutics, Dr. Bruce Perry:
What Happened to You? - Bruce D. Perry, M.D., Ph.D. & Oprah Winfrey
The Boy Who Was Raised as a Dog - Bruce D. Perry, M.D., Ph.D. & Maia Szalavitz
Written by Seth Gersbach, MSW