When you believe without knowing you believe that you are damaged at your core, you also believe that you need to hide that damage for anyone to love you. You walk around ashamed of being yourself. You try hard to make up for the way you look, walk, feel. Decisions are agonizing because if you, the person who makes the decision, is damaged, then how can you trust what you decide? You doubt your own impulses so you become masterful at looking outside yourself for comfort. You become an expert at finding experts and programs, at striving and trying hard and then harder to change yourself, but this process only reaffirms what you already believe about yourself -- that your needs and choices cannot be trusted, and left to your own devices you are out of control (p.82-83)