Trauma & PIT

Understanding the 5 Core Issues of Post-Induction Therapy

Pia Mellody's framework identifies five wounds of developmental trauma — and five corresponding ways they show up in adult life. Here's what they are and how healing works.

9 min read

Post-Induction Therapy, developed by Pia Mellody at The Meadows treatment centre, is built around a deceptively simple framework: five core issues that arise from childhood trauma, each with a corresponding adult symptom. Understanding these five issues gives you a map — both of what went wrong and what healing looks like.

1. Self-Esteem

The Wound

Growing up feeling "less than" — not good enough, inherently flawed.

Adult Symptom

Either low self-worth and self-criticism, or grandiosity as a defence.

Healing involves developing an accurate, balanced view of yourself — neither better than nor less than others, but equal in worth.

2. Boundaries

The Wound

Physical or emotional boundaries were violated — through abuse, enmeshment, or neglect.

Adult Symptom

Either walled-off and unable to let people in, or no boundaries at all — letting anyone in.

Healing means learning where you end and others begin — protecting yourself without isolating yourself.

3. Reality

The Wound

Your perception was denied — "that didn't happen," "you're too sensitive," "you're imagining it."

Adult Symptom

Second-guessing your own experience, or rigidly controlling reality because uncertainty feels unsafe.

Healing is learning to trust your own perceptions while tolerating that others may see things differently.

4. Dependency

The Wound

Your needs weren't met reliably — you learned not to need, or to need desperately.

Adult Symptom

Either fiercely independent and unable to ask for help, or completely dependent and unable to function alone.

Healing means learning healthy interdependence — being able to both give and receive care without losing yourself.

5. Moderation

The Wound

You weren't taught how to self-soothe — extremes were modelled or imposed.

Adult Symptom

All-or-nothing behaviour — addiction, compulsivity, emotional extremes, or rigid deprivation.

Healing means finding the middle ground — neither chaos nor rigidity, but flexibility and balance.

How PIT Addresses All Five

PIT works through each issue systematically, helping you identify how the wound shows up in your current life, reconnect with the younger self who first experienced it, and practise new ways of relating to yourself and others. It's structured but deeply experiential — not just talking about the wound, but feeling it and resolving it in real time with the therapist as a witness and guide.

Experience the PIT Framework in Therapy

As a PIT-trained therapist, Richard uses the five core issues framework to guide healing — helping you understand your story and build a new relationship with yourself.

Learn About PIT Therapy