Why Therapy Still Matters: Getting Beneath the Symptoms

Most people who arrive at therapy already know the outline of their story. They have lived the anxiety that arrives without warning, the patterns that repeat in relationships, the ways they push people away or cling too tightly, the late-night cycles of self-criticism, or the physical symptoms that never quite resolve. What they often lack is a coherent explanation for why those patterns persist and what would actually need to change for them to loosen. That gap is where skilled therapy operates. It is not primarily a place to recount events the client already understands. It is a place to examine the full system-past and present, mind and body and interrupt the loops that keep generating the same outcomes.

The need for that kind of work remains high. In Australia, recent figures show around 15 percent of people aged 15 and over experiencing high psychological distress and roughly 9 percent experiencing very high distress. Service use has increased, yet access remains uneven by location, income, and workforce capacity. Internationally, large numbers of adults with mental health conditions receive no treatment at all in any given year, and even among those who do enter therapy, outcomes vary significantly with the quality of the approach and the therapeutic relationship. Long-running outcome research has found that roughly three-quarters of people who enter psychotherapy show some benefit, but the depth and durability of that benefit depend on whether the work reaches the drivers of the problem rather than managing surface symptoms indefinitely.

Natalie Georgakopoulos, a Melbourne-based psychotherapist and counsellor who works both in person and online, approaches this from a particular stance. She holds a completed law degree and is three months from finishing her Masters of Counselling. Her practice, Inner Soma, focuses on trauma and the range of conditions that commonly develop in its wake. She is direct about the source of her orientation: more than twenty years of lived experience with trauma has shaped her understanding more than formal training alone. “Trauma is not something you can teach,” she says. “You either understand it because you lived it, or you don’t understand it.” That perspective informs how she works. Clients are not invited simply to share their history. They already know it. The task is to look at the whole picture—what happened, what the body learned, what still gets activated, and what would need to shift for different responses to become available.

A central premise of her work is that many of the presentations people bring ADHD traits, addiction, eating disorders, chronic stress, anxiety, depression, grief, and anxious or avoidant attachment—do not arise in isolation. They develop as adaptive responses to earlier experiences that were never fully processed. The body and nervous system find ways to cope; those ways later become the problem. Addiction can function as regulation. Eating disorders can function as control or numbing. Anxiety and hypervigilance can be the residue of environments that were unpredictable. Attachment patterns formed in childhood continue to organise adult relationships long after the original conditions have changed. Treating only the current symptom, without tracing how and when the pattern was established, often leaves the underlying mechanism intact.

This view aligns with broader clinical understanding of trauma’s reach. Single-incident trauma and complex developmental trauma both leave physiological traces. Research associated with Bessel van der Kolk and others has shown that trauma is stored in the body as well as in narrative memory; talk alone frequently fails to shift the somatic residue. That is one reason evidence-based protocols such as EMDR have become widely recommended. The World Health Organization, the American Psychological Association, and several national guidelines list EMDR as a first-line treatment for PTSD. Network meta-analyses have ranked it among the strongest interventions for symptom reduction, and some systematic reviews of trauma-focused psychotherapies have found that 65 to 86 percent of participants no longer meet diagnostic criteria after treatment, with particularly strong results in non-military populations. EMDR uses bilateral stimulation while the client focuses on a target memory, aiming to reprocess the material so that it loses its emotional charge and can be integrated. For complex trauma, practitioners often adapt the standard protocol with more extensive preparation and attention to attachment wounds and negative core beliefs.

Georgakopoulos combines EMDR with cognitive behavioural therapy, somatic practices, and more holistic elements such as inner-child work and breathwork, applied according to the individual rather than as a fixed sequence. Somatic approaches emphasise nervous-system regulation, body awareness, and the gradual expansion of capacity to tolerate sensation and emotion. They are especially relevant when clients experience chronic hyperarousal, shutdown, or physical symptoms that do not resolve with cognitive work alone. Breathwork and related practices can help clients learn to modulate their own state outside the session. The integration is deliberate: talking therapy provides the map and the language; body-based methods address the places where the map has not yet reached.

She also pays attention to the gut-brain connection. Research on the microbiota-gut-brain axis has linked early-life stress and trauma to changes in microbial composition, intestinal permeability, inflammatory signalling, and HPA-axis function. These pathways can influence mood, anxiety, cognitive clarity, and gastrointestinal symptoms. Epidemiological data associate PTSD with elevated rates of gastrointestinal disorders, and preclinical work shows that early adversity can alter stress responsiveness in ways that affect both gut microbes and brain circuits. While the field is still developing, the practical implication is straightforward: chronic stress and unprocessed trauma often appear in the body as well as the mind, and addressing one without the other can leave residual symptoms.

Attachment patterns form another frequent focus. Anxious and avoidant styles, shaped by early relational experiences, organise how people seek or avoid closeness, interpret others’ behaviour, and regulate distress in relationships. These patterns are not character flaws; they are learned strategies. Therapy that examines their origins and current triggers can loosen the automatic responses. Grief and loss are treated similarly not only as events to be discussed but as processes that can re-activate earlier unresolved material and require both emotional processing and somatic settling.

The practical value of this kind of work is that it aims at the mechanisms that keep regenerating the problem. Symptom management has its place, especially for stabilisation, but durable change usually requires identifying when and why certain reactions were installed, what they were protecting against, and what alternative responses can be built once the nervous system is no longer operating from the old threat template. Georgakopoulos describes the process as looking at everything as a whole and figuring out why it is not working. The tone is direct rather than interpretive or circular. Clients receive tools, alternative frameworks, and concrete practices alongside the deeper processing.

Not every person needs the same combination of methods, and not every therapist works from a trauma-informed, root-cause orientation. Outcomes research has repeatedly shown that the quality of the therapeutic alliance predicts a meaningful share of results, and that clients are more likely to continue when the approach matches their preferences. Barriers remain real: cost, wait times, geographic access, and the difficulty of finding a practitioner whose style and expertise fit. At the same time, the expansion of telehealth has widened options for many people, including those in regional areas.

Therapy matters because unexamined adaptive patterns tend to keep producing the same costs, relational, physical, occupational, and emotional until the conditions that sustain them are addressed. For people whose histories include trauma or unstable early environments, approaches that treat both the narrative and the body, that combine established protocols with attention to the whole system, and that are delivered by practitioners who understand the material from the inside as well as from training, offer a more complete route than symptom tracking alone. Georgakopoulos works primarily with individuals who have experienced trauma or traumatic upbringings. Her services through Inner Soma are available in Melbourne and online. Further details are at inner-soma.com, on Instagram at innersoma__, or by email at [email protected].