JM,
I think that was a really good explanation for something that is really difficult to explain. I think your advice to pay attention to your emotions and body are really good ones.
Hummingbird,
I agree with JM, this is one of those tricky things. This behavior is so pervasive that it takes a lot of time, and growth in a lot of areas to start to get a handle on it.
I love the way that you said that in taking care of others' needs you are taking care of your needs. Which is true because right now, it may be that the only way you can feel secure is by feeling like you're performing correctly.
This issue has a LOT to do with boundaries. I was complaining to my T once in a session how sick to death I was of working on my issues and how much time and energy it was sucking up. Then I said, I sometimes wonder what I could be doing if I had that time and energy for other things. I think my T had been waiting for that one for a long time. He said that was a really good question. What could I be doing with my family, with my friends, for myself?
Where it got interesting was my reaction. What I heard was "you've been here long enough, and it's really time you were better and left. Stop whining and just get on with it. (That last sentence is pure mom.)" I told my T it felt like that's what I heard and he told me that I was so scared to think of my own needs that when he tried to be encouraging I heard it as condemnation. I spent a number of terrified weeks trying to think about what I wanted. Everytime I tried to think of it I got scared. Much later when I was in a much better place, I went in for a session and told my T I had actually felt a little lost that week because I WASN'T dealing with a crisis. He told me that for so long there had been so many people within my boundaries that there was no room to figure out what I wanted. But now that I had boundaries in place, it was ok to take my time and figure that out. We tend to approach that as trying to think about what we want and then going to do it But in reality, you have to try things and then pay attention to how you're feeling about doing them.
One of the biggest problems to overcome is that we often feel guilty when we think of our own needs. I know I struggled with a very deep sense of "how can I trust that I'm not being selfish?" I think that's where the relationship with our T is SO important. By living out loud in front of them, you have someone to give you feedback and to validate when your needs are reasonable and proper. Part of the re-wiring that takes place in forming a secure attachment is what should have been done when we were kids. Learning that your needs were legitimate, that you mattered enough that your needs would be met, and there was nothing unreasonable about getting your needs met.
I hope this was coherent. There was so much to say, because again, I think this is an issue that is very interwoven throughout all the issues that its like picking out a single thread from a tapestry. Its also not something you solve by understanding it, you learn it by experiencing it in the relationship with your T. Which tends to be really confusing while you're going through it. I really think one of the secrets of successful therapy is the ability to tolerate feeling confused and staying with the confusion until it clears up. Once you understand it, it feels like "wow, how did I ever not get that?" To quote my T, "just because it's simple, doesn't mean it's easy."

Hope some of this helps.
AG