It depends on the type of therapy/therapist, but my current therapy helps with those types of patterns in a few ways:

By bringing out the feelings behind them (so not just looking at the biographical facts of where it comes from, but also the emotional impact those events and experiences had then and now).

Exploring why it's been hard to change the pattern and what happens when I try and can't make the change.

Looking more closely at the situations that cause the pattern to repeat and reemerge, and the feelings and actions that come up around them.

Talking about what it would feel like for the pattern to change, and looking at what happens along those lines as I actually start making changes.

It's been slow and difficult, but it's made a huge difference for me.