Self‐determination theory (SDT) maintains that the adequate support and satisfaction of individuals' psychological needs for autonomy, competence, and relatedness promotes the gradual unfolding of individuals' integrative tendencies, as manifested through intrinsic motivation, internalization, identity development, and integrative emotion regulation. At the same time, the thwarting of these same psychological needs and the resultant need frustration is presumed to evoke or amplify a variety of psychopathologies, many of which involve autonomy disturbances. We begin by defining what autonomy involves and how socializing agents, particularly parents, can provide a nurturing (i.e., need‐supportive) environment, and we review research within the SDT literature that has shed light on various integrative tendencies and how caregivers facilitate them. In the second part of this chapter, we detail how many forms of psychopathology involve autonomy disturbances and are associated with a history of psychological need thwarting. We especially focus on internally controlling regulation in internalizing disorders; impairments of internalization in conduct disorders and antisocial behavior; and fragmented self‐functioning in borderline and dissociative disorders. The role of autonomy support as an ameliorative factor in treatment settings is then discussed among other translational issues. Finally we highlight some implications of recognizing the important role of basic psychological needs for both growth‐related and pathology‐related processes.