So, my understanding is that it takes 10 confirmations to get the XMR balance unlocked in the wallet. I my deposited XMR from an exchange to my XMR wallet over 48 hours ago and I am at 4/10 confirmations. Therefore I still cannot spend or access my XMR coins. Why did I not get all 10 confirmations and more importantly how to get them moving so I can spend my coins?
It takes 10 confirmations to be able to spend your received XMR. If you are stuck at only 4 confirmations after 48 hours your node is not synchronized to the network.
If you're using a remote node, use a different one. If you're using your own node, check the logs.
Also see this Q/A (which answers a very similar problem and for which the same steps can be followed in your case).