patient to ask it, and keep asking it, day after day, week after week, month after month, about every conceivable
aspect of his life. What do I want to accomplish in my career? Where do I want to be, professionally, ten years from
now? What do I want to feel about my work? What do I want others to appreciate in my work? What qualities do I
want to find in friends? What qualities do I want to find in a romantic partner? What do I want to feel in regard to a
romantic partner? What do I want to be made to feel sexually? How do I want to spend my time with my friends
and loved ones? What do I want to find, and to experience, in the books I read?—in the movies I see?—in the
music I listen to?
Most patients initially experience considerable difficulty in answering such questions (except, perhaps, in vague
and useless generalities). But if he is encouraged to persist, to go on asking them until the answers begin to come,
the patient will be led to identify not only his desires (i.e., his values), but also and equally importantly, his
frustrations, his disappointments, his hurts and grievances. The number of such questions to be asked are almost
without limit; above, I have indicated only a few.
- There are two categories in which it is useful to have the patient organize his problems. Some of the patient's
problems may be susceptible to immediate partial or total correction, by alterations in his behavior in issues which
are subject to his direct volitional control—for example, lying, physically abusing one's child, sexual promiscuity,
failing to seek a job, seeking escape from one's problems by excessive socializing, etc. Other problems are clearly
not correctable merely by an act of choice or decision—for example, feelings of anxiety or depression,
inappropriate sexual desires, difficulty in thinking clearly, psychosomatic illness, etc. Sometimes a patient needs
help in determining in which category a given problem belongs. (Not all problems readily fit exclusively into either
category; mildly compulsive behavior, for instance, represents a borderline case.)
A plan should be worked out whereby the patient will proceed, across a specified period of time, to alter those
aspects of his behavior which he recognizes to be within his direct control. The confidence that results from his
rational regulation of his behavior in such areas helps him in working on those problems requiring more intensive
therapy.