capturing the beautiful calamity of healing in therapy

The Three Questions of Therapy

The Three Questions of Therapy

Why go to therapy? 

One of my first clients taught me that therapy- and the greater meaning of existence- eventually came down to exploring (and possibly answering) three fundamental, chronological questions:

Why should I live?

How should I live?

What can I do to make my life better? 

Sam was a young man who came from a good, suburban home with loving parents. He was also one of the angriest people I had ever met.

Sam was an existentialist in every sense of the word- he analyzed life, death, and everything existing in between, and he was miserable with himself and everything around him.When I first met him, he was nihilistic and angry, a troubled young soul who wanted to believe in God (because it sounded whimsical and fantastic), but felt equally disturbed by the grotesque pain of the universe. He liked reading about Wiccan culture and Buddhist philosophies; he quoted Nietzsche and Sartre and rolled his eyes at anything resembling a surface-level conversation, postmodern trends, or displays of just average intelligence.

When I first met him, he was nihilistic and dismissive, a troubled young soul who wanted to believe in God (because it sounded whimsical and fantastic), but he also felt equally disturbed by the grotesque pain of the universe. He liked reading about Wiccan culture and Buddhist philosophies; he quoted Nietzsche and Sartre and rolled his eyes at anything resembling a surface-level conversation, postmodern trends, or displays of just average intelligence.

So, why go to therapy? He had been diagnosed “Bipolar,” a catchall, overused term for clients exhibiting moods “outside of normal.” I disagreed with the diagnosis; it seemed too simplistic and overarching.

At the time, I was a novice therapist still in graduate school. I worked in an outpatient clinic, and my caseload generally consisted of cooperative and motivated clients. Why go to therapy was simple for them- they wanted to be challenged and interpretations. They wanted to absorb my every word, even the ones that probably didn’t make sense.

Sam wasn’t like them. He was not the homework or the role-playing type- he wasn’t even really for the basic question-and-answer dialogue.

Sam wanted therapy because he wanted to rant. He wanted to rant about the inequality of humanity and the inefficient hierarchical structures in politics. He wanted to rant about his “stupid” family members and the atrocious music playing on Top 40 radio. He wanted to go on and on about the injustice and the uselessness of life.

His rants were enticing. And, for the first two sessions, I let him roll his eyes and make insults; I let him moan and sigh and shake his head in dismay. I let him rant because I didn’t know how else to intervene. He seemed entirely disinterested in changing or listening, and he baffled me. Didn’t people go to therapy because something in their life wasn’t working?

Beginning of our third session, I confronted his attitude. After all, why go to therapy if you didn’t want to change?

His response? Because I get to be the client that you always remember…the one you couldn’t fix.

I had no idea what to say back (again, very novice therapist).

I just said, You could be right, but I hope you’re not. I hope you’re not unfixable.

He laughed, as if my idea was comical and entertaining to him, and then he resumed with the ranting.

Fourth session, he was less angry, and I got my first smile. Fifth session, he unveieled a tiny bit of vulnerability- just a sliver- and I latched onto it like it was forbidden candy. Soon, bigger things happened. He developed a romantic crush, despite believing all love was pointless and doomed. He got a job, despite believing money was corrupt and any efforts to obtain it was unjustified.

In talking about these changes, he told me, I realized that if I want to stay unfixable, I stay unfixable. 

He was right. If we don’t change, we don’t change. And if we don’t move, we stay where we are. Even the best therapist in the world can’t help the person refusing to ask for help.

Here’s what I believe about existentialism: It’s fascinating and beautiful. We live in a strange and fascinating universe, and it can be tantalizing to think about all the pieces in existence- how they tie together, why we are here, what’s our purpose.

Here’s what I also believe about existentialism: It can be a nauseating hamster wheel or a sinking hole of despair. It can be an excuse to feel miserable, a cop-out for the utter dread and painstaking realities we face in our existence.

If I want to stay unfixable, I stay unfixable. 

Hence, the emergence of the three questions for why go to therapy.

Why should I live?

How should I live?

What can I do to make my life better? 

After the awakening that nothing and no one would fix him except himself, Sam began to ask and explore these questions. In doing so, he discovered newfound relief, optimism, and even felt some excitement in a world he had previously met with dread. He learned that options existed,but that he had to be the one to seize them. Most of all, he learned that the change was up to him. If he truly wanted to be unfixable, then unfixable he would be.

I couldn’t provide the answers for Sam because I genuinely didn’t have them. I don’t have them for any clients. It is their quest- it was Sam’s quest- and sometimes that first step is simply acknowledging that something has the potential to change.

*All reasonable efforts have been made by this writer to protect utmost client confidentiality. Because of this, names and identifying details in this piece have been changed, omitted, and/or embellished.