therapy relationship (or, in a therapy group, the relationships among the group members), I can point out on the spot how a patient influences the responses of other people. Thus, though Dave could resist assuming responsibility for his marital problems, he could not resist the immediate data he himself was generating in group therapy: that is, his secretive, teasing, and elusive behavior was activating the other group members to respond to him much as his wife did at home.
In similar fashion, Betty’s (“Fat Lady”) therapy was ineffective as long as she could attribute her loneliness to the flaky, rootless California culture. It was only when I demonstrated how, in our hours together, her impersonal, shy, distancing manner re-created the same impersonal environment in therapy, that she could begin to explore her responsibility for creating her own isolation.
While the assumption of responsibility brings the patient into the vestibule of change, it is not synonymous with change. And it is change that is always the true quarry, however much a therapist may court insight, responsibility assumption, and self-actualization.
Freedom not only requires us to bear responsibility for our life choices but also posits that change requires an act of will. Though will is a concept therapists seldom use explicitly, we nonetheless devote much effort to influencing a patient’s will. We endlessly clarify and interpret, assuming (and it is a secular leap of faith, lacking convincing empirical support) that understanding will invariably beget change. When years of interpretation have failed to generate change, we may begin to make direct appeals to the will: “Effort, too, is needed. You have to try, you know. There’s a time for thinking and analyzing but there’s also a time for action.” And when direct exhortation fails, the therapist is reduced, as these stories bear witness, to employing any known means by which one person can influence another. Thus, I may advise, argue, badger, cajole, goad, implore, or simply endure, hoping that the patient’s neurotic worldview will crumble away from sheer fatigue.
It is through willing , the mainspring of action, that our freedom is enacted. I see willing as having two stages: a person initiates through wishing and then enacts through deciding.
Some people are wish-blocked, knowing neither what they feel nor what they want. Without opinions, without impulses, without inclinations, they become parasites on the desires of others. Such people tend to be tiresome. Betty was boring precisely because she stifled her wishes, and others grew weary of supplying wish and imagination for her.
Other patients cannot decide. Though they know exactly what they want and what they must do, they cannot act and, instead, pace tormentedly before the door of decision. Saul, in “Three Unopened Letters,” knew that any reasonable man would open the letters; yet the fear they invoked paralyzed his will. Thelma (“Love’s Executioner”) knew that her love obsession was stripping her life of reality. She knew that she was, as she put it, living her life eight years ago, and that, to regain it, she would have to give up her infatuation. But that she could not, or would not, do and fiercely resisted all my attempts to energize her will.
Decisions are difficult for many reasons, some reaching down into the very socket of being. John Gardner, in his novel Grendel, tells of a wise man who sums up his meditation on life’s mysteries in two simple but terrible postulates: “Things fade: alternatives exclude.” Of the first postulate, death, I have already spoken. The second, “alternatives exclude,” is an important key to understanding why decision is difficult. Decision invariably involves renunciation: for every yes there must be a no, each decision eliminating or killing other options (the root of the word decide means “slay,” as in homicide or suicide). Thus, Thelma clung to the infinitesimal