Abstract

Marcia Hill A businessman once remarked to me that the traditional way of paying for therapy was like paying to have a house built by the brick. I replied that if we used that analogy, then it would also mean that the builder/therapist would be in the position of having the blueprints changed several times in mid-project, of having little idea how many workers would show up on any given day, and of being beset by occasional natural disasters that wiped out some of the work already accomplished. And that is even before we try to factor in the general skill and experience of the builder or her expertise with the particular kind of house the client wants. Given the unpredictability of that scenario, it’s difficult to know how to think about those therapies that do not go well. To think that even an ideal therapist can succeed with every client insults the power of the client and implies therapist omnipotence. Conversely, assuming that an ideally moti- vated client can succeed with any therapist--or, put differently, that all failure is resistance--is a convenient excuse to duck therapist responsibil- ity. Sometimes the most talented of therapists and the most motivated