I think it important to take a step back often and ask this important therapeutic question: Do I really have a problem?

I think as therapists our starting assumption is that if someone takes the time and makes the effort to schedule and actually show up for an appointment, then obviously something is wrong with that person. I think almost always that person showing up thinks that something is wrong, often having a self-diagnosis.

I don’t want to put myself out of work, but taking time to discern if there actually is a problem may be just the ‘therapy’.

Two questions seem to initially come to mind as together with someone we consider if there is a problem:


1. How did you come to believe there is a problem?
2. How is this problem negatively impacting your life?

Number one concerns our beliefs about ourselves. Where are the messages we’re accepting coming from? This then raises further questions of source legitimacy. If we believe there is a problem because others are telling us there is (directly or often, thanks to social media and news media, indirectly), is that true?

And if we come to a problem determination through means of our own (although how can this not also be influenced), are we the best judge of ourselves?

Number two gets at the crux of determining the problem, often referred to as the scope. What, specifically, is this problem doing in your life? And even further, is the impact manageable? Here there are a plethora of questions relating to goals in life, daily functioning, wants, needs, and responsibilities. All areas of these are to be examined in order to determine the scope of the problem.


Just as truth is the critical aspect of number one, range is the critical aspect of number two. How much is this problem negatively impacting your life?

And while subjective, asking the question can help determine what kind of therapeutic intervention may offer the best help. Yes, perhaps psychotherapy would be good to hash things out, talk about problem origins, put together change strategies, and assess their effectiveness. Or even more subtly, form an understanding, interpersonal connection to share stories, a means for catharsis in a sense.

I once has a client convinced he had a problem with masturbation (too much). When we actually sat down and reviewed his reasons for believing there was a problem along with the actual impacts to his life, we determined that while he may engage in more self-stimulation than ‘normal’ there was actually not a problem to be fixed, solved, or remedied.


Talking through these two initial questions provided the distancing needed to properly assess the situation.

The result was relief and self-acceptance and, I think, a more critical discerning eye toward self-examination and self-understanding. And this may have been the very ‘therapy’ most warranted.