The decision to enter therapy for many people is arrived at slowly. Reticence or vacillation can stem from uncertainty or anxiety. A person may realize that trouble is building but be unable to gauge whether it has become serious enough that visiting a counselor would be advisable. In contrast to those times when a psychological blow lands with sufficient force that the recipient is felled abruptly, there are occasions when a slide downhill proceeds insidiously. A difficulty with the potential to grow more severe might not at first appear as ominous, and it may worsen only gradually, so that increases in its intensity can be absorbed without inducing a sense of alarm. While someone may see a problem exists without knowing how bad it is, in other cases a person will know the problem has gotten out of hand but avoids squarely facing that fact.

          A shift in thinking about one’s prospects and powers usually precedes consulting a therapist. It is necessary to acknowledge that counterproductive patterns are too firmly in place, or that the wherewithal is missing to grapple with pressing circumstances, or that life is moving off course to a worrisome degree. It is also necessary to relinquish the belief that whatever is bringing grief can be managed singlehandedly. Having to entertain such thoughts may be unnerving because they threaten the image of oneself it would be pleasing to maintain. And given everything else, externally or internally, that is challenging, a person might be disinclined to embrace a perspective that adds to the weight of the existing load. Keeping unwelcome realities at bay could secure a temporary comfort, though it would prevent acting in response to them with the aim of instituting change. Repeatedly opting for the short-term dividend can exact a high toll over time. A psychological condition may deteriorate when one puts off learning to handle provocation from without or the unsoundness within. Attending to issues that have been neglected too long will necessitate a tougher climb upward, which would need to be started from a weaker position, thereby reducing the pace of progress, and possibly lowering the chances of a fuller success. A willingness to accept personal limits, and to back away from a stance of utter self-reliance, opens the door to making a decision that would constitute, even before arriving at a therapist’s office, a pivotal step in taking charge of one’s life.     

          A person who is ambivalent about entering counseling can have worries beyond the drop in status supposedly confirmed by partaking in a clinical venture. Concerns about entrusting one’s mental fate to a stranger, who may not only be unable to help but could potentially make matters worse, might also interfere with giving therapy a try. And unfamiliarity with the characteristics of a therapeutic dialogue, and the ways in which it attempts to foster a positive outcome, can deter someone from risking what seems like a voyage into the unknown. Those who are reluctant to obtain assistance may relent when the mounting costs of leaving a problem unresolved reach unpleasant proportions. People who are quicker in projecting themselves into the unattractive future toward which a downward trajectory is pointing, and who can, if warranted, abandon the idea that the situation will miraculously repair itself, are more likely to avert the deeper pain that is a feature of a steep or a prolonged decline.                

          Just about everyone who gets into therapy is facing an immediate challenge, but people differ in how prominently a troubled upbringing figures in their current plight. Someone can emerge from a childhood during which the parenting was not quite good enough, or may have in fact been downright bad, without the proper footing for heading into adulthood. Oppression or rejection encountered during one’s formative years imposes a double burden. A child pays a price, in the form of insecurity or self-dislike, for being on the receiving end of inadequacy, and, because parental example plays a significant role in the shaping of personality, insufficient exposure to empathy or decency will constrain, at least until healthier influences enter the picture, how much a part of one’s make-up these virtues become. What happens initially at home may carry forward into what occurs elsewhere later on. Since it is natural to acquire qualities that are frequently observed in the process of the growing up, being the object of poor treatment can saddle a person with the tendency to make life difficult for others, a repercussion likely to provoke further disaffection. Familial behavior needn’t be ill-intentioned, however, for it to produce an adverse effect. Having a mother or father who is prone to nervousness, pessimism or impulsivity, or who displays excess or deficiency of another kind, may predispose a son or daughter to exhibit the very same trait. When emotional distance is a staple of the environment in which one is raised, the end result is unlikely to be a comfort with intimacy. The internal experience of people whose lives get off to a less fortunate start tends to be unfavorable rather than not, while the unfolding story in such instances is typically characterized more by limitation than by strength.

          Psychological difficulty may play out in a single but significant area or in multiple realms at once. It can interfere with the fulfillment of personal ambitions or complicate relationships with others. Often coexisting with the presence of a problem is the absence of the capacity to remove it as an impediment. It is a sign of trouble when, at junctures where inner harmony is dependent upon meeting the moment capably, a person either cannot start or cannot stop behaving in a particular manner. Someone may be unable to bring forth adaptive conduct through an act of resolve, or to exercise the restraint necessary to prevent unwanted habits from recurring. A lack of awareness about the response required to contend with a predicament can underlie the inability to change for the better. For want of a conceivable alternative, one is left vulnerable to traveling a similar road as before, sustained possibly by wishes that improvement might somehow materialize. Recognizing the profitable course of action, however, is no guarantee that it will be implemented. A person may have yet to acquire the experience to behave as the situation calls for, or could fail to summon good reasons to override a desire to react unconstructively. Progress is impeded when the risks or labors associated with converting aspiration into effort are accentuated, or when the disruptive impact on self-control of succumbing to temptation is downplayed or ungrasped. The odds of a lapse in striving are increased when being in a state of feeling burdened or deprived is seen as grounds for veering toward pleasurable distraction. Questionable impulses that have repeatedly prevailed do not usually recede spontaneously, and can strenuously resist attempts to outmaneuver or elude them. Unless someone is able to throw sufficient psychological weight behind the urge to subvert the internal antagonist, the chance to act purposefully will be lost.      

          One of my goals as a counselor is to create an atmosphere that makes it easier to talk about difficult subjects. This calls for a flexible approach tailored to the range or momentary condition of the person. For example, I might actively draw someone out who is having trouble piecing together an account of the situation, or who finds it hard to report what is occurring within because things inside feel blocked or jumbled. Remarks of mine that accurately characterize, or add substance to, the disclosures of the other person could facilitate the journey inward. As the recitation of the narrative gains momentum, its contours can become both broader and more specific, and the descriptive richness of the elaboration may exceed the expectations of the teller. Should a participant in therapy be unsure about the next turn the conversation ought to take, and be comfortable with sitting in silence, I will provide room for contemplation, so that a direction in which the discussion could proceed might eventually emerge. When the story is flowing freely, I stand back and absorb its details and psychological dimensions, and then respond to the material presented, offering observations, and possibly guidance, or inquiring further in order to learn more. With the questions I pose, and through seeking to name the ideas and sentiments beneath the words already spoken, I hope to put a person in touch with elements of experience that are deserving of focus but outside the field of view. A sense of relief may accompany the gain in awareness when subsurface currents are captured in language. Feeling understood can alleviate the apprehension about not being understood and have a beneficial influence on subsequent sharing. Greater calmness may allow recessed content within the mind to rise to the surface, and a growing confidence in the listener could encourage a willingness to take risks regarding the topics to be aired. Thoughts may be raised for exploration even though they are only partially formed, or when it is unclear along which lines their introduction would send the exchange. Concerns or emotions that are uncomfortable to face, because they expose vulnerability or place one in an unflattering light, might be more readily expressed aloud. The reward for overcoming a reticence toward openness, or for seeing previously unrecognized aspects of one’s conduct, organization or relationships, is an experience of liberation.

          A person in psychological trouble may feel stumped when it comes to finding a means to remedy the distress. Should someone be unable to figure out how to tackle a problem, I will offer for consideration suggestions for becoming unstuck. Based on my appraisal of the strengths and the gaps in a person's thinking and behavior, and drawing on my sense of the resources needed to handle the demands of the circumstances, I will propose ways of looking at matters and courses of action designed to narrow the divide between the capacities available and the competencies required. The spheres in which change can occur include the physiological, the cognitive and the behavioral. The activity in any one of these areas could affect what takes place in the other two.

          It is hard to use one's faculties effectively after the nervous system becomes highly aroused. Poise and rationality suffer when autonomic reactivity spikes or is chronically above optimal levels, making it tougher to think clearly, to keep emotionality in check, or to behave ably. Painful recollection, fruitless preoccupation, endless self-denigration, or fearful anticipation can each undermine composure. Learning to dampen visceral intensity through self-calming techniques, which promote a shift in attention to thoughts or images that are emotionally neutral, could be restorative. The tensions inside will ease when the body is not riled up by what is going on in the mind. A quieter state may bring to the fore a heightened feeling of self-possession, granting a person a better shot at assuming control. Useful ideas might arise about how to orient or comport oneself, and access to behavior that overarousal had disabled may be regained.

         Urges or cravings may intrude upon consciousness, occupying a sizable portion of the psychic terrain and placing a person in jeopardy of losing agency. An unhealthy impulse, after emerging within, could escape restraint and find expression as behavior, leaving one worse off for not having mustered the determination to act otherwise. The drama in psychological life revolves around whether someone who is in danger of falling prey to an unruly mental force will rally, so that a sequence en route to an unfortunate end is displaced by the taking of corrective steps. Inserting into the stream of thought a new perspective or a different set of considerations, whether it is generated independently or supplied by a friend or counselor, can nullify the influence of a surfacing threat and lay the foundation for self-strengthening action. For example, gorging on food, drinking too much, shopping compulsively or smoking nonstop are forms of excess to which people could become subject. These habits take hold because they succeed, during the interval before their impact subsides, in disrupting a dysphoric state by dosing the system with pleasurable sensation. However acceptable, or at least tolerable, such conduct may have been initially, when attention was primarily fixed on the immediate relief it could deliver, along the way a change in attitude can occur, as the person observes the ill-effects of exhibiting the reaction too consistently. Misgivings arise once the physical or financial costs of routinely yielding to temptation make themselves known, or after it becomes undeniable that the endangering behavior is operating outside the range of volitional control. Over time someone gets caught between opposing currents, wanting to embrace the habit because of the bad feeling it can relieve, and wanting to stop the repetition because of the bad feeling it can engender. How the impulse is experienced is related to where in its cycle a person stands. As it swells somatically or completes the leap between inner and outer worlds, it may seem alluring and compelling. But regret often replaces desire in the aftermath of an intemperate act. The behavior that, before the fact, was seen as a vehicle for easing perturbation, comes to be viewed, once it is a fait accompli, as an indication of weakness. And each addition to the accumulating number of lapses is likely to spur anew the unhappy recognition that one again failed to keep from happening what one would have preferred not occur.

          The person who can no longer countenance being governed by impulse, and who has reached the point of needing to gain leverage over it, begins the contest at a disadvantage. While the problem starts life as an outgrowth with, for each individual, a particular set of roots, its very expression, on occasion after occasion, causes it to become, for just about everyone, a contributing factor to its own continuation. The predicament facing the would-be master of runaway habit is that the indulgence which eventually sparks an urgency to diminish its recurrence, or to quash it permanently, also detracts from the ability to put an initiative at self-change into effect. Faith in one’s powers is not acquired through witnessing behavior that instills doubt about one’s capacity. Past deficiency subverts the conviction that success is possible, decreasing the odds, when dealing with a comparable test subsequently, that someone will make an effort, or persist should the demands tax the resources available. To move from worrying about not succeeding to adopting a can-do stance requires rejecting pessimism about one's prospects while envisaging the actualization of a formerly unsustainable deed. Uncertainty about whether a craving can be eliminated may be quieted by drawing examples from prior experience of the saving response being brought, to whatever degree, to fruition. Convincing oneself that restraint is possible after breakdowns in discipline have stirred up self-doubt could be aided by seeing earlier behavior in a different light. The unattractive facets of the record, not only plentiful and blatant but intimidating as well, would need to be disregarded, while more salutary interventions, though having proved decisive in only a minority of the skirmishes, are honored, in the hope that their future influence will be disproportionate to their former presence. Invoking memories of choice-points where recalcitrant habit has been subdued can both energize the push to overturn any momentary fear of being unequal to the challenge and inspire an attempt to repeat the successful performance. The prompt I-did-it-before-so-I-could-do-it-again may serve as a launching pad for counteraction when the specter of insufficiency makes a heartening conclusion by no means assured. Even a single strand of improvement might be used to pull oneself toward a further uptick in efficacy. In the absence of evidence that bouts of excess can be prevented from running their course, a person will have extra trouble limbering up for combat cognitively, and is vulnerable to standing idly by the next time the wayward tendency forcefully asserts itself.   

          For those without earlier triumphs to recall when confronting the lure of impulse once again, there are other avenues to a mind-set that could underpin resolve. Someone who tires of being a slave to a debilitating habit, and who is ready to approach the matter with a new seriousness, can reshape the reigning priorities by changing how the consequences of acting with abandon and showing restraint are construed. When the entrenched pattern is playing out unthinkingly, a rapid escape from unpleasant feeling is the anticipated outcome that drives a person to surrender to impulse. Moreover, the thought of not doing the urge's bidding is unsettling because it is linked to the peril of having to withstand a hard-to-bear state for longer than seems manageable. During the maneuver that transforms the internal landscape, an exchange in status, akin to a reversal between figure and ground, comes about. The rationale for impulsivity is removed from authority, and a reconfigured outlook, focused on the logic for imposing behavior that cuts against the grain of established habit, is planted at the forefront of awareness. In the revision whose goal is to enhance self-control, emphasis is shifted from the equilibrium to be restored by heeding the call of impulse to the price to be paid for taking a shortcut to a reduction in tension. And in the corresponding segment of this interior pivot, the emphasis shifts from the frustration to be endured by delaying the release of a burgeoning inclination to the returns to be garnered from erecting a disciplined response. Holding fast to these adjustments in viewpoint, especially if once dominant ideas threaten to topple them, can favorably affect the balance of power within, and become the precursor to obtaining an uphill victory.      

          The penalties for rushing headlong toward gratification too regularly are an upsurge of discontent and an ebbing of power. Capitulation in the face of an onslaught of desire can spawn self-disappointment for having missed the opportunity to react effectively at a critical moment. As the number of instances of impulsivity grows larger, and the cumulative loss of mastery becomes stark, one may feel shamed, even sickened, by the turn fate has taken. Should the uncontrollable actions harden into a refractory pattern, and be experienced as having a life of their own, the verdict issuing from inside could be sweeping and severe. Rather than viewing the flare-ups as ill-advised conduct that begs for repair, they could be interpreted, especially if vexing deficits are evident in several domains simultaneously or there exists a proneness to channel vehemence inward, as an incontrovertible sign of one's utter lack of value as a person. The failure to prevent a consuming urge from emerging as behavior can influence whether it will be possible to exercise restraint subsequently. Since it is difficult to gain sustenance from observing an absence of competence, and because maintaining an effort requires a belief in one’s capability, each setback contributes to the higher likelihood of another defeat when the same battle is joined on the next front. How strong a grasp a person has of these realities will have a bearing on the course of the struggle. Someone stands a chance to break the momentum of bad habit by concentrating, once a craving is beginning to undercut the potential to resist it, and after directing the mind forward in time, on the losses to be suffered on the far side of tumbling into unbridled action. Instead of being driven by the imperative to erase immediate pain, one can be guided by the intention to avoid becoming trapped within the problem more deeply. Vividly picturing, at a moment of vulnerability, the sour feeling in store and the weaker future being cemented were rashness to prevail, could unlock the motivation to parry its expression, so that further self-damage is averted and a stepping-stone toward additional progress is put in place.

          A boost in self-respect and an infusion of new resolve are the benefits that may derive from keeping an impulse from seizing control of the helm of the mind. A tactic for skirting trouble involves treating an intruding urge not as a command to be obeyed lest intolerable tension persist, but as a call to brave the pressure in need of release until an experience of mastery solidifies. There are modes of thinking that can help temper the disquiet within, and facilitate a reversal in the relative intensity of the competing inclinations. A person in the throes of a developing impulse might profit from realizing that the situation presents a choice between seeking comfort and acquiring strength. Remaining aware that the easy satisfaction to be gained from running toward pleasure is usually fleeting, leaving enervation in its wake, could lessen its appeal as an option. Psychological muscle is built by resisting the push of an unwholesome inner force, or by pushing past an inner resistance to engaging in advantageous though demanding action. A keenly felt sense that a dedicated effort to counter being overtaken by desire will enhance mental toughness can provide the incentive for someone to gather the energy to embark upon it. Another consequence of standing firm while being driven toward excess, which could serve as an impetus for acting resolutely, is the effect of the initiative on the depth of one's self-regard. Recognizing at an urgent moment that a choice exists between feeling good by flooding the body with sensation, and feeling good about oneself for containing a harmful desire, can be a prelude, for the person who aches to escape the grip of the habitual, to selecting the truly nourishing alternative. The delight in displaying fortitude at junctures where one had been victimized by appetite may prove to be an ample substitute for the mindless pleasures being left behind.