Sometimes it may seem to others that the person who comes in for psychotherapy does not really need it. How can John need therapy He has everything: a great wife and children, he makes a nice enough living, he is good looking, and he always seems happy. Or, why would Mary ever need to go to a shrink She is happily married, she has a good job, has two wonderful children, etc, etc. Well, as we all know, outward appearances can be deceiving. Inside the perfect picture window that looks so happy and content often lies a very different story. If you knew John better, you would know that he came from a family where, if you did not rise to the very top of the corporate ladder by the time you were forty, you were considered a failure. Making $180,000 a year would be unheard of for most people, but within John's frame of reference, believe it or not, he feels like a downright failure. And Mary, whose mother had been an abusive alcoholic her whole life until she died two years ago, is still wrestling with demons from her childhood that get in the way of her feeling like she deserves any modicum of happiness. So, appearances can be deceiving. On the other hand, there are people whose lives appear to be a train wreck even to the most distant observer. Bill has never held a job for more than six months, goes through relationships like there is no tomorrow, has a temper that can be triggered by the most innocuous of events, yet believes that all of his problems are inevitably caused by bad breaks, and others' behaviors, never of his own making. It is always out there. Bill will likely never cross the threshold of a therapist's office, unless dragged there by a desperately unhappy girlfriend, by a family member or friend, or in some cases because the court has sent him as part of his rehabilitation. And when he reluctantly walks in the door, his prognosis for real change is poor unless he can begin to see that he has played a role in his many years of mistakes,...