Imagine a game in which you alone determine when play begins and ends. Although not an easy contest, you get to set the goals and mark the finish line. You can interrupt the match whenever you want and restart later if you wish. The game may last a long time or a short time, but you are assisted by another player who will help your cause.

Now guess the name of the game.

Psychotherapy.

As I’ve described it — and I hope you agree — there is no opponent other than the one you face daily in the mirror. Then why is “the talking cure” so hard?

Lack of willpower is one of the reasons. And, ironically, strength of will (or rather, its absence) is the one least discussed with patients.

Counselors don’t talk to clients about will because doing so sounds critical and blaming, as well as being unhelpful. Examples? “You need courage. You must push through.” Or, worse yet, “man up.” In practice, that means tolerating the emotional pain of facing yourself and uncovering difficult truths about yourself; spade in hand, excavating excruciating memories you’ve dismissed or buried. It presents one of the greatest challenges any of us ever face: change.

Therapists are also hesitant to admit their own lack of all the tools to heal. Yet, we are helpless without your motivation, persistence, and courage. If you dodge self-revelation, keep your barriers high, are unwilling or unable to try new things, don’t show up faithfully to appointments, fail to give negative feedback when necessary, don’t bother to do therapeutic homework between sessions or think carefully about what happened in the meeting — well then, the doc’s job is hard if not impossible.

Sports metaphors come to mind: “the team that wants victory more will win.” Or, “we must give everything we’ve got.” Green Bay Packers coach Vince Lombardi encouraged his players by saying, “Winning isn’t everything. The will to win is the only thing.”*

Even military examples apply. In criticizing a recent failure of the Iraqi forces against the Islāmic State (ISIS or ISIL), US Defense Secretary Ashton Carter said, the Iraqis had “no will to fight” despite vastly outnumbering the enemy.

A psychiatric mentor of mine called the presence of this will, “therapeutic integrity.” With those two words he was referring to people who stop at almost nothing to improve their lives, sometimes leading the treatment by their own self-exploration and risk taking — demonstrating tenacity and quiet determination. This is not a question of fear, but rather of heroic triumph over fear. Indeed, some wonderful models of this characteristic don’t even realize they exhibit anything special.

An example: a middle class, middle-aged woman suffered sexual and physical abuse in childhood, and was much criticized as an adult — to the point of becoming the family scapegoat. Psychiatrically hospitalized, the exposure of painful repressed memories of her abuse contributed to a brief catatonic state in which she was mute. After a long process of treatment she went from terrible guilt and depression to recognizing and grieving what had been done to her by those she loved. Eventually, this person (who had been fearful of noises and male strangers) wound up providing humanitarian aid in Africa in the midst of a civil war.

She had therapeutic integrity. Heaps of it.

This doesn’t mean the lady didn’t falter or struggle. It doesn’t mean she had no issues with her therapist (me) or an easy time when I went on vacation. It means she “hung in” until she was where she wanted to be. I don’t know whether my client was gifted with resilience due to her genetic makeup. On first encounter her voice was quiet, her body language suggested timidity, her eyes downcast. She was bolstered by a powerful religious faith, but did express temporary doubts about a superior being who would permit what happened to her. Somehow she found strength in herself beyond a therapist’s ability to create.

Not every patient must possess great amounts of intestinal fortitude. Not every person’s durability is stretched to the limit by the arduous road bringing him to treatment and by the therapy itself. Sometimes, however, the presence of “will” is the difference between success and failure of the heroic assault against psychopathological demons.

I don’t blame those who can’t find this quality. Sometimes the therapist is at fault for lacking skill. I think it another one of life’s inequities that resilience is not evenly distributed. I tried to enable everyone in my practice to find this ability.

Many times the resilience seemed to take forever to retrieve. I looked hard for the tiniest of eggs fertilized by a therapeutic spark. No matter how small the egg, with progress the zygote of willpower grew. On other occasions dedication in the face of terrible odds wasn’t anywhere to be found.

In the consulting room, alone with the therapist, you are pitted against yourself. No enemy is fighting you but what is inside, the echoes of past defeats, the injuries still fettering you. I won’t criticize you if the steam roller of the world flattened you and left you unable to get up. I only know I never succeeded in lifting anyone who didn’t (at least in some small part of himself) want to be lifted or who required me to do the heaviest part of the lifting.

Norman Cousins said, “Free will and determinism are like a game of cards. The hand that is dealt you is determinism. The way you play your hand is free will.”

Ralph Waldo Emerson put it this way: ”They can conquer who believe they can. He has not learned the first lesson in life who does not every day surmount a fear.”**

The game is over only when you say so. That is as much control as any of us get.

—

*Actually, there is some argument whether Lombardi wished to say precisely this or something close: “Winning isn’t everything; it’s the only thing.”

**The italics are mine.

The top photo is of Sultan Rakhmanov in a 1980 weight lifting competition. It is the work of Vitaliy Saveliev. The second photo is called Weight Lifting: Black and White by imagesbywestfall. Both are sourced from Wikimedia Commons.