can't and won't

It is still so difficult to tell the difference between can't and won't.

With most medical problems, such as if you break your leg, catch a virus or rip your cornea, the problem is clear, and except for indirect causes, such as skiing, killing sick people, or smoking, you don't feel like the difficulty was your fault. It's different with mental problems.

People often come to me and they are filled with anxiety. They can't get to work, it makes them terribly jittery. flustered, and confused.

So we work together to find the stresses in their lives, both long term and short term. Then we teach them techniques of how to deal with anxiety, racing thoughts, negative anticipation, catastrophic thoughts and irrational fears. Often, we add some medication to the mix.

I try my best to get them ready to relaunch into the world. I feel that almost all of my clients try too, but sometimes, nothing really changes. They remain too consumed with fears, too trapped by their thoughts, too much just stuck in a bad place.

So, we try again. We do some variations, new explanations, new drugs, new ways of breaking down the obstacles, new ways to try and relax.

But then, sometimes, not much changes.

Then, I, the experienced, all knowing, all caring therapist, can only say:

"HELLO" this is all I have to sell. I don't have any more magic.

I begin to feel like I am dealing with a "won't" instead of a "can't." A some point in psychological treatment, the client has to take the risk of making the change. I try to arrange the changes so that they are not fatal.

But, who knows.