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It seems to be that both of these ideas can be addressed if we look at the job of a mental health worker not as a vehicle to get people where they want to go, but rather to help bring them to a place in which they feel comfortable existing. Often times people go into therapy with specific concerns about life, relationships, problems, etc. and yet, don't come out a successful therapeutic experience with those issues solved -- instead, if things have worked, they have been resolved. I think that this is why, specifically, I felt something was remiss with CBT, as what we think we want to change is often not what ends up needing changing. I think a goal of fitting in or acclimating may not mean changing oneself as much as it means changing how one views oneself in the scheme of things, changing how one wants to be viewed, changing how one views other people. If I feel I fit in, then I do, don't I? (It's not as if it is a card-carrying club.) And, in that direction, I think helping someone "fit in" is exactly what therapy is always for -- leading someone to the life they want to be leading.

I also am interested in the issue Ryan raises. What about someone with schizoid personality disorder, with no interest in social relationships, and very little ability to experience pleasure? Often this person won't present for treatment. Often they won't even feel dissatisfied with their status quoe. But is there room for a mental health professional to say, wait, there is a potential problem here?