The first step in all therapeutic change is responsibility assumption. If one feels in no way responsible for one’s predicament, then how can one change it? That was precisely the situation with Betty: she completely externalized the problem. It was not her doing: it was the work transfer, or the sterile California culture, or the absence of cultural events, or the jock social scene, or society’s miserable attitude toward obese people. Despite my best efforts, Betty denied any personal contribution to her unhappy life situation.
