By David Waters - I used to get very excited when I thought that clients were about to embark on what I called a project—a course of action that crystallized a problem into a unifying undertaking. But however valuable creativity can be in setting up the conditions in which transformation may take place, change itself requires repetition and commitment to altering habits.

What first made me fall in love with being a therapist was the idea that I could make a living by having conversations that cut through everyday pretenses, got directly to the heart of the matter, and helped people change their lives. That was then, and this is now. Today as a profession---and as a society---we're much more fearbound and rule conscious than we used to be. Yet the sacred space of the therapy room is the ideal place to really exercise your creativity. It's taken me more than 30 years to realize that it's the combination of two strange bedfellows---imagination and repetition---that holds the key to change.

In these days of Managed Care and Therapeutic Minimalism, my biggest concern about therapy is that we don't ask enough of it. Too often, we don't push ourselves or our clients hard enough to make the changes that make a real difference in people's lives. It's taken me more than 30 years to realize that it's the combination of two strange bedfellows---imagination and repetition---that holds the key to change. To move clients out of their ruts, their numbness, and their stuck places, we need to get their attention and start their adrenaline going at a rate that wakes them up and helps them to experience the fullness of life again.

We need Big Moments to move clients out of their ruts, their numbness, and their stuck places. But the Big Moment needs many little moments to make it stick.