We’re now so firmly in the era of standardized, manualized, empirically validated, insurance-friendly, client-soothing psychotherapy that it’s easy to forget the radical origins of our field. In late 19th-century Vienna, Freud shocked conservative, straight-laced, bourgeois society with his radical ideas (i.e., the psychic challenges adults face mostly stem from childhood sexual traumas) and treatments (i.e., all talk, all the time). Similarly, even if all the creative, new movements in the field—behaviorism, Gestalt therapy, humanist psychology, cognitive behavioral therapy, family therapy—weren’t equally revolutionary, in their day they all had at least a certain out-of-the-box quality. Today, however, it often seems that the only unbreakable rule for doing therapy is never to surprise, never to be anything other than soothing, neutral, nonconfrontational, usually non­directive, and pleasant, and never to shock anyone—not clients and certainly not the insurance companies that reimburse their treatment.

But there are times when clients are deeply stuck, not just in the unhappy circumstances of their pain—the failing marriage, the unrelenting depression, the crippling anxiety—but in the unshakable sense that nothing they do will make any difference. Having tried and tried and tried to make things better—usually, of course, by engaging in the same ineffective behavior over and over again—they give therapy a go. Often, they’ve seen several therapists;…