Very much the same thing holds true in psychotherapy: some clients simply get more from therapy than others. Why? In part it has to do with how well matched a client and the approach of the {280} therapist are. In part it is the amount of confidence the client comes to feel toward the therapist as a person. Beyond these, the qualities of a successful client are very similar to those of a successful student. Specifically, clients who have successful experiences in therapy tend to share these characteristics: * While in therapy, they are motivated to change: They feel considerable internal pressure to do something to resolve their problems. They come to feel a sense of initiative and determination. They come to believe in the process of therapy and feel it can be of help to them. * They are self-disciplined. They keep appointments regularly, they attempt to implement the therapist's recommendations, and they are less incapacitated by their difficulties than other clients with similar problems. * They have a level of emotional maturity that is high enough to withstand some of the painful feelings or frustrations they encounter in therapy. * Frequently they come to _enjoy_ therapy. Obviously, a great deal does depend on the therapist. And yet, while a good student can learn much in spite of a poor teacher, a poor student learns little from an excellent teacher. Successful therapy depends primarily on the client. Other factors can affect your ability to succeed in therapy, but these are factors over which you have no control: * whether you have the emotional support and sympathy of an understanding and tolerant spouse or family * whether you have had a long history of emotional problems in connection with work and interpersonal relations (deeply ingrained habits are harder to break) * whether precipitating factors brought about your present difficulties or they just appeared "out of the blue" * how long you have had your present problem * what the problem is: whether it is purely emotional or it has affected your capacity to think coherently and realistically * whether there have been fortunate or unfortunate events in your life before and during therapy {281} What the future holds in store for you after therapy relies greatly on many of these same factors and on many of the personality qualities that helped you, or hindered you, as a client in therapy (see Chapter 21). SO, DOES PSYCHOTHERAPY WORK? Yes, for certain clients and under certain circumstances. The main changes that psychotherapies aim for are either to eliminate destructive habits of thought, attitude, or behavior or to establish new, constructive habits. Neither one can be accomplished by means of a medically effective treatment that is applied to the patient until a cure occurs.