A few emotional problems fall under the heading of true psychiatric disorders and result from physical causes. They include, for example, epilepsy, drug addiction, and Alzheimer's disease. But these conditions are in the minority; most emotional "disorders" have not been traced to underlying organic causes. There are several currently competing hypotheses relating to possible biochemical bases of schizophrenia, mania, depression, and anxiety disorders. As time goes by and medical research progresses, more emotional conditions will very likely be tied to underlying physical problems. Until that time, however, they remain _medically_ incurable conditions. At present, the possibility of overcoming them depends heavily on clients themselves, their ability to find an approach to therapy that is appropriate for their personality and their goals or problems, and their good fortune in locating a therapist who is able to help them to summon the faith, energy, determination, and courage necessary to overcome their sense of demoralization. {282} 21 LIFE AFTER THERAPY Theoretically, psychotherapy is never-ending, since emotional growth can go on as long as one lives. Lewis R. Wolberg, _The Technique of Psychotherapy_ It can be difficult to know when to terminate therapy: difficult for you, the client, and sometimes also difficult for the therapist. Some periods in therapy do not lead to a successful outcome. You may become dissatisfied with the process of therapy or with the therapist. Or, the therapist may become disappointed in your willingness to work and to change. An impasse may be reached where it seems no progress can be made. When this happens, it can be hard to know when to draw a line, to say: "We've tried, but we have to face the fact that we're not getting anywhere." But sometimes this has to be said, and then you may decide to look elsewhere for help. On the other hand, when your therapy has been successful and has led to clear, constructive results, it may also be difficult to know when to stop. To most clients, what tends to be most important is _relief from symptoms_. When this is achieved, you may be tempted to terminate. But relief from troubling symptoms is not always a sign that problems have been resolved. {283} Frequently, relief from distress comes about because of _problem avoidance_. You may have structured your life in a way that circumvents, rather than faces, the things that trouble you. There are times when this is indeed the best solution. However, the tendency is for clients to associate relief with effective therapy, and often this is not the case. The therapist, on the other hand, may have certain personal values that he wishes to satisfy before ending therapy with you: he may favor, for example, qualities of assertiveness and ambitiousness (or qualities of submissiveness and compliance), want you to develop these traits, and feel reluctant to end therapy until you have done this.