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One of the things I hear most often in therapy is some version of, “Something must be wrong with me.” People come in struggling with anxiety, depression, trauma, perfectionism, difficult relationships, or years of dieting and binge eating. Their stories are different, but many have reached the same conclusion. They believe they are the problem.
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I think this is one of the most painful beliefs a person can carry. Once you start believing you are broken, every setback feels like proof. A binge becomes evidence that you have no self-control. A panic attack means you cannot cope. A difficult relationship makes you wonder whether you are too needy, too sensitive, or simply too much.
Therapy can sometimes reinforce this without meaning to. We have to talk about symptoms, diagnoses, and patterns, and those things matter. I believe in evidence-based treatment, and I know how helpful a diagnosis can be when it gives someone language for what they are experiencing. But a diagnosis should never become a person’s entire identity.
I was thinking about this during my recent conversation with Kathryn Hansen, author of Brain Over Binge. We talked about how recovery does not have to begin with the idea that a person is broken. It can begin with the understanding that they already have the ability to move toward healing, even if they do not fully trust that ability yet.
This does not mean recovery is easy or that serious mental health concerns can be solved with positive thinking. It simply changes the way we begin. Instead of only asking, “What is wrong with me?” we can ask, “What happened to me? What have I been trying to cope with? What patterns once helped me survive, and which ones are no longer helping?”
I see this often with people who struggle with food. Many come into therapy convinced that they cannot trust themselves around eating. They describe themselves as undisciplined or out of control. Yet when we look more closely, there is usually much more going on. They may have been restricting food, ignoring hunger, living under chronic stress, or using food to manage emotions they never learned how to express.
Once we understand the behavior, the story begins to change. What seemed like a personal failure often makes sense in the context of deprivation, stress, trauma, or years of diet culture. The behavior may still need to change, but shame no longer has to be the tool we use to change it.
That shift allows people to become curious instead of cruel toward themselves. They start asking what was happening before the binge, whether they had eaten enough, what they were feeling, or what need they were trying to meet. Those questions lead somewhere. Self-criticism usually does not.
I also believe therapy should help people trust themselves more over time. The goal is not for clients to depend on me for every answer. My hope is that they gradually become more confident in their own judgment, more aware of what they feel, and more able to recognize what they need.
Sometimes the most important thing I can do is not give an answer right away. It is to ask a question and give someone enough space to hear their own response. Many people already know when something feels wrong, when a relationship is draining them, or when they have pushed themselves too far. The problem is that they have learned not to trust what they know.
This is why I often think of therapy as a process of remembering rather than fixing. Underneath the anxiety, shame, and conditioning, there is usually a part of the person that still knows what feels safe, what matters, and what is no longer working. Therapy helps make that voice easier to hear.
Healing is not about becoming a completely different person. It is not about reaching some perfect version of yourself who never struggles again. It is about learning to meet yourself with more honesty, compassion, and trust.
The most meaningful therapy does not leave people repeating the therapist’s words. It helps them find their own.
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