‘I Don’t Feel Like a Productive Member of Society’

One session, after yet another uneventful review of her psychiatric symptoms, during which she denied every symptom, I had 20 minutes left and nothing else to talk about. I decided to dive into her work history. After all, not being able to hold a job was her chief complaint. I asked her to tell me about every job she’d ever had. How did she get her first job? Why was she fired from her last? What had her employment journey been like?

Twenty minutes later, I realized something: She had done something consistently for eight years in her life. She volunteered at a soup kitchen. Eight years! I hadn’t worked for that many years yet myself. She explained that, while she didn’t have to worry about having a roof over her head and food on the table, she knew that wasn’t the case for everyone. Somehow, it was deeply important to her that everyone had access to those basic needs.

I asked her why she stopped going to the soup kitchen. She told me that she’d gotten a paying job and became too busy to continue volunteering. Since then, she hadn’t gone back. When I asked why, she shrugged and said, “I don’t know.” I suggested, “Maybe you should go back.” She reacted as if this was a brilliant idea that she could have never been able to come up with by herself. She said she’d definitely go.

I didn’t believe her. I assumed she’d return next month with the usual excuse of forgetting, and I’d be left scrambling for another 30-minute filler session. I was so wrong.

At her next visit, she proudly announced that she had started volunteering at the soup kitchen again—she had already gone three or four times that month. I was pleasantly surprised.

Right before her visit, I had learned about a simple therapy technique during didactics called “Three Good Things.” I explained the concept to her and asked if she’d be interested in trying it. She agreed, so I printed out a worksheet and handed it to her as homework. Again, I fully expected her to come back with nothing but excuses.

But once again, she surprised me. The next month, she returned with a messily scribbled stack of papers. She had written down three good things every single day. Frankly, I couldn’t have shown that level of commitment myself. There was something almost divine in her doing. She was clearly desperate to get better, to feel happy again, and to reclaim some sense of meaning in her life.

Most of her entries were simple: “I brushed my teeth.” “I got out of bed this morning.” “I went to bed around 10 p.m.” “I took my meds.” But one stood out to me: “Made in-person psychiatrist appointment, when I REALLY wanted to reschedule.” As time went on, her accomplishments grew more sophisticated. Her later entries read, “I didn’t feel guilty setting boundaries with my parents,” “I got some exercise,” and “I spent time with friends at a park.” The most impressive? She had hit a 700-day streak on Duolingo.

She told me, “Doing this, I realized how difficult it’s been to just get out of the house. But once I’m out, I feel more motivated and can actually get things done.” She then shared another observation: “I also noticed how much anxiety has been driving my life. I think I need more help to tackle this. Can we consider increasing my meds?”

To be honest, this all just happened a month ago. But I hope that maybe, years later, she’ll reminisce: “That was the beginning of my journey toward recovery.” ■