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The Four Questions
Copyright © 2009 by Richard A. Grossman, Ph.D.  ·  All Rights reserved  ·  E-Mail: ragrossman@voicelessness.com
There are three questions that I hear repeatedly in my work as a therapist:  Who (or what) am I?  Do I have any value?  Why doesn’t anybody see or hear me?  Sometimes there is a fourth question:  Why should I live?  These are not intellectual questions to be discussed with a glass of wine over dinner; they are deadly serious and come directly from the heart, and they reflect a primordial experience of the world separate from problem solving and reason.

Usually it is not the questions themselves that bring people to my office, at least not directly.  Typically a relationship has failed or is failing, a job has been lost, an illness has occurred, or something has happened in the person’s life that has dramatically reduced their sense of agency.  Instead of resilience and conviction, the person is surprised to find a bottomless pit.  Suddenly, the person experiences the terror and helplessness of freefall, and they make the telephone call.  It only takes a session or two, however, to find there are two problems:  the current situation and what the situation has uncovered.

Where do these questions come from?  Why are some people terrorized by the four questions their whole life, while others don't even notice their existence?  And why are they so cleverly disguised in many people’s lives—only to suddenly emerge as all-encompassing and sometimes life-threatening ruminations?   It is currently fashionable to posit a purely biological explanation for behavior that we can’t explain (just as, in past decades, it was fashionable to posit a purely familial explanation):  the four questions are really cognitive manifestations of a neurotransmitter imbalance (too little synaptic serotonin), or reflective of a broader genetic problem.  There is truth to both of these answers but they are incomplete.  Biology certainly plays a role, but biology and life experience interact—each one affecting the other.
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