“Doctor, Doctor, I want a big change, as long as I don’t have to change.”1
Michele S. Piccolo, PhD – Jan 2026
This running joke captures, with a kind of everyday wisdom, a familiar dilemma and the many “sliding doors” that shape the possibilities for change, or for staying just as we are, in mental life. We often find ourselves waiting in a space of expectation, hoping we can “stick to our guns” while some decisive “game changer” arrives from the outside. It may appear in a dramatic and unlikely form, such as “winning the lottery,” or in a more modest and realistic one: a promotion, a new role, a fortunate turn of events. Such moments, we tell ourselves, might finally make improvement, what we call “change”, possible.
There is, however, another invitation, quieter and more demanding. It asks us to “let go of our guns,” so to speak, and to reconsider our inner stance toward a reality that may remain stubbornly unchanged, immovable, and at times plainly unwelcoming. In this case, the shift does not occur in the outer world but within. It is an effort to see differently, to revise our understanding, to approach life from a new angle, from the inside out.
These two orientations are not strict opposites. They are not all-or-nothing distinctions, but positions along a living spectrum, with countless variations in between. Human change, like human thought itself, tends to unfold less through sudden transformations than through gradual realignments, as the self and the world are slowly brought into a new and tentative balance.
In my practice, it has been common to meet clients who arrive in therapy expecting change of the first kind, that is, a change in external circumstances. I recall one doctoral student who, after months of work, asked in earnest, “I have been coming to therapy for months now; when will my dissertation adviser start to treat me differently?” Beneath the question lay a familiar conviction: “I have been doing the work; when will destiny reward me with a change of fortune?”
The student was taken aback when I replied that therapy would not alter the external facts of their situation. If the adviser were ever to behave differently, it would not be because some “higher authority” had whispered, in a dream, instructions to the professor on how to revalue their pupil, my patient. Therapy does not reach into the minds of third parties. If the adviser’s disposition were a difficult one, therapy would not remake that professor’s psychology; who would remain, in essence, the same person.
If change were to become possible at all, it would be of a subtler and more uncertain kind. Perhaps “if a newly found responsiveness to the professor’s remarks from you would suddenly touch a positive chord, it might speak to the professor’s heart, to the extent that he might reconsider his approach toward you.” Such a shift would resemble a kind of conversion: not forced, not strategized, spontaneous rather than guaranteed. And even then, it could not be counted on, nor arranged in advance, nor demanded as an outcome.
For this reason, I suggested a different question, one that turns the inquiry inward: rather than waiting on the hope that others might change, one might ask, “In case nothing in the people around me changes, what can I change in myself to obtain a better feeling of things here and now?”
As the weeks went by, that patient gradually gained insight into their hope that some “higher authority” might intervene and change their external circumstances. This hope revealed a deeply rooted conviction, one that often takes shape early in life, when we move through the world as toddlers and “bigger humans”—our parental figures or caregivers—quite literally take care of things for us. In that early arrangement, difficulties are managed elsewhere, by someone larger, stronger, and supposedly wiser.
What emerged in the therapeutic work was the expectation that, even in adulthood, a parental figure, now a hidden and phantasized, would step into daily life and arrange a better order of things on the patient’s behalf. Here we see how an element of developmental psychology, thoughts and feelings formed while we are still growing and still being shaped by experience, can harden into a settled way of seeing the world. What was once adaptive becomes a crystallized worldview — an unconscious expectation that someone will take care.
Such a worldview carries with it quiet but powerful expectations: “a caregiver should take care of me,” and, alongside it, a notably passive stance toward life. The unspoken question lingers: “Should things simply happen to me out of someone else’s intervention, or should I make things happen out of my initiative?” The movement along this spectrum—from passivity to initiative—has long been a central clinical concern in therapeutic work, since the time of “good old Freud,” and it remains just as relevant today.
Does such a patient need to be told, bluntly, “grow up and realize that no one will come to your rescue other than yourself”? Or do they need to hear instead, “I hear you; we all wish, again and again, to be taken care of; it is hard to step out of that stage when someone ‘bigger’ once handled things for us”? The first approach—declaring that “we are alone on this planet”—lands like a splash of icy water to the head: bracing, perhaps clarifying, but also numbing. The second approach moves at a different tempo. It is grounded in empathy and patience, recognizing that outgrowing such a position cannot happen overnight.
This is the central point of this reflection. Change, especially psychological change of the kind in which we slowly “let go of our guns,” tends to be gradual and unhurried. Much like a toddler learning to walk, we need time to take our first steps without holding on to mommy’s or daddy’s hand, to move from one side of the room to the other without outside support. Even when progress is slow, it is still a genuine change, though of an internal kind. It requires rethinking and reconsidering, again and again.
In this sense, we are invited to play the game of life as if no one out there will come to the rescue. Then, should it turn out that “we are not alone,” and something “bigger” truly does arrive to help—“a lottery ticket,” perhaps—it will be received as a welcome and unexpected novelty, what some might call “grace,” rather than as a necessity for survival. By then, we will already be quick on our feet, knowing that we must place one foot in front of the other and summon our own strength in the walk.
And yet, this grown-up stance does not emerge out of thin air. Such a worldview of adulthood—the way a grownup spontaneously meets the world—takes shape in childhood, during the formative years when we first take things in. For this reason, therapy so often involves “walking the memory lane,” a careful return to earlier scenes of life, in order to recover the thoughts and feelings of the toddler within. Only by revisiting those early positions can we gradually outgrow them and arrive, step by step, at a more self-supported way of being.
- 1. This is the first in a series of blog posts that will deliberately set aside scholarly references in favor of a more familiar and easygoing language. And yet, between the lines, one may still glimpse psychoanalytic ideas, sensing their presence without needing to name them outright. ↩︎
