Stuck in an existential quagmire: The role of perceived true self-knowledge in client stuckness

Introduction: Research suggests that perceived true self-knowledge is important for well-being. However, less discussion exists about how perceived true self-knowledge affects therapy outcomes. We suggest that perceived true self-knowledge may be important when attempting to address client stuckness (i.e., lack of progress in therapy; Beaudoin, 2008). We argue that when clients perceive a lack of true self-knowledge, they are unable to draw upon the true self-concept as a source of meaning. This may hinder therapeutic progress and contribute to client stuckness. Methods: We present theoretical evidence for the role of perceived true self-knowledge in experiences of stuckness. Then, we present case studies of two stuck clients and their therapeutic interventions as preliminary evidence for our model. Results: Direct strategies geared at enhancing true self-knowledge by helping the client construct coherent self-concepts worked for one client, but not for the other. Indirect strategies, grounded in social psychological research, are outlined as a method of enhancing perceptions of true self-knowledge for clients who do not benefit from direct strategies. Discussion: Potential moderators for the effectiveness of direct versus indirect strategies to enhance true self-knowledge are discussed. We then outline promising avenues for future research that include attempts to investigate the prevalence of self-alienation in clinical populations, and the effectiveness of strategies aimed at enhancing perceived true self-knowledge among clients experiencing stuckness.