Sometimes it comes with the person. In the case of Marie, she walked in having always been a very hopeful person. She had that combination of agency and pathways. Many military people have it; they just lose it along the way.
In the case of John, at the beginning he had multiple issues that I would prefer not to get into, but when I told him that I thought we could treat this, he said, “That's not what I have been hearing. Are you sure about this?” He struggled with that. I said, “Isn't it nice that you have a therapist who's hopeful? I'll carry the hope for a while.” He appreciated that. Eventually he took it on and continued.
It's interesting, though; it remained an issue throughout the whole treatment. I met them both last week, and they both said that when their SUDS were hitting peaks, they didn't believe the treatment would actually work. The only reason they continued to do it was not that I was such a wonderful therapist that I had convinced them, but that they wanted to be able to say that they had done absolutely everything. It was just real stubbornness on their part that they got through it.
That they had hope to begin with carried them. I think it's something we need to work on all the time as therapists.