Prescribe the problem

by Dale Davidson March 18, 2026

I just finished Lori Gottlieb's book, Maybe You Should Talk to Someone.

Maybe You Should Talk to Someone: A Therapist, HER Therapist, and Our Lives Revealed

Lori is a therapist (of The Atlantic's 'Dear Therapist' column) who wrote a book about her own experience with therapy and the work she did with some of her patients.

I'm not in therapy, but it's cool to learn about some of the techniques they use with their patients.

One of them is called "Paradoxical Intervention."

Basically a patient tells the therapist their problem and then the therapist agrees with them and tells them that they definitely can't or shouldn't do the thing they can't do.

Sometimes a therapist will deliberately “prescribe the problem” or symptom that the patient wants to resolve. A young man who keeps putting off finding a job might be told in therapy that he can’t look for a job; a woman who won’t initiate sex with her partner might be told not to initiate it for a month. This strategy, in which the therapist instructs patients not to do what they’re already not doing, is called a paradoxical intervention. Given the ethical considerations involved, a therapist has to be well trained on how and when to use paradoxical directives, but the idea behind them is that if patients believe that a behavior or symptom is beyond their control, then making it voluntary, something they can choose whether or not to do, calls that belief into question. Once patients realize that they’re choosing a behavior, they can examine the secondary gains—the unconscious benefits it offers (avoidance, rebellion, a cry for help).

If I were your therapist and you were resisting going 1099, believing you're not qualified, it's too risky, etc., I would tell you to definitely NOT go 1099 and that instead you should stay in your W2 job for the rest of your life.

My prescription would then trigger you to reflect on what hidden benefits you get from choosing to stay in your W2 role (prestige, a sense of security, etc.)

Once you surface these hidden benefits, you can then perform a more realistic analysis of what the costs and benefits are to going 1099 and make a choice with all your feelings in the open.

Okay so I might be stretching a bit, but there ARE reasons why making the leap to 1099 can stir up lots of emotions and resistance. You understand intellectually why it would make sense to take the risk but something holds you back.

So I'll ask you this: what would it mean to choose to stay as a W2 employee? What would you stop worrying about if you told yourself, "I will not go 1099." What worries would persist?

Once you do the analysis, maybe then you can make a choice and move on with your life.

Want the full playbook? Check out Going 1099.