If most emotional problems, like most medical problems, are caused by
bad luck as well as by factors over which man has control, then those who
suffer from such problems must accept a burden of helplessness. When
patients and their families overuse theories of causality to avoid
accepting their helplessness and to create an illusory sense of human
control, unjust assignment of responsibility and excessive expectations for
change may erode self-esteem and make change more difficult. The authors
present examples of interventions that challenge the overuse of theories of
causality. Although these interventions aroused hopelessness, they also
fostered realistic hope and change.Abstract Teaser