Does a patient seek treatment to change (i.e. "get better") or is h/she simply looking for relief of their symptoms.

People tend to go to the doctor to relieve an achy back, fever, a rash, etc. --we want to feel better--for sure, but getting to the root of the problem is something entirely different. In some cases going to the doctor, chiropractor, psychiatrist can offer the illusion that you're actually doing something about it--a false sense of security that things "will get better."

Meadow writes in her unpublished manuscript, "In treatment we find that the individual who seeks us out is often faced with painful symptoms which he wishes could be eradicated, but not at the expense of knowing the unknowable . . . the patient does not enter treatment to find out what his secret desires are. In fact, he prefers to remain in a status quo relationship with his treating partner in a place where he can experience the environment as a stable, known, and comfortable, and that comfort is most likely to occur in a repetition of the past."

Environments relationships (painful as they sometimes can be) that are predictable, old, familiar and safe seem to be more desirable than what is involved in knowing.

Do we really desire to know the truth?

In Mills' paper "Lacan on Paranoiac Knowledge," he writes "although people may show interest in knowing why their lives and interpersonal relationships are unsatisfactory, and specifically what keeps interfering with their adjustment and happiness, Lacan (1955-56/1993b) suggests that there is a more fundamental unconscious wish not to know any of those things . . . this is why Lacan says that patients do not want to give up their symptoms because they provide familiarity and meaning: we enjoy our symptoms too much! . . . from this standpoint, the unconscious is first and foremost sadomasochistic: it inflicts a perverse pleasure through suffering at its own hands."

The desire to change is far more complicated than is consciously admitted.