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Resolving Guilt in Therapy

Martin Hsia and his Moment of Meaning

  • Have you ever felt guilty?
  • Have you made life decisions based on guilt?
  • Do you beat yourself up over choices you made long ago?

Of course you have, we all have. We tightly hold the wrongs of our past and punish ourselves for decisions we made decades prior. Decisions we never would have made had we known the consequences. Decisions we wish we could do over.

The past offers no "do overs." Our history is written in stone, and now we're left with the consequence: guilt. How could I be so stupid? Why didn't I know better? What does that say about me? Many of us carry those questions around daily. So what have you done to resolve it? Is it resolved, or are you still afflicted with guilt?

Glendale, California psychologist Dr. Martin Hsia saw the impact of guilt in a client who felt like a "piece of crap" for something that occurred 40 years ago. He had a shameful secret from his past and took full responsibility into his adulthood, serving a life sentence for the split-second choice of a teen.

In the video above, Dr. Hsia artfully employs a CBT technique known as the "blame pie" to help a client gain perspective on his problem as one of the stories told at the Moments of Meaning event earlier this year. He also took a minute to share some his thoughts about his talk:

Ryan: Why did you choose to tell this particular story?

Martin: This story has been drastically transformed to protect confidentiality. What does remain the same is the core structure: a tragedy, a relentless self-blame which became part of this person's foundation and identity, and a fresh set of eyes offered in therapy leading to a sudden and dramatic breakthrough. I chose to tell this story because to me, I experienced as powerfully as ever the potential for therapy to break down walls and bring fresh perspective. Even though I was in the therapy chair, I did not feel as if I was "working" or guiding the process - the path we took seemed natural and intuitive, even if not easy.

Ryan: What do you hope viewers will learn from it?

Martin: I hope viewers will be touched by this client's struggle, but even more inspired by his discovery. The mind plays tricks on itself, but also holds the keys to its own discovery and growth - and therapy can help with that key-testing process. Profound change is possible, even after years of stagnancy and struggle; and though even therapists cannot predict exactly how or when those changes will happen, the important thing is to engage, to explore, and to keep reflecting together.

Ryan: What was it like performing this on stage?

Martin: The unique challenge of crafting and delivering this story was trying to paint a portrait of this client and our interactions in a short amount of time, while also building up towards his shocking moment of meaning. The moment of staring at the Blame Pie illustrates the disorientation of being confronted with a reality that deviates so drastically from a previous perception. As he starts to allow the actual reality to settle in, the ripple effect on his whole life begins to shift, and I hope that experience comes through to the viewer.

Ryan: Yeah, I think it does, along with a lot of your compassion and insight. Thanks, Martin.


Moments of Meaning is a non-profit event developed with the purpose of demystifying therapy and reducing therapy stigma through storytelling. Come see more talks at the website and connect through the Facebook page. It's a National Psychotherapy Day event, by the way.

Join me at my Facebook and website as well. It's guilt-free!

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