The Anxiety of Change
There comes a moment in every psychotherapeutic relationship where the client asks something like: so I feel like I understand my past and myself now, so what do I do with all that understanding? The implication of statements like this is summed up in another kind of comment: I get all that, but my life is still the same.
The risk in many kinds of psychotherapy is too much emphasis on understanding and awareness and not enough on what to do with all that. Both are part of a process where people come to see themselves and their past differently and come to therefore live differently based on that. And it's also a feedback loop where the change can inform the understanding as much as the understanding informs the change.
So even the most psychoanalytic therapist will have to face this question and try to answer it. Understanding can, for some people, imply and necessitate living differently, but not for all. Therapists need to be prepared to help the process where someone decides how to push through entrenched patterns, to bear uncomfortable states and situations.
This leads to an important point about how we are. Humans don't like change. We shy away, for the most part, from the unfamiliar. We interpret anxiety about something as a reason to not do it. But in many cases, anxiety is just telling us we're on unfamiliar turf. The hardest thing for all of us to do is decide to go towards what makes us anxious, not away. Change is uncomfortable and all the understanding in the world won't necessarily change us. Sometimes we need to do something.