Her life is in turmoil. Her children do this; her parents do that. Her career is a mess. It seems like she needs help and advice more than therapy.

Possibly so. If your preferred mode of assistance is service, then by all means trust yourself and advise as needed. However, if you choose to be a psychotherapist, the person she needs help and advice from, is…(guess who?) Herself! As you describe the situation, her children, her parents, and her career are all content. Each is both a stage on which she acts out her life drama, and a prop in her play.

Since two of her current processes are 1) creating a mess and 2) not-taking advice, you might suggest

“Let’s explore how you manage Not to take the advice given to you by . . . (parents, co-workers, advice columnists, television shows, friends, neighbors, employers, career counselors, religious leaders, etc.)”

“About the messes in your life, let’s assume that any human in your position might have done the same thing. Given that they might have played a small part in the making of that mess, what might that part be?”

Imagine that this woman is doing her best to teach herself something. Neither of us knows what the “something” is. Outside of session, both of us are clear we wouldn’t choose to go about learning whatever her lesson is in quite the same miserable way. In session however, if we can come from the perspective that she (and every person) is resolutely moving in a positive direction, then it is much easier to accept that creating messes and turmoil is exactly what this woman needs to be doing.

“Close your eyes. Imagine that your life is even messier. . .What is different? . . .What would you have to do to make that happen?”

“Now imagine that your life is much less messy . . . What is different?. . .What would one have to do to make That happen?”

Your job is to trust her completely and invite her to attend to herself, her process, and her experience as she experiments with a) doing what she is doing, more, b) doing what she is doing, less, and c) staying exactly the same.