She's been in therapy since she was 16. She's 27 now. Eleven years of weekly sessions, two therapists, one psychiatrist, three different diagnoses, and a medicine cabinet that's evolved through SSRIs, SNRIs, and whatever her current provider thinks might help.

She's done the work. She can name her attachment style, identify her triggers, trace her patterns back to childhood, and explain exactly why she struggles with intimacy, commitment, and risk. She has language for everything.

She also hasn't held a job longer than eight months, hasn't maintained a relationship past the six-month mark, and hasn't lived outside her parents' house since college. She's been preparing for life for over a decade. She hasn't started it.

This isn't a failure of therapy. It's a failure of what therapy has become.

The Adlerian Distinction

Alfred Adler distinguished between two types of compensation for feelings of inferiority.

Useful compensation builds genuine competence. You feel inadequate, so you develop skills. You practice. You fail. You try again. You become capable. The inferiority resolves because you actually became better at something.

Neurotic compensation builds elaborate strategies for avoiding the tasks of life while maintaining a sense of superiority. You feel inadequate, so you construct a story about why you can't engage yet. You're not ready. You're still healing. You're working on yourself. The inferiority never resolves because you never test yourself against reality.

Adler would look at the modern therapy-industrial complex and see something familiar: avoidance dressed as insight.

The Pattern

The pattern is predictable once you see it.

You feel inferior in some domain: relationships, career, social situations, self-worth. The inferiority is painful. You seek help. You enter therapy.

Therapy provides relief. You're understood. You're validated. You have a space where your struggles are taken seriously, where you're not judged, where you can process without consequence.

This is genuinely valuable. For a time.

But then something shifts. Therapy stops being preparation for the tasks of life and becomes a substitute for them. The safe space becomes the only space. The processing becomes the point.

Years pass. You're still in therapy. You're still "working on yourself." You can articulate your wounds with precision. You understand your patterns deeply. You've developed a sophisticated internal vocabulary for your suffering.

But the tasks of life remain unattempted. You haven't risked the relationship. You haven't taken the job. You haven't moved out. You haven't started.

You're always almost ready. You never have to begin.

Fictive Superiority

Adler had a term for this: fictive superiority.

It's the belief that you're doing important inner work, which exempts you from the outer work that actually builds competence and connection. You're not avoiding life. You're engaged in something deeper. You're healing.

The fictional goal shifts from "become capable" to "become healed." And because healing is never complete (when is anyone fully healed?), the goal recedes forever. There's always more work to do. Always another layer to process. Always a reason why you're not quite ready yet.

This isn't conscious. Nobody wakes up and decides to use therapy as an avoidance mechanism. It happens gradually. The relief of the therapeutic space becomes preferable to the risk of the real world. The identity of "someone who is healing" becomes preferable to the identity of "someone who might fail."

The Therapy-Industrial Complex

This pattern is enabled by a system that profits from it.

Therapy has become a $20+ billion industry in the United States. The average therapist sees 20-30 clients per week. The incentive structure is simple: retention. A client who terminates is revenue lost. A client who stays for years is revenue secured.

This doesn't mean therapists are consciously keeping people dependent. Most genuinely want to help. But the structure doesn't reward termination. It doesn't reward building clients who don't need you anymore. It rewards ongoing engagement.

Meanwhile, the cultural narrative has shifted. Therapy is no longer a tool for crisis intervention or specific skill-building. It's a lifestyle. "Everyone should be in therapy" has become a truism. Being in therapy is a signal of self-awareness, emotional intelligence, and personal growth.

The result: people enter therapy without clear goals and stay without clear endpoints. The question "what would it look like to be done?" is rarely asked. The assumption is that you're never done. There's always more work.

What Adler Would Say

Adler's therapy was short, directive, and focused on action.

He wasn't interested in excavating your childhood for years. He wanted to know: what are you avoiding? What would it take to stop avoiding it? What's the smallest step you could take toward the tasks of life?

His measure of progress wasn't insight. It was behavior. Are you working? Are you connecting? Are you contributing? If not, all the self-understanding in the world is just sophisticated avoidance.

Adler would ask the perpetual patient a simple question: What are you getting out of staying stuck?

The answer is usually safety. Staying in therapy, staying in preparation mode, staying "not ready yet" protects you from the possibility of failure. You can't fail at a relationship you never start. You can't get fired from a job you never take. You can't be rejected by a community you never join.

The fictional goal of healing protects you from the real risks of living.

The Tasks of Life

Adler organized human functioning around three tasks: work, love, and community.

Work: Contributing something of value. Building competence. Being useful.

Love: Genuine intimacy. Vulnerability. Commitment to another person.

Community: Belonging to something larger than yourself. Contributing to the collective. Social interest.

Mental health, for Adler, was the capacity to engage with all three. Neurosis was the retreat from one or more of them.

The perpetual patient often has elaborate explanations for why they can't engage with these tasks yet. They're not ready for a relationship until they've healed their attachment wounds. They can't commit to a career until they've figured out their purpose. They can't join a community until they feel more secure in themselves.

These explanations feel reasonable. They're also indefinite postponements. The healing is never complete. The readiness never arrives. The tasks remain unattempted.

The Way Out

The way out isn't to quit therapy. It's to change what therapy is for.

Set a termination goal. What would it look like to be done? What specific capacity are you trying to build? When will you know you've built it?

Measure behavior, not insight. Progress isn't understanding your patterns. Progress is changing them. Are you doing things differently? Are you engaging with the tasks of life?

Time-limit the preparation. Preparation that never ends is avoidance. Set a deadline. After six months, you start the thing you've been preparing for, ready or not.

Distinguish processing from postponing. Some processing is necessary. But if you've been processing the same issue for years without behavioral change, you're not processing. You're hiding.

Ask the Adlerian question. What are you getting out of staying stuck? What would you have to risk if you declared yourself ready?

The Uncomfortable Truth

The uncomfortable truth is that readiness is a fiction.

Nobody is ever fully ready for the tasks of life. You're not ready for the relationship until you're in it. You're not ready for the job until you're doing it. You're not ready for the community until you've joined it.

Competence comes from engagement, not preparation. You become capable by doing the thing, failing at the thing, and doing it again. Not by thinking about the thing in a safe room for a decade.

Adler understood this a century ago. Therapy was supposed to be a bridge to life, not a substitute for it. Somewhere along the way, we forgot.

The perpetual patient isn't broken. They're protected. And the protection has become a prison.

The way out is the same as it's always been: attempt the tasks of life. Fail. Try again. Build competence through action, not insight.

You'll never be ready. Start anyway.