Psychotherapists face many challenges in practicing their craft. Some patients feel hopeless, while others may be threatened by awareness of negative feelings, and some may be paralyzed with shame. But what can be most threatening to the integrity of the therapeutic process is when patients chronically come very late to sessions or miss them completely. The usual approach to dealing with challenges to the therapy process is to explore them in session. Chronic lateness, however, leaves little time for these explorations. I have long tried to get a better understanding of the causes of these difficulties.

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