Do you believe in fate? Destiny? If fate does exist, how much responsibility must we accept for our lives? Are we responsible for everything that occurs to us--even choosing our own birth, as some suggest--or do we bear little or no responsibility for a cosmically, theologically or genetically preordained destiny?

One of the most confusing and difficult issues psychotherapy patients struggle with is personal responsibility. In existential depth psychology especially, responsibility is a focal point, along with other "ultimate concerns" such as freedom, meaning, limitation, suffering, death, and the daimonic. For the patient, the existential question is: What am I responsible for? How much responsibility must I take? One of the most common mistakes patients make regarding responsibility is either taking too little or too much responsibility for that which has happened in life.

When we habitually repudiate or slough off responsibility for negative thoughts, feelings, and behavior patterns and the effects of that behavior on others, we perceive ourselves as passive victims of powers beyond our control, for which we take no personal responsibility. Accepting responsibility for those problems for which we are accountable is prerequisite to changing one's life. It is a matter of personal power: If we deny our power to engender destructive consequences, refusing responsibility for having, often unconsciously, done so, where will the power to creatively transform one's life and relationships come from? We are, for instance, clearly not responsible for our genes, nor the myriad physical and mental predispositions to which they render us vulnerable. Genetics are part of fate. But we are responsible for how we deal with our inherited biological and genetic makeup, and for doing what we can to cultivate our strengths and manage our vulnerabilities rather than exacerbating them through self-destructive lifestyles.

On the other hand, some individuals tend to take excessive responsibility for people, events, and circumstances that are beyond their control. For example, psychotic patients may feel irrationally responsible for causing a deadly earthquake or plane crash. Others frequently feel responsible for the destructive behaviors or evil deeds of their parents, blaming themselves for having been unloved, neglected, betrayed, abused or abandoned during childhood. Some may take on too much responsibility for the feelings and actions of spouses, lovers, children, friends--a kind of codependency. In such situations, effective psychotherapy involves reducing hyper-responsibility, assisting the patient in sorting out that for which he or she is and is not responsible.

The philosophical questions of fate, destiny and responsibility are central to psychotherapy. But different approaches to the understanding and treatment of mental disorders today diverge radically as to how much responsibility patients must take for themselves. (See my previous post.) Responsibility is intrinsically related to freedom: Some "New Age" therapies preach complete responsibility for and freedom from fate as an attainable human potentiality. Cognitive therapies disregard the fateful influences of the daimonic, the shadow, the unconscious. Others grossly overemphasize biochemistry or behavior, tending to negate the patient's responsibility so insidiously that their freedom too is further undermined. The fact is that there are certain things in life we are responsible for, and many that we are not. The secret is to discover the delicate balance between fate and responsibility without relinquishing our relative freedom to become who we wish, or denying that which fatefully determines what we are.

Is fate different from destiny? For me, yes. Fate refers to the existential givens of life, those aspects of existence that are immutable, inexorable and inevitable, and over which we can exert little or no control. From an existential perspective, we are "thrown" into life without any choice or responsibility in the matter. We are born into a world at a biologically predetermined time, in a particular place, to specific parents, of a certain gender, and with innate strengths, talents, traits, temperament, limitations and vulnerabilities. All this is our fate, the cards we are dealt in life. How can we hold ourselves responsible for fate?

Destiny is different than fate. Destiny, as psychiatrist Alexander Lowen (1980) notes, "is related to the word destination. It refers to what . . . [we become], whereas fate describes what one is." (p. 49) Destiny is what we do with fate, how we play the hand we're each dealt by fate. Destiny is determined not solely by fate, but by how we choose to respond to fate. We are responsible for those choices. Part of each person's fate includes a personal destiny. But whether that destiny is fulfilled or not depends in part on the person and whether he or she is willing to accept responsibility for and courageously pursue that destiny. Finding and fulfilling our destiny is a principal goal of existential depth psychology.

Ludwig van Beethoven's dramatic encounter with fate and destiny might be illustrative. As I recount in my book, Anger, Madness, and the Daimonic, Beethoven was physically and emotionally abused as a boy, and extremely introverted, even as a child. (See my previous post on introversion and extraversion.) Frustrated by his unfortunate childhood circumstances and in his later efforts to earn a living as a musician and lead a "normal" life of marriage and family, young Beethoven became more and more angry and withdrawn from the world. Then, at twenty-eight, just as he started having success with his music, he began to lose his hearing. Such was his fate. His first reaction, understandably, was anger. Then, he fell into a deep depression. He laments in a letter that "the most beautiful years of my life must pass without accomplishing the promise of my talent and powers." Nonetheless, six months later, Beethoven decides "to rise superior to every obstacle," combatively refusing to submit to fate: "No! I cannot endure it. I will take Fate by the throat; it shall not wholly overcome me." (pp. 289-290) Taking this defiant stance, he turned his towering rage toward transcending the terrible tragedy of his eventually total deafness. Despite this awful fate, Beethoven went on to compose his most heroic and beautiful music, deterred only by death at the age of fifty-seven. There is a time to resolutely accept fate, and a time to furiously fight it. That responsibility is ours. Beethoven accepted his fate but refused to allow it to determine his destiny. In psychotherapy, we each must learn to do the same.