People frequently come to treatment trying to face one of life’s essential challenges. They are struggling to bear significant losses or to age gracefully and with dignity. Some wonder whether their lives could bring them more joy, or less anxiety, rage, guilt, shame, or loneliness. Many question whether they should be protesting injustices, in their communities, the world at large, or within personal and professional relationships. This introductory chapter examines some analytic approaches to these quandaries.