In my work as a psychotherapist, I often talk with people who think really badly of themselves. Generally their thoughts are unfair and inaccurate, and a lot of our work addresses these distorted views of oneself.

When a patient I'll call Jay told me he didn't feel successful in his professional life, my knee-jerk reaction as a therapist was to try to help him feel better about what he'd accomplished. As a CBT therapist, that meant looking at the evidence together and seeing if the success he'd had (which was not insignificant) matched his view of himself.

Together Jay and I reviewed all that he'd done since college, especially the many successful digital start-ups he'd created. He didn't argue with me but after our discussion he seemed unconvinced. I assumed we had more work to do in future sessions to help him recognize and feel his accomplishments.

There was a mismatch between Jay's accomplishments and what he felt he should have accomplished. I automatically addressed the latter鈥攖rying to change his feelings about what he'd accomplished.

Before our next session, though, I wondered something鈥攚hat if his dissatisfaction with his professional success was based on an important intuition? What if we needed to address not his self-esteem but his tendency to limit himself and avoid taking risks? Maybe Jay was right.

In our next session I raised this possibility with Jay, and the way his eyes lit up told me everything I needed to know. We began to address the ways he had imposed limits on himself and tried to justify staying at the same level. Given Jay's enormous talents, it was no surprise that these limits had felt confining. He needed to grow.

Importantly what Jay was after was not the soulless pursuit of always more. He was not craving admiration or wealth or power. Rather, his drive came from a very grounded realization that he'd been living his life as if he had one foot on the brake, and it wasn't a satisfying way to live.

I suspect most of us limit ourselves the way Jay had. Why hold ourselves back? The main reason is fear, which has many faces:

Each of these fears could come true. The question, as always, is not if something bad could happen but if the potential reward is worth the risk. I asked Jay how he would feel if he made bold moves toward his bigger goals and ended up failing. While he couldn't know for sure, he strongly suspected he'd be happier having tried and failed than always wondering what would have happened had he tried. I tend to agree.

One caveat: It's important to approach our goals from a place of wholeness rather than seeing ourselves as deficient. We are fundamentally sound the way we are, and yet we don't have to stay exactly as we are. An acorn and an oak sapling is each perfect in its own way. At the same time, change鈥攇rowth鈥攊s the natural order of things.

I don't know the rest of Jay's story. After a couple more sessions he decided to end therapy. I suspect and hope it was because he felt like he'd gotten what he needed and could do what he wanted to do.

If you think about it now, chances are you can identify a goal you've had鈥攎aybe for a long time鈥攖hat you haven't really pursued. What's holding you back? Is it worth the risks?