Consent is one thing “my appendix is killing me, help!” while actually doing the work yourself is another. Obviously any intervention requires consent to really work, but once you’ve consented to the appendectomy your role ends. You don’t have to actively engage in your own surgery past the act of wanting it. By contrast merely consenting to therapy isn’t enough, you have to do a lot of hard work as well. The fact that the hard work of everything from overcoming neuroses and anxieties to battling substance abuse is the patient doing the work suggests something about the nature of therapeutic intervention as “treatment” rather than advice-giving.