Keen, a professor and practicing psychotherapist, addresses the essential distinction between the truly serious questions involved in human life and the superficial aspects so generally engaging people's concern-and often professional treatment-which he terms, triviality. He considers how contemporary practice of psychotherapy often fails to admit to the critical difference, fails to recognize it in practice, and subsequently treats patients for irrelevancies while neglecting core, essential issues. Keen addressed his concern about the prevalent practices among psychological/medical practitioners vis-a-vis the prescriptive drug control of mental problems in earlier publications. In this work, including a therapy case study, Keen's position-an important one warranting wide attention in the medical and helping professions-stresses that pharmacotherapy threatens our access, and openness to ultimate issues. For professionals and scholars in medicine, public health, clinical psychology, psychiatrists, and psychotherapists.