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I think this difference is often (though not always) trivial. Lots of people have a strong need to talk about really important and vulnerable things, and the only real outlet they have for this is therapy, under the guise of "this will help you", which makes it less shameful.
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Similarly - why did Alan, the multi millionaire from the Louis Theroux Vegas episode believe the casino host was his "friend". Interestingly he now drives an uber, supposedly because he's sold his business and wants to meet/ talk to people:
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