That is usually what we start with. A couple of times I have mentioned an issue and he asks how it actually affects my life. I think about it and realize it doesn't; it's just something I've noticed about myself that seems different than "normal" people. If it is not affecting me, he doesn't seem interested in discussing. I think that probably shows how far off "normal" that I am. We have too much to work on to waste time on stuff that isn't actively interfering in my life.