I think "mattering" is more about an internal sense of purpose than any objective impact on the world. I can see how therapists would feel the former - I have no idea how one would measure the latter. On a wide enough scale, nobody makes a difference. On a small enough one, everyone does.
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"Fantasy, abandoned by reason, produces impossible monsters; united with it, she is the mother of the arts and the origin of their marvels." - Francisco de Goya
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