In his book “The Insistence of God” John D.Caputo writes about “Perhaps”. He says that “‘Perhaps’ is the abdication of faith, decision, ethics, judgement, and knowledge of philosophy and theology, a retreat to the safety of the indecisive and uncommitted.” To his list of philosophy and theology, I want to add psychotherapy and its family as another set of disciplines that do well to work with “perhaps”.

People often ask me how does psychotherapy work? I usually quote Freud’s maxim about making conscious the unconscious. If I’m feeling a little mischievous I will quote his other maxim that the point of psyochoanalysis is to turn neurotic misery into ordinary unhappiness. Much less high flown but as true.

One of the dangers of this work is that we can end up believing our patients’ fantasies about us. It’s too easy to feel oneself to be an oracle. Foretelling and forthtelling. And if a patient has the temerity to disagree with us, we can always fall back on the “Denial defence”. My patient doesn’t want to hear what I’m saying because it’s too difficult to hear. Thus they refute my interpretation. It’s all their fault they aren’t getting better. They won’t hear what I’m telling them! (Sometimes this is true. A patient doesn’t want to hear what I think. They may not be ready to hear me. In which case one comes back to the issue another day. Or we try and think together about why they can’t / don’t / won’t hear what I’m saying). As much as we can, we try to go gently into that sometimes dark night. As the therapist I might try and hold up a light to show us the path. But I can only go so far ahead before I lose my way, my patient or both!

This is where Caputo’s “perhaps” comes in. The psychoanalyst Wilfred Bion is reputed to have said that “… if there aren’t two anxious people in the room, the two being both the therapist and the patient, then there was not much point in turning up to find out what you already knew.” One always goes into therapy session with a sense of “perhaps”. A curiosity about where the conversation will take you both. A hope that as the therapist you are good enough for your patient.

I often ask my patients about their dreams, if they can remember them. Here, in particular, I’m in “perhaps” territory. A dream never has only one possible meaning. But I try to put the dream into a context. What have we been talking about in our sessions? What do I know about my patient’s hopes, fears and concerns? What associations does the dream have for my patient? From this mix we try to find a meaning. One that fits. But always there is a sense of “perhaps”. To quote Caputo again we “…retreat to the safety of the indecisive and uncommitted.” Another way of thinking about Caputo’s “perhaps” is to view it as a kind of play. Where all things are possible and constantly in flux. Today the kitchen table may be the USS Enterprise. Tomorrow it might be a submarine. We don’t challenge this idea but play with it. In a “perhaps” sort of way.