I was talking to somebody recently and trying to describe my counselling work. “It’s a bit like ‘Hide and Seek’” I suggested. Or, at times, like ‘Russian Roulette’. Other times it can feel like ‘Pin the tail on the Donkey’”My friend looked a bit puzzled. I tried for another analogy.”It’s a bit like trying to build a 3D jigsaw. You have  to find a way to keep all the pieces intact whilst trying to build new things onto it.”I wanted to sound clever and quote Freud’s maxims “Where id was, shall ego be.” And that the aim of therapy is to make conscious the unconscious but I wasn’t sure this would help much. “It’s a complicated process that we try to make look simple.” I said. How to explain ideas like Transference and Counter Transference; Splitting; The Paranoid- Schizoid position; Projective Identification and so on. It took me years to get to grips with them ( and I still am)! But despite the complexity of my answer, it was a very good question. What does happen in the counselling room? How does one describe a task so simple and yet so complex?

At its simplest, counselling is all about a relationship. I see my counsellor and we talk to each other. And, hopefully, hear each other. (Not always guaranteed by either side.) Within that framework I then build a picture of my patients’ inner world. Of their early life, their childhood, school, university, work, relationships and so on. I look for the repeating patterns. This week my patient’s world is wonderful and ever more shall be! I remind them that two weeks ago they were suicidally angry and had decided to join a silent order of Buddhist nuns.”Oh! Yes, But that was then. Things  are better now.” My task is to hold both past and present, making a connection between them to help my patient make their own connections. (This is Freud’s “making conscious the unconscious.”) I might then wonder what my patient’s early life had been like. How did his parents relate to each other and to their children? I half know the answer but want to help my patient see their own presenting past ( the past being re enacted in the present). Plus I want to know for myself and my work if my musing is accurate. The idea of therapy is that the model fits the patient. Not the other way round. In this case, my patient came from a home where “today was always a new beginning”,which is less positive than it sounds. “Those who forget their past are doomed to repeat it.” as the philosopher George Santayana put it.

So in this conversation between therapist and patient, all manner of strands are being weaved together. Or, a 3D map of their world is being carefully and jointly built.

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