3 Therapies

PSYCHOTHERAPY

In the arena of self-knowledge, psychotherapy may be the single most useful intervention of the last 200 years. It is a tool and, like all tools, it finds its purpose in helping us to overcome an inborn weakness and to extend our capacities beyond those originally gifted to us by nature. It is, in this sense, not metaphysically different from a bucket, which remedies the problem of trying to hold water in our palms, or a knife, which makes up for the bluntness of our teeth.

Therapy is an invention devised to correct the substantial difficulties we face understanding ourselves, trusting others, communicating successfully, honouring our potential and feeling adequately serene, confident, authentic, direct and unashamed.

For such an important invention, psychotherapy is low on overt signs of innovation. Technically speaking, it requires only a comfortable room free of any interruptions, fifty minutes, possibly twice a week for a year or so and two chairs. But at the level of training, the psychotherapist needs to undertake a period of extensive education in the workings of our minds which – in the more responsible jurisdictions – has some of the rigour, intellectual ambition and periods of hands-on experience demanded by the acquisition of a pilot’s licence.

To deliver on its promises, psychotherapy relies on at least eight distinct moves.

Witnessing

Most of what we are remains a secret to the world, because we are aware of how much of it flouts the laws of decency and sobriety we would like to live by. We know that we would not last long in society if a stream of our uncensored inner data ever leaked out of our minds.

A lot of what is inside us can seem daft: how we felt a strange impulse to burst into tears when reading a children’s book (about an elephant befriending a baby sparrow); how we sometimes imagine acquiring the power to go back in time and correct the missed opportunities of adolescence. Some of it is, from a harsh angle, distinctly pathetic: how worried we are about asking where the bathroom is; how envious we are of a close acquaintance; how much we worry about our hair. A significant part is alarming and quasi-illegal: our fantasies about a work colleague and a family member; our plans for what we’d ideally do to an enemy.

In response to our isolation, we are often told about the importance of friends. But we know that the tacit contract of any friendship is that we will not bother the incumbent with more than a fraction of our madness. A lover is another solution, but it is – likewise – not in the remit of even a highly patient partner to delve into, and accept, more than a modest share of what we are.

In every social interaction, we sensibly ensure that there remains a large and secure divide between what we say and what is truly going on inside our minds.

The exception can be psychotherapy. Here, remarkably, we are allowed to divulge pretty much everything we feel – and indeed, if the process is to work, should strive to do so. We don’t have to impress the therapist or reassure them of our sanity. We need to tell them what is going on. There is no need to stop them thinking we are perverted, odd or terrified. We can gingerly hint at some very dark things about us and will find that our interlocutor isn’t horrified or offended but, on the contrary, calmly interested. We’re not – we’re learning – monsters or freaks. We arrive at the opposite of loneliness. This may be the first (and perhaps the last) human we are ever properly honest with.

Worldliness

Therapists know a lot about the unvarnished truths of human nature. They have close-up experience of the greatest traumas – incest and rape, suicide and depression – as well as the smaller pains and paradoxes: a longing provoked by a glance at a person in a library that took up the better part of twenty years, an otherwise gentle soul who broke a door, or a handsome, athletic man who can no longer perform sexually.

They know that inside every adult there remains a child who is confused, angry, hurt and longing to have their say and their reality recognized. They appreciate that this child has to get to know themselves again and will want to be heard, perhaps through tears or near-incomprehensible mutterings, which might be utterly at odds with the surface maturity and self-command normally associated with the grown-up sitting in the therapeutic chair.

Therapists know the human heart, not primarily through books, but by being courageous about exploring their own nature. They may not share our fantasies exactly, but they accept that their own are as colourful and as complex. They don’t have our precise anxieties, but they know well enough the powerful and peculiar fears that hold us all hostage.

They can start to help us because they have an accurately broad grasp of what it means to be normal – which is, of course, far from what we insist on pretending it might be. They don’t require us to be conventionally good or typical to shore up their fragile sense of self or reality. Their only hope is that we will be able to admit, at last, without too much defensiveness, to some of what is really going on inside us.

Kindness

They are, furthermore, and very gratifyingly, on our side. Without ill intention, most people are not quite; they are intermittently jealous, bored, vindictive, keen to prove a point or distracted by their own lives. But the therapist brings a focused, generous attention to our case. Their room is set aside from day-to-day pressures. They’re sorry that we suffered. They understand that it must have been worrying, enraging or exciting. They know we didn’t do it on purpose or that if we did we had our reasons. Without flattering us in a rote way, they strive to enter into our experience and to side with it. They look at reality through our eyes so that they can start to correct a legacy of shame and isolation.

At the same time, their kindness makes ours a bit less necessary. Normal life requires that we constantly weigh the impact of our words on other people. We have to consider their priorities, ask how their children are and hold their concerns in mind.

Here there is no such call. Like a parent who doesn’t need a small child to reciprocate, the therapist voluntarily forgoes equality in the relationship; they won’t talk of their regrets or insist on their anecdotes. They simply want to help us find what is best for us, understood on our terms. They won’t have a preconceived view of how we’re meant to live, just a great deal of sympathy for the complexities and the suffering we’ve endured already.

That said, kindness is not merely pleasant. Knowing that we have someone on our side is designed to lend us the courage to face up to experiences we normally evade. In a sufficiently calm, reassuring and interested environment, we can look at areas of vulnerability we are otherwise too burdened to tackle. We can dare to think that perhaps we were wrong or that we have been angry for long enough; that it might be best to outgrow our justifications or halt our compulsion to charm others indiscriminately.

The kindness of another gives us the security needed to probe constructively at our scared, puzzling, evasive minds.

Listening

It’s one of the structural flaws of these minds that it is immensely hard for us to think deeply and coherently for any length of time. We keep losing the thread. Competing, irrelevant ideas have a habit of flitting across the mental horizon and scrambling our tentative insights. Every now and then, consciousness goes entirely blank. Left to our own devices, we quickly start to doubt the value of what we are trying to make sense of and can experience overpowering urges to check the news or eat a biscuit. And as a result, some of the topics we most need to examine – where our relationship is really going, what we might do next at work, how we should best answer a letter, what bothers us so much about the way our partner returns our hand after an attempt at a caress – founder into the mental sands, to our grave psychological cost.

What helps enormously in our attempts to know our own minds is, surprisingly, the presence of another mind. For all the glamour of the solitary seer, thinking usually happens best in tandem. It is the curiosity of someone else that gives us the confidence to remain curious about ourselves. It is the application of a light pressure from outside us that firms up the jumbled impressions within. The requirement to verbalize our intimations mobilizes our flabby reserves of concentration.

Occasionally a friend might be unusually attentive and ready to hear us out. But it isn’t enough merely for them to be quiet. The highest possibilities of listening extend beyond the privilege of not being interrupted. To be really heard means being the recipient of a strategy of ‘active listening’.

From the start, the therapist will use a succession of very quiet but significant prompts to help us develop and stick at the points we are circling. These suggest that there is no hurry but that someone is there, following every utterance and willing us on. At strategic points, the therapist will drop in a mission-critical and hugely benign ‘do say more’ or an equally powerful ‘go on’. Therapists are expert at the low-key positive sound: the benevolent, nuanced ‘ahh’ and the potent ‘mmm’, two of the most significant noises in the aural repertoire of psychotherapy which together invite us to remain faithful to what we were starting to say, however peculiar or useless it might at first have seemed.

As beneficiaries of active listening, our memories and concerns don’t have to fall into neat, well-formed sentences. The active listener contains and nurtures the emerging confusion. They gently take us back over ground we’ve covered too fast and prompt us to address a salient point we might have sidestepped; they will help us chip away at an agitating issue while continually reassuring us that what we are saying is valuable.

They’re not treating us like strangely ineffective communicators; they’re just immensely alive to how difficult it is for anyone to piece together what they really have on their minds.

Time

Therapy is built on the understanding that we will not be able to transmit our key experiences in one or two self-contained blocks. We live in time and have to decode ourselves at different periods. Things emerge, sometimes very slowly, over months. We can’t be in all the moods we need to access on every occasion. Some weeks will find us readier than others to investigate particular memories or consider certain viewpoints. So long as we keep showing up and sharing, we’ll drop enough clues to assemble – eventually – a psychological portrait of the self, like an ancient vase slowly being pieced together from fragments scattered across miles of sand.

Interpretation

The therapist’s active listening is not meandering: what underpins it is an attempt to understand – for our sake – how the subterranean operations of the past are affecting the present.

We arrive in therapy with questions. We have a presenting problem which hints at, but does not fully capture, the origins of our suffering. Why, for instance, do we appear so repeatedly to fall for people who control and humiliate us? How can we be so convinced we need to leave a job and yet have remained unable to locate a more satisfying replacement for so long? Why are we paralysed by anxiety in every public context? Why do we sabotage sexual possibilities?

By their questions and their attention, their careful probing and investigative stealth, the therapist tries – harder than anyone may yet have done – to discover how our presenting problem might be related to the rest of our existence and, in particular, to the turmoils of childhood. Over many sessions, a succession of small discoveries contributes to an emerging picture of the sources of our emotional wounds and of the way in which our character evolved defences in response to them in a manner that hampers our possibilities today.

We may, for example, start to sense how a feeling of rivalry with a parent led us to retire early from workplace challenges in order to hold on to their love, as well as seeing, perhaps for the first time, that the logic of our self-sabotage no longer holds. Or we might perceive the way an attitude of aggressive cynicism, which restricts our personalities and our friendships, might have had its origins in a parent who let us down at a time when we couldn’t contain our vulnerability, and thereby turned us into people who try at every juncture to disappoint themselves early and definitively rather than risk allowing the world to turn down our hopes at a time of its own choosing.

But it is no good stating any of this too starkly. An interpretation – delivered in its bare bones – will be anticlimactic and bathetic and most likely prompt resistance or aggression. For the interpretation to work its effect, we as clients need to move from merely assenting to it intellectually to having an internal experience of the emotions it refers to. We need to feel for ourselves, rather than take on trust, the poignant drama undergone by the person we once were. There is, in this setting, no point in being too clever.

An intellectual understanding of the past, though not wrong, won’t by itself be effective in the sense of being able to release us from our symptoms. For this, we have to edge our way towards a far more close-up, detailed, visceral appreciation of where we have come from and what we have suffered. We need to strive for what we can call an emotional understanding of the past, as opposed to a top-down, abbreviated, intellectual one.

We will have to re-experience at a novelistic level of detail a whole set of scenes from our early life in which our problems around fathers and mothers and authority were formed. We will need to let our imaginations wander back to certain moments that have been too unbearable to keep alive in a three-dimensional form in our active memories (the mind liking, unless actively prompted, to reduce most of what we’ve been through to headings rather than the full story, a document which it shelves in remote locations of the inner library). We need not only to know that we had a difficult relationship with our father, but to relive the sorrow as if it were happening to us today. We need to be back in his book-lined study when we were not more than six; we need to remember the light coming in from the garden, the corduroy trousers we were wearing, the sound of our father’s voice as it reached its pitch of heightened anxiety, the rage he flew into because we had not met his expectations, the tears that ran down our cheeks, the shouting that followed us as we fled out into the corridor, the feeling that we wanted to die and that everything good was destroyed. We need the novel, not the essay.

Psychotherapy knows that thinking is hugely important – but on its own, within the therapeutic process itself, it is not the key to fixing our psychological problems. It insists on a crucial difference between broadly recognizing that we were shy as a child and re-experiencing, in its full intensity, what it was like to feel cowed, ignored and in constant danger of being rebuffed or mocked; the difference between knowing, in an abstract way, that our mother wasn’t much focused on us when we were little and reconnecting with the desolate feelings we had when we tried to share certain of our needs with her.

Therapy builds on the idea of a return to live feelings. It’s only when we’re properly in touch with our feelings that we can correct them with the help of our more mature faculties – and thereby address the real troubles of our adult lives.

Oddly (and interestingly) this means intellectual people can have a particularly tricky time in therapy. They get interested in the ideas. But they don’t so easily recreate and exhibit the pains and distresses of their earlier, less sophisticated selves, though it’s actually these parts of who we all are that need to be encountered, listened to and – perhaps for the first time – comforted and reassured.

A Relationship

The ongoing contact between ourselves and the therapist, the weekly sessions that may continue over months or years, contribute to the creation of something that sounds, in a professional context, distinctly odd: a relationship.

We are almost certain to have come to see a therapist in the first place because, in some way, having relationships has become beset with difficulties: maybe we try to please people at once, secure their admiration, but then feel inauthentic and inwardly numb and so pull back. Perhaps we fall in love very powerfully, but then always discover a major flaw in a partner that puts us off and makes us end the story and restart the cycle. Perhaps we are simply very lonely.

The relationship with the therapist may have little in common with the unions of ordinary life. We won’t ever go shopping together or watch TV side by side in bed. But unavoidably and conveniently, we will bring to our encounters with the therapist the very tendencies that are likely to emerge in our relations with other people in our lives. Without intending this, in the therapist’s office we will play out our characteristic moves: we may be seductive but then cold; or full of idealization but then manifest a strong wish to flee; we’ll be preternaturally polite but full of hidden contempt. Except that now, in the presence of the therapist, our tendencies will have a chance to be witnessed, slowed down, discussed, sympathetically explored and – in their more damaging manifestations – overcome. The relationship with the therapist becomes a litmus test of our behaviour with people in general and thereby allows us, on the basis of greater self-awareness, to modify and improve, in the direction of greater kindness, trust, authenticity and joy, the way we typically relate to others.

In the therapy room, all our proclivities and habits are noticed and can be commented on – not as reproaches but as important information about our character that we deserve to become aware of. The therapist will gently point out that we’re reacting as if we had been attacked, when they only asked a question; they might draw our attention to how readily we seem to want to tell them impressive things about our finances (yet they like us anyway) or how we seem to rush to agree with them when they’re only trying out an idea which they themselves are not very sure of (we could dare to disagree and not upset them). They will signal where we are prone to pin to them attitudes or outlooks that they don’t actually have. They may note how invested we seem to be in the idea that they are disappointed in us, or find us boring, or are revolted by our sexuality. They will with stealth point out our habit of casting people in the present in roles that must derive from the past and will search with us for the origins of these attributions, which are liable to mimic what we felt towards influential caregivers and now shape what we expect from everyone.

Through a relationship with someone who will not respond as ordinary people will, who will not shout at us, complain, say nothing or run away – in other words, with a proper grown-up – we can be helped to understand our immaturities. This may be for us the first properly healthy relationship we have had, one in which we learn to hold off from imposing our assumptions on the other and trust them enough to let them see the larger, more complex reality of who we are, without too much intervening shame or embarrassment. It becomes a model – earned in a highly unusual situation – that we can then start to apply in the more humdrum but consequential setting of daily life, with our friends and our partners. We are given some tools with which to start to have adult relationships of our own.

Inner Voices

Somewhere in our minds, removed from the day to day, there sit judges. They watch what we do, study how we perform, examine the effect we have on others, track our successes and failures – and then, eventually, they pass verdicts. These determine our levels of confidence and self-compassion, they lend us a sense of whether we are worthwhile beings or, conversely, should not really exist. The judges are in charge of our self-esteem.

The verdict of an inner judge doesn’t follow an objective rule book or statute. Two individuals can end up with wildly different verdicts on the esteem they deserve even though they may have done and said much the same thing. Certain judges simply seem more predisposed than others to lend their audiences an essentially buoyant, warm, appreciative and generous view of themselves, while others encourage them to be hugely critical, disappointed and sometimes close to disgust or ready for self-destruction.

The origin of the voice of the inner judge is simple to trace: it is an internalization of the voices of people who were once outside us. We absorb the tones of contempt and indifference or charity and warmth that we will have heard across our formative years. Sometimes a voice is positive and benign, encouraging us to run those final few yards. But frequently the inner voice is not very nice at all. It is defeatist and punitive, panic-ridden and humiliating. It doesn’t represent anything like our best insights or most mature capacities.

An inner voice was always an outer voice that we have – imperceptibly – made our own. We’ve absorbed the tone of a kind and gentle caregiver who liked to laugh indulgently at our foibles and had endearing names for us. Or else we have taken in the voice of a harassed or angry parent, never satisfied with anything we achieved and full of rage and contempt.

We take in these voices because at certain moments in the past they sounded so compelling and irresistible. The authority figures repeated their messages over and over until they got lodged in our own way of thinking and became a part of our minds.

A good internal voice is rather like (and just as important as) a genuinely decent judge: someone who can separate good from bad but who will always be merciful, fair, accurate in understanding what’s going on and interested in helping us deal with our problems. It’s not that we should stop judging ourselves, rather that we should learn to be better judges of ourselves.

Part of improving how we judge our lives involves learning – in a conscious, deliberate way – to speak to ourselves in a new and different tone, which means exposing ourselves to better voices. We need to hear constructive, kindly voices often enough and around tricky enough issues that they come to feel like normal and natural responses – so that, eventually, they become our own thoughts.

When things don’t go as we want, we can ask ourselves what a benevolent fair judge would say, and then actively rehearse to ourselves the words of consolation they would most likely have offered (we’ll tend to know immediately).

We need to become better friends to ourselves. The idea sounds odd, initially, because we naturally imagine a friend as someone else, not as a part of our own mind. But there is value in the concept because of the extent to which we know how to treat our own friends with a sympathy and imagination that we don’t apply to ourselves. If a friend is in trouble our first instinct is rarely to tell them that they are fundamentally a failure. If a friend complains that their partner isn’t very warm to them, we don’t tell them that they are getting what they deserve. In friendship, we know instinctively how to deploy strategies of wisdom and consolation that we stubbornly refuse to apply to ourselves.

The good friend is compassionate. When we fail, as we will, they are understanding and generous around our mishaps. Our folly doesn’t exclude us from the circle of their love. The good friend deftly conveys that to screw up is what humans do. The good friend brings, as a starting point, their own and humanity’s vivid experience of messing up as key points of reference. They’re continually telling us that though our specific case might be unique the general structure is common. People don’t just sometimes fail. Everyone fails, as a rule; it’s just we seldom know the details.

It is ironic – yet essentially hopeful – that we usually know quite well how to be a better friend to near strangers than to ourselves. The hopefulness lies in the fact that we already possess the relevant skills of friendship, it’s just that we haven’t as yet directed them to the person who probably needs them most – namely, of course, ourselves.

Part of what therapy offers us is a chance to improve how we judge ourselves and the voices we hear in our heads. It can involve learning – in a conscious, deliberate way – to speak to ourselves in the manner the therapist once spoke to us over many months. In the face of challenges, we can imaginatively enquire what the therapist would say now. And because we will have heard them for so long and over so many issues, we will know; their way of thinking will have become a part of our own thoughts.

HOW PSYCHOTHERAPY MIGHT CHANGE US

What sort of person, then, might we be after therapy, if the process goes as well as could be hoped?

Evidently, still – quite often – unhappy. People will continue to misunderstand us; we’ll meet with opposition; there will be things it would be nice to have that will be out of reach; success will come to people who don’t appear to deserve it and much that’s good about us won’t be fully appreciated by others. We’ll still have to compete and submit to the judgement of others; we’ll still be lonely sometimes; and therapy won’t stop us having to watch the people we love pass away, and falling ill and eventually dying ourselves. Therapy can’t make life better than it truly is.

But with these caveats in place, there are some low-key but in truth very substantial benefits we can expect. We’ll have slightly more freedom. A key feature of the defences we build up against our primal wounds is that they are rigid and so limit our room for manoeuvre. For example, we may have very distinctive but unfortunate characters we go for in love; or we can’t be touched in certain places; or we feel we have to be constantly cynical or else insistently jolly. Our sense of who we are allowed to be and what we can do is held prisoner by the shocks of the past.

But the more we understand the original challenges and the logic of our responses to them, the more we can risk deviating from whom we once felt we had to be in order to survive. Perhaps we can, after all, afford to hope; or be less afraid, or go on top, or spend some time alone, or try a new professional path.

We realize that what we had believed to be our inherent personality was really just a position we had crouched into in order to deal with a prevailing atmosphere. And having taken a measure of the true present situation, we may accept that there could, after all, be other, sufficiently safe ways for us to be.

We can be readier to explain ourselves. We had learned to be ashamed and silent. But the therapist’s kindness and attention encourage us to be less disgusted by ourselves and furtive around our needs. Having once voiced our deeper fears and wishes, they become ever so slightly easier to bring up again with someone else. There may be an alternative to silence.

With a greater sense of our right to exist, we may become better able to articulate how it feels to be us. Instead of just resenting another person’s criticism, we might explain why we believe they have been unjust to us. If we are upset by our partner, we don’t need to accuse them of being evil and slam doors. We’ll know to explain how (perhaps strangely) sensitive we are and how much reassurance we need to feel secure in their affection. Instead of trying to pretend that nothing is ever our fault, we can offer a candid explanation of one or two of our (unfortunate) limitations.

We can be more compassionate. We will inevitably, in the course of therapy, realize how much we were let down by certain people in the past. A natural response might be blame. But the eventual, mature reaction (building on an understanding of how our own flaws arose) will be to interpret others’ harmful behaviour as a consequence of their own disturbance. The people who caused our primal wounds almost invariably didn’t mean to do so; they were themselves hurt and struggling to endure. We can develop a sad but realistic picture of a world in which sorrows and anxieties are blindly passed down the generations. The insight isn’t only true with regard to experience; holding it in mind will mean there is less to fear. Those who wounded us were not superior, impressive beings who knew our special weaknesses and justly targeted them. They were themselves highly frantic, damaged creatures trying their best to cope with the litany of private sorrows to which every life condemns us.

PHILOSOPHICAL MEDITATION

To understand ourselves, we need not only to learn of our past but also to take regular stock of what is flowing through our consciousness in the present.

In so far as there is public encouragement of the idea, it tends to be according to practices collectively referred to under the term ‘meditation’. In meditation, we strive to empty consciousness of its normal medley of anxieties, hurts and excitements, and concentrate on the sensations of the immediate moment, allowing even events as apparently minor but as fundamental as the act of breathing to be noticed. In a bid for serenity and liberation, we still the agitations of what the Buddhists evocatively term our ‘monkey minds’.

But there is another approach to consider, this one based not on Eastern thought but on ideas transmitted to us via the Western tradition. In ‘philosophical meditation’, instead of being prompted to sidestep our worries and ambitions, we are directed to set aside time to untangle, examine and confront them.

It is a basic, distinctive quirk of our minds that few of the emotions we carry in them are properly acknowledged, understood or truly felt, that most of our affective content exists in an ‘unprocessed’ form within us. Philosophical meditation seeks to lend us a structure within which to sieve the confused content that muddies our stream of consciousness.

Key to the practice is regularly to turn over three large questions. The first asks what we might be anxious about right now.

We are rarely without a sizeable backlog of worries, far greater than we tend consciously to recognize. Life, properly felt, is an infinitely alarming process even in its apparently calmer stretches. We face a medley of ongoing uncertainties and threats. Even ordinary days contain concealed charges of fear and challenge: navigating through a train station, attending a meeting, being introduced to a new colleague, being handed responsibility for a task or a person, keeping control over our bodies in public settings – all contain the grounds for agitation that we are under pressure to think should not be taken seriously. We need, during our meditative sessions, to give every so-called small anxiety a chance to be heard, for what lends our worries their force is not so much that we have them but that we don’t allow ourselves the time to know, interpret and contextualize them adequately. Only by being listened to in generous, almost pedantic detail will anxieties lose their hold on us. At almost any time, within our minds, a chaotic procession flows which would make little sense if recorded and transcribed: … biscuits to the train why earrings deal they can’t do it I have to Milo phone list do it the bathroom now I can’t do, 11.20, 33 per cent it a 10.30 tomorrow with Luke why invoices separately detailed why me trees branches sleep right temples … But such streams can gradually be tamed, drained, ordered and evaporated into something far less daunting and illogical. Each word can be encouraged to grow into a paragraph or page and thereby lose its hold on us. We can force ourselves to imagine what might happen if our vague, catastrophic forebodings truly came to pass. We can refuse to let our concerns covertly nag at us and look at them squarely until we are no longer cowed. We can turn a jumble of worries into that most calming, and intellectually noble, of documents: a list.

A philosophical meditation moves on to a second enquiry: what am I upset about right now? This may sound oddly presumptuous, because we frequently have no particular sense of having been upset by anything. Our self-image leans towards the well defended. But almost certainly we are somewhere being too brave for our own good. We are almost invariably carrying around with us pulses of regret, loss, envy, vulnerability and sorrow. These may not register in immediate consciousness, not because they don’t exist, but because we have grown overly used to no one around us giving a damn and have dutifully taken heed, along the course of our development, to recommendations that we toughen up a little. Yet a life among others exposes us daily to small darts and pinpricks: a meeting ends abruptly, a call doesn’t come, an anticipated reunion feels disappointingly distant, someone doesn’t touch us when we need reassurance, news of a friend’s latest project leaves us envious. We are mental athletes at shrugging such things off, but there is a cost to our stoicism. From small humiliations and slights, large blocks of resentment eventually form that render us unable to love or trust. What we call depression is in fact sadness and anger that have for too long not been paid the attention they deserve.

But during a philosophical meditation we can throw off our customary, reckless bravery and let our sadness take its natural, due shape. There may not be an immediate solution to many of our sorrows, but it helps immeasurably to know their contours. We might, as we turn over our griefs, large and small, imagine that we are sharing them with an extremely kind, patient figure who gives us the chance to evoke hurt in detail, someone with whom there is no pressure to rush, be grown up or impressive, and who allows us to admit without fear to the many curious things that have pained and diminished us in the previous hours.

The third question to consider within a philosophical meditation is: what am I ambitious and excited about right now?

A part of our mind is forever forward-thinking and hopeful, seeking to maximize opportunities and develop potential. Much of this energy registers as vague tension about new directions we might take. We could experience this inchoate restlessness when we read an article, hear of a colleague’s plans or glimpse an idea about next year flit across our mental landscape as we lie in the bath or walk around a park. The excitement points indistinctly to better, more fulfilled versions of ourselves. We should allow our minds to wonder at greater length than usual about what the excitement (it could be a view, a book, a place, an insight) might want to tell us about ourselves. In a poem written in 1908, the German poet Rilke described coming across an ancient statue of the Greek god Apollo. It had had its arms knocked off at the shoulders but still manifested the intelligence and dignity of the culture that had produced it. Rilke felt an unclear excitement, and as he meditated upon and investigated his response, he concluded that the statue was sending him a message, which he announced in the final, dramatic line of his short poem, ‘Archaic Torso of Apollo’:

Du mußt dein Leben ändern.

[You must change your life.]

Under the unhealthy sway of German Romanticism, Rilke realized that he had developed an abstruse way of thinking and expressing himself. Now the Greek statue was being recognized by one part of his mind as a symbol of the intellectual clarity of ancient Greece, which his conscience knew he needed to pay more attention to. By decoding his excitement, Rilke was catching sight of an alternative way of being.

The case may be particular, but the underlying principle is universal. We each face calls, triggered by chance encounters with people, objects or ideas, to change our lives. Something within us knows far better than our day-to-day consciousness permits us to realize the direction we need to go in in order to become whom we could really be.

A daily period of philosophical meditation does not so much dissolve problems as create an occasion during which the mind can order and understand itself. Fears, resentments and hopes become easier to name; we grow less scared of the contents of our own minds – and less resentful, calmer and clearer about our direction. We start, in faltering steps, to know ourselves slightly better.

A MORE NORMAL NORMALITY

If part of the reason we don’t look more regularly into ourselves is our shame and fear at the unusual nature of what we may find there, then a crucial collective resource in the path to self-knowledge is a redrawn sense of what is normal.

Our picture of acceptability is – very often – way out of line with what is actually true and widespread. Many things that we might assume to be uniquely odd or disconcertingly strange about us are in reality wholly ubiquitous, though simply rarely spoken of in the reserved and cautious public sphere.

Any idea of the normal currently in circulation is not an accurate map of what is customary for a human to be. We are – each one of us – far more compulsive, anxious, sexual, tender, mean, generous, playful, thoughtful, dazed and at sea than we are encouraged to accept.

The misunderstanding begins with a basic fact about our minds: that we know through immediate experience what is going on inside us, but can only know about others from what they choose to tell us – which will almost always be a very edited version of the truth. We know our somewhat shocking reality from close up; we are left to guess about other people’s from what their faces tell us, which is not very much.

We simply cannot trust that sides of our deep selves will have counterparts in those we meet, and so remain silent and shy, struggling to believe that the imposing, competent strangers we encounter can have any of the vulnerabilities, perversions and idiocies we’re so intimately familiar with inside our own characters.

Ideally, the task of culture would be to compensate for the failings of our brains. It should assist us to a more correct vision of what other people are normally like – by taking us, in realistic and sensitive ways, into the inner lives of strangers. Novels, films and songs should constantly be defining and evoking states of mind we thought we were alone in experiencing but that belong to the typical lot of humankind. We should put down the average novel wondering – with relief – how the novelist had come to know so much about us. We should begin to understand that an average stranger is always far more likely to be as we know we are – with all our quirks, fragilities, compulsions and surprising aspects – than they are to resemble the apparently ‘normal’ person their exterior implies.

We need culture to take on the task because we cannot do it all by ourselves. In order to know ourselves well, we rely on the level of self-awareness, courage and honesty circulating in society as a whole. We will be as hypocritical as the most representative voices around us and we will, conversely, be freed by what society is prepared to countenance as acceptable.

There is, at present, so much we pretend not to feel. Starting in childhood, we have instilled in us, so subtly we don’t even notice, strong notions about what is and is not permissible to experience. Traditionally, boys were not allowed to acknowledge that they felt like crying and girls weren’t allowed to entertain certain kinds of ambitions. We might not have such obviously naive prohibitions today, but other, equally powerful ones have taken their place. We may have picked up covert but forceful indications that no decent person could be enthusiastic about making money or unable to cope at work, tempted by an affair or still upset over a break-up.

Furthermore, despite the apparently sexually liberated spirit of the times, the lion’s share of our sexual impulses remains impossible to avow. There is still a great deal we are not meant to feel in order to fit that most desirable of categories: a good boy or girl.

The way to greater honesty follows some of the techniques evident from the rehabilitation of the people who commit crimes. We must reduce the shame and danger of confession. We need a broader, more reassuring sense of what is common. Of course it is normal to be envious, crude, sexual, weak, in need, childlike, grandiose, terrified and furious. It is normal to desire random adventures even within loving, committed unions. It is normal to be hurt by ‘small’ signs of rejection, and to be made quickly very insecure by any evidence of neglect by a partner. It is normal to harbour hopes for ourselves professionally that go far beyond what we have currently been able to achieve. It is normal to envy other people, many times a day, to be very upset by any kind of criticism of our work or performance, and to be so sad we regularly daydream of flight or a premature end.

The journey to self-knowledge needs to begin with a better map of the terrain of normality.

THE IMPORTANCE OF A BREAKDOWN

One of the great problems of human beings is that we’re far too good at keeping going. We’re experts at surrendering to the demands of the external world, living up to what is expected of us and getting on with the priorities defined by others around us. We keep showing up and doing our tasks – and we can pull off this magical feat for up to decades at a time without so much as an outward twitch or crack.

Until suddenly, one day, much to everyone’s surprise (including our own), we break. The rupture can take many forms. We can no longer get out of bed. We fall into silence. We develop all-consuming social anxiety. We refuse to eat. We babble incoherently. We lose command over part of our body. We are compelled to do something extremely scandalous and entirely contrary to our normal behaviour. We become wholly paranoid in a given area. We refuse to play by the usual rules in our relationship, we have an affair, ramp up the fighting, or otherwise poke a very large stick in the wheels of daily life.

Breakdowns are hugely inconvenient for everyone and so, unsurprisingly, there is an immediate rush to medicalize them and attempt to excise them from the scene, so that business as usual can resume.

But this is to misunderstand what is going on when we break down. A breakdown is not merely a random piece of madness or malfunction, it is a very real – albeit very inarticulate – bid for health and self-knowledge. It is an attempt by one part of our mind to force the other into a process of growth, self-understanding and self-development which it has hitherto refused to undertake. If we can put it paradoxically, it is an attempt to jump-start a process of getting well, properly well, through a stage of falling very ill.

The danger, therefore, if we merely medicalize a breakdown and attempt to shift it away at once is that we will miss the lesson embedded within our sickness. A breakdown isn’t just a pain, though it is that too of course; it is an extraordinary opportunity to learn.

The reason we break down is that we have not, over years, flexed very much. There were things we needed to hear inside our minds that we deftly put to one side; there were messages we needed to heed, bits of emotional learning and communicating we didn’t do, and now, after being patient for so long, far too long, the emotional self is attempting to make itself heard in the only way it now knows how. It has become entirely desperate – and we should understand and even sympathize with its mute rage. What the breakdown is telling us above anything else is that it must no longer be business as usual; that things have to change or (and this can be properly frightening to witness) that death might be preferable.

Why can’t we simply listen to the emotional need calmly and in good time, thus avoiding the melodrama of a breakdown? Because the conscious mind is inherently lazy and squeamish and so reluctant to engage with what the breakdown eventually has to tell it with brutality. For years, it refuses to listen to a particular sadness, or is in flight from a dysfunction in a relationship, or pushes desires down very far beneath the surface.

A good mental physician tries hard to listen to rather than censor the illness. They detect within its oddities a plea for more time for ourselves, for a closer relationship, for a more honest, fulfilled way of being, for acceptance for who we really are sexually … That is why we started to drink, or to become reclusive, or to grow entirely paranoid or manically seductive.

A crisis represents an appetite for growth that hasn’t found another way of expressing itself. Many people, after a horrific few months or years of breakdown, will say, ‘I don’t know how I’d ever have got well if I hadn’t fallen ill.’

In the midst of a breakdown, we often wonder whether we have gone mad. We have not. We’re behaving oddly no doubt, but beneath the agitation we are on a hidden yet logical search for health. We haven’t become ill; we were ill already. Our crisis, if we can get through it, is an attempt to dislodge us from a toxic status quo and constitutes an insistent call to rebuild our lives on a more authentic and sincere basis. It belongs, in the most acute and panicked way, to the search for self-knowledge.