Letting Thought Happen: Language and Psychotherapy


by Barbara Latham
This paper first appeared in Between Psychotherapy and Philosophy, ed. Paul Gordon, Rosalind Mayo. Whurr Publishers/ Wiley. London and Philadelphia: 2004. pp79-102.



A.i.   You find words beautiful – the right word like a fine stone found at the beach. For me a word is only a bullet.
A bullet shot straight at her as she is, inevitably, condemned.
If any word could be lodged, out of context, a bit of shrapnel, fixed and solid to worry over and always an accusation, what could I say?

A.ii.   Your repertoire of words includes “love” and “understanding” but they are not in mine. Never presume that is a little drama we might play together. All I know is hate or rage. That or going numb. (“Catatonia is safer than murder”, she later says.)

Although psychotherapy is referred to as the “talking cure”, we face the many impediments to conversation – making time for difficulties masked in much of our lives.
We may enter a consulting room afraid of ourselves, or afraid for ourselves, or go in and uncover much getting in the way of the hoped for exchange.

A.iii.   I dreamt of my hands reaching out, to be in touch with you but missing – thwarted by fumbling after too many years spent out of touch with anyone.
That dream is truer than this non-stop talk. I prepare all the things to say and fill each session but who am I speaking to when I still can’t begin to look at you?
[E.v.] [Where several vignettes are taken from one therapy, the section, e.g. E, and the number, for instance v, are given in brackets so that those who wish can cross-reference.]
A.iv.   Even here I’m set on winning over the audience. How are you to place any faith in me when I hear myself ingratiate? [E.v.]

If what is told in therapy are tales of a self, told for a reason, are they entirely to be believed?

A.v.   Therapy suits me too well. I’m usually at the mercy of misgiving – uncertain as to how I will be found out.

Here I am the author of myself and who can contradict?

A.vi.   He arrived with sharp, metallic certainties – he was a robot and I the authority.
We appeared to be stuck with the categorical belief that he knew he lacked whatever constitutes humanity and needed an expert. Fixing a faulty object seemed to be my set task.
It was one way to begin.
(His taking ecstasy seemed to make more of a difference to him.)

A.vii.   “My sexual life began at six”, she said matter-of-matter-of-factly. “I see nothing wrong with it. The man was kind to me.”
Nevertheless she came because she was unraveling over yet another lover treating her badly.
Men used her, she believed and was beside herself. [A.xiii.]

A.viii.   “Don’t speak to me as if I was a person!” [A.i.]

A.ix.   She was in trouble and sent to therapy – it was excruciating for her.
“Don’t look at me! Whatever you do don’t look!”
She could only come if I promised never to make her speak of herself.
It was a year before I knew her father looked on her at birth and, seeing a defect, insisted that she, unlike her siblings, definitely was not his. He never relented over this.
The mother was determined her daughter must struggle on as if the considerable physical disability did not exist – she must contrive to make part of herself invisible at home and school.

A.x.   Another woman half hides as I open the door, then keeps her back to me.
She would prefer therapy to be a talking about, rather than a showing herself.
The complicated past (before her birth and soon after) apparently provides an impenetrable thicket to be cleared. Might she then become more visible? [B.vi.]

A.xi.   She comes locked in a legacy – a crucial imperative growing up was to render herself inaccessible to her father’s sexually predatory eyes and intrusive ways. [D.v., C.viii.]

A.xii.   She lived in terror. I never doubted that, as she rocked on the couch wrapped about herself, banging her head on the wall.
With no possibility yet for a meeting of minds, I go some of the way with her: although the horrors she insists come from a colleague’s room are not what I can share, I can make sure I finish my time with her at 11.15am while he works on the hour.
It makes a considerable difference that I have taken account of her fears, so she never leaves my room to find him opening his door.
It takes a couple of years before we have woven enough for her to begin to see she might be sealed in old fears that no longer prevail and for me to make more sense of her state.

A.xiii.   How can she tell me, when she is lost in a sea of equally unreliable words?
How would what I say be anymore reliable?
Where, then, do we begin to find anything meaningful?
Language was used for deceit.
What was actually happening was ignored – including her being left for a year as a small girl.
What was addressed was how things were supposed to be.
Together we slip and slide – sentences pouring out as she arrives at the wrong time or the wrong day.
Slowly the ritual slots into place and the routine holds.
Then a few vivid dreams come to her. Several of them still clear to me 13 years on, these dreams provided something different.
She believed they were important and protected them (as she failed to do with most of herself) looking to wonder if her words to me could convey their power. And she now had a way of listening to hear if my words showed I was seeing enough of what mattered to her.
She’d been a painter with more trust in images, but not all words were equal trickery once they related to clear dreams. [A.vii.]

A.xiv.   “Matilda told such dreadful lies” making others gasp and stretch their eyes, as they saw her fail to grasp the facts family adherence demanded.
“That poem seemed planted in my Christmas book to shame me.”
She was ready to apologise if only she could see what they knew to be obvious. For her, certainties slipped away – dropping her down a chute of doubt. Bewildered by what they insisted was the truth, it wasn’t until teenage years she began seeing their fixed views on everyone outside the family were absurd – that their beliefs on racial difference were not common prejudice but utterly bizarre.
But still she isn’t sure if anything she says to me is true.

A.xv.   Children weren’t supposed to know. They didn’t give us any details so I imagined what might be going on from what my senses told me. Although an active imagination gave me more of the truth, it was suspect. It still is, I’m afraid. [B.iii., E.i.]

A.xvi.   Their conviction was scary. You are this – you are that – because you are our daughter.
At school I loved a dressing up box – seeing if I could wear something else.
At home I stared in the mirror, puzzled over how they saw all of what I was. They claimed to have God at their disposal.
“I don’t want your interpreting – I want to find for myself.”

She feels a need to keep me gagged until. . . [B.vii.]

A.xvii.   We meet to engage week after week. She has been judged the wrong kind of daughter, the wrong kind of child at school and then the wrong kind of person seeking help.
We hover on the edge of proving this true once again – that I am the wrong kind of listener, or she not the right sort of person to be in therapy.
For her these categories are clear and it is assumed I share them.
Although most denunciation is reserved for herself, there is fury and contempt for where I fail to get the measure of her despair.
“She is in siege with herself”, she says but how to begin finding a way out if it is certain I can only confirm that life-long, harsh indictment that she is destructive and wrong?
Nevertheless we are helped by her unrelenting and scrupulous honesty as well as sincerity of purpose. [A.i., A.viii.]

A.xviii.   In her teens she was sent to a mental hospital by a doctor she trusted to listen to her troubled soul and visions of being at Christ’s cross.
She recognized that my judgment not carrying any authority to impose a “medical solution” is what enabled her to come but remained profoundly wary.
Her getting to my door implied a wish to risk once again sharing her confusions, however, one step inside the room she froze.
“I can’t be caught out and exposed – I wouldn’t survive it a second time.”
This pattern went on and on. [E.iv.]

A.xix.   Her mother was the one who knew.
She came and spoke in tongues and marvellous metaphors.
She had come from hospital where she had yolk all over her head, she said, from reaching up to what she thought was sky and finding she broke blue birds’ eggs.
A suicide attempt, the doctor said.
For several years she did to me what might have been done to her – she drowned me out.
I could not be heard until the multitude of entrancing images could be understood and not dismissed as mad. [F.v.]

Some argue that these difficulties in communication arise if you attempt a therapeutic discourse with anyone who wishes to come.
It is implied that if you select only those who can “make use of an interpretation”, language can be used as a tool by therapists and suitable patients (those who are ready and willing to play our game.)
But how can language not be problematic?
Psychotherapy itself draws our attention to the complexities of being in language and to what we can, with honesty, say of ourselves.
To wonder at what can be conveyed and what can’t be grasped, aren’t we attending to being human?


Therapy is not a particular conversation. Some assume it is a telling of their history, so that is their way to begin and, thankfully, exchanges vary enormously with each person. Few arrive expecting us to work directly with symptoms. (In therapy, as in literature, truth is honoured by moving indirectly). More often people start wanting only to put out their version of events, seeking to have it reinforced (and might be shocked to realise how little they control what is seen.)
Some feel they have to obliterate if there is to be space for their understanding to exist.

B.i.   “It has to be your mind or mine!”
There are therapists who rise to this as a power struggle they ought to win, if they have “the truth”.

B.ii.   Only if I stay “entirely professional”, (i.e. not much of a person) can he conceive of a place where he will not be further burdened by responsibility.
It was put on him to look after his deaf and mute sister who took the time and attention.

Others appear oblivious as to how they might be influenced by our responses and silence. But in a context of communication, where meaning unfolds and interconnections spun, how can the therapist not be part of the subtle process?
If we are in the room and present to the person, how is it possible just to observe and monitor?

Once we establish a ritual practice of meeting regularly, setting aside time to be together in silence and with attention to what is said, we become aware of what is keeping things fixed so that nothing else comes into view.
The righteous may keep on tracks but so do those convinced they are one thing, whether faulty in some particular way, or much maligned.
Since most people come with intention they begin to listen to themselves.

B.iii.   Why am I driven to make a good story of myself as if nothing less will do? [A.xv., E.i.]

B.iv.   I’ve been vile – kicking and fighting my way towards the love I’m certain I need.
Then, despite myself, here we are drawn back to this.
Do you wipe out weeks of nastiness?

B.v.   Then: niggling doubt that nothing you hear is cherished makes me clam up. You get some sense of my life then move on to the next one, as if all this from me had never been.
Later: I get so caught in those old demands, which I put on you. What really sustains is what I radiate, yet convince myself I’m barely prepared to live if it can’t be guaranteed I’ll be important.

B.vi.   Another, who comes to speak but is afraid of being seen, comes with dreams of being sealed in plastic capsules. She can’t make any contact.
Gradually what encloses is permeable, until she manages to free one arm through a wardrobe wall to reach towards me.
She can nearly touch me in her dreams. [A.x.]

B.vii.   Maybe that isn’t quite accurate: mother would adamantly disagree.
How do you know if what you say corresponds to what actually happened?
Sometimes what I bring to you briefly takes on substance and conviction, but my shadows of perpetual doubt wait outside your door.

B.viii.   Perhaps I erected a folly in the garden of a somewhat barren heart to re-feel all this.
It kicked me alive but if I’ll never leave a second lot of kids, was it ever real?
It wasn’t simply ridiculous.
But what is absurd is a man shut up with a woman with sex off the menu – it couldn’t happen anywhere else in my life.

B.ix.   I wanted my stories and ideas heard but whenever I began they were quickly snatched up. Mother was a therapist and knew what everything really meant. I can’t carry on blaming her. It’s me. Before I’m even half sure what I’m trying to tell you, my sense of things is whipped up to some intellectual confection. I see you aren’t interested in them – nor am I. Despite their sterility I can’t stop.
Any effort to give voice to what might be meaningful is choked with psychotherapy theory she doesn’t resist reading. She also brings a bombardment of short cut clichés from magazines and ready-made programmes for living in self-help books (also offered to me).
She remains puzzled as to whether what establishes meaning for her is indeed some authority outside herself. She jumps into meta-comments about her thought and behaviour (but so do therapists, unless they reserve this habit for when they are discussing colleagues).
Therapy is not a business of being told about oneself by books or therapists, it is more a learning to recognise something of oneself. If the experience of therapy is partly letting thought happen, our task as therapists cannot be to pass on our own thoughts or speculations about people and their past.
Once we begin talking about things, rather than addressing what is being shown to us, we can only encourage those in therapy to do the same.
Of course many therapists agree that they address what is manifest in the room, even if it is their own system of belief (often to do with child development) which they are seeking and finding.
It is hard to see how this can help people come more alive to ways of thinking they want for themselves.

B.x.   I used to find it easy to pray. I grew up with it. At school I liked the peace of chapel – emptying myself and finding an idea or image rise in the stillness. I want that back. These days my head is permanently engaged – as if being busy with lists and mending the washing machine is its only track.

We know that people in therapy who decipher whatever comes their way according to one particular code cannot let the unexpected appear. However, this capacity in language for making constructions, which we then believe, gets in the way for all of us. Even words of wisdom, from our predecessors’ thought, are too liable to detach themselves and turn into preconceptions. Yet it is obviously alluring to attach oneself to someone more esteemed, whether Freud or R.D. Laing.
Given our capacity to hold onto beliefs and generally misuse ideas, how can we expect ourselves, or anyone, to have a simple relationship with language?
As we are drawn into the manifold complications of human speech, none of us is to be entirely trusted.


Language is there before us – a particular family and cultural discourse already in play, with a grammar to structure our minds.
If we are to speak at all we can only join, to become suspended in particular conceptions, (for example, notions of what constitutes a self are shaped by different languages and then vary considerably with each era.)
We can have no foundation for viewing ourselves outside what we inhabit.
How could we have any absolute or pure thought which is not part of the shared language in which we are already immersed?

C.i.   She spun for 24 hours with the astonishing force of one in the grip of an eruption which would no longer be denied.
Insisting she was a spinning wheel, her usual strength increased to push off two men who took it upon themselves to insist she rest, she was driven and claimed she would stop only once she’d found the pure thread of herself to spin.
It was a start – it brought her to recognition that there was no way out of a power struggle if she was not going to accept being told what she thought. She’d hoped, that, rather than fight, she’d find direct access to herself, but found those she’d expected to help were as quick as most of us to take over her half-formed sense of things and tell her what it meant. [D.vi.]

C.ii.   His four year old was fascinated by death and kept asking when granny would be dead.
One night when the boy asked “where do all the dead people go?” the father began an explanation, only to be cut short with an emphatic “no, they go back into that light.”
“Where does that come from? What can it possibly mean to him? I’d be more comfortable assuming it’s his way of refusing to consider decomposing flesh but he didn’t sound defensive, just matter of fact.” [B.x.]

What, of all we might attend to, are we seeing?
The ancient Greeks were looking to see the gods show themselves but who can even speak of such things now?

C.iii.   Her parents still think Indian, she says, but she grew up in London. “If I don’t see things as they do, I’ll be lost to my family” – and her extended network matters. She has no wish to live “selfishly, proving I can be an individual, cut off from my community.”
Nevertheless she came saying she was afraid, “perhaps I’ll become lost to myself if I never express how things are for me.”
Both literally and figuratively she speaks a different language from her family.

C.iv.   “My daughter”, she says, “takes up any words she hears – she is quick and absorbs them accurately – she only has to hear a word once – it’s rare she uses any incorrectly. Presumably she fills them with more comprehension over time. She used the word ‘library’ long before she’d ever been in the one we pass on the bus. Do we all take up the same words to suffuse with differing comprehension?”

The discipline of the practice supposedly holds us back from jumping to conclusions about what is being meant by the use of even familiar words.
We keep listening, as we might persevere with poetry, (reading and re-reading till we get the feel of it, not reaching for a theoretical commentary on the text.)
It is more a matter of capacity to stay with the baffling than going into the consulting room equipped with a system of knowledge for ready interpretations, translating the patients words into our own. However, if we as therapists are not equipped with superior knowledge, we can only cultivate limited qualities of perceptiveness or discrimination: claiming expertise provides more protection, especially in the face of those who know us all too well!

C.v.   She is teaching on a counselling course and says she is “fully adept at therapy-speak and cynical.”
“I’ve always been applauded as highly articulate. Who knows where any of it is connected?”

She no longer attempts speaking in her mother tongue – “that is when I truly despair at my success.”

We attempt to meet the person we are with – “don’t speak to me as if I was a person!” And often go back, over and over the same detail, for either or both to get a better feel of what is being said.

C.vi.   She was beginning to gather details and told me a fact.
“I have found out,” she says “that I was 2 when I was sent to boarding school.”
To get by she learnt to disconnect – whether the mother is dead or alive, whether she is dead or alive to her mother, is a regularly recurring dream.
One great horror was disintegrating after taking acid, when she became isolated in outer space, eternally unable to make contact.
She sought herself through the accounts of others and wondered, at first, if I might provide her with a story, patched together from theories of child development, telling her what it meant to be sent away at 2.
We had this fact between us but would we ever share much sense of its significance?
We met over many years.
An institution had held her in place growing up – our routine of meeting and the consulting room became another fixture. It was through disruption to this, with holiday breaks and a change of our meeting place, which prompted such disconnection, it was as if we’d barely ever met, that both of us were shown something of what happened to her. Facts – illegitimate and sent away at two – which could only be spoken lightly early in our contact, began to gather weight. [G.ii.]
Together we made more sense of patterns in her life; we did not reach an explanation. Over time people can become more aware of their reasons, or grateful their behaviour is more comprehensible, but that is the best therapy can do (Heaton, 2000). It is not the same as knowing the causes of human suffering – any such knowledge base would enable prediction, which analysts have been singularly unable to do. Who knows how any life will unfold?

C.vii.   “I can’t bear to watch her make my mistakes but what can I do?”
Her daughter turns away sharply these days if she attempts to mention anything to do with physicality.
“I am beginning to accept I can’t just pass on what I know, and nor can you.”

C.viii.   When I agreed to come for three months, I expected to just get things off my chest about my father, as if it would be that easy to make peace with myself and him.
I supposed I could pass on what hadn’t been said, as if it was simply there in waiting. One way of dealing with him was to try and never be properly present. I got proficient at going AWOL while he hit. If I was only half there it’s hardly surprising this is difficult. Disconnecting made it seem safer with him but I’m left still semi-absent to myself.
[A.xi., D.v.]

C.ix.   She writes poetry I can admire. “At least there were words for making a game with the day – nothing else was my own – with 11 of us and a small place, even my bed was shared.” [A.v., E.vi.]
She never missed a session but rarely let me finish a sentence, possibly keeping me to my better intentions of saying what is required and only what is required.


Making space to attend to what has not previously been seen, with someone who can bear to witness our anguish, faults and contradictions, creates strong emotions.
As therapists we listen for the way we are addressed and what might be being assumed in that. Usually it is not explicit.

D.i.   My family keeps its hold – some knotted and steeled frame has a grip, though so much of me falls through the gaps. Unfocused rage at all they were unable to hear, made you seem the incarnation of perfect understanding – as if I could rely on you absolutely.
Oh well, I can, at least, still bring my dreaming here, while mother continues ringing every day to be petulant about the weather.

We hear the pain of human life and a particular version of it.
Since we have all been involved in story telling from birth, we bring a fundamental sense of narrative intelligibility to what is said.
People claim it is the first time anyone listened without waiting impatiently to change the subject or to have their say. For some it is time to dare to speak.

D.ii.   What was maddening was not what actually occurred, though that was grisly and terrifying – Dad’s eruptions of violence were extreme – but then we had to pretend they’d never happened. She kept away. She could not stand up to him and we weren’t allowed to say what he’d done. Not to her – not to anyone. Her only acknowledgement was to offer us sweets I couldn’t accept. It was crazy but I’m the one in therapy, not them. I was the one who grew afraid of being mad.

D.iii.   She was suicidal and her doctor “sent” her.
Then: I spend my days swamped by nameless miseries so don’t expect me to talk.
She was as good as her word, although she came regularly for months and left her heavy silence in the room.
Later: I know it’s small but to me it’s a miracle. I’m learning to stay in the dark opened for whispers I used to miss when I went dead. It is astonishing that something shapes, unseen in the dark, to throw light on things before duly vanishing.

D.iv.   I never imagined being able to tell him of my frustration. Anyway he fell onto the pillow and into sleep as soon as he was spent.
Although I smouldered, I bridled my tongue for fear of saying more than I meant. Since he was the one to kindle sparks in the first place, I was scared of destroying more than I knew.
Thank goodness I took the risk.

Pitfalls in plenty await, as they do everywhere in language.
Some get carried away with what they find to say, insisting on inflicting it on friends or family as “the truth”.
In the existential novel I am not Stiller (Frisch, 1954), the hero writes:

At times I have the feeling that one emerges from what has been written as a snake emerges from its skin. That’s it; you cannot write yourself down, you can only cast your skin. But who is going to be interested in this dead skin?

D.v.   My sister complains therapy is turning me into an “emotional flasher”. I can’t resist flaunting my bits of story. I still hate being looked at as much as when I started. It sounds absurd but, while I’m doing my emotional peep show, I have the illusion of being in control of what is seen.
At least my sister and I talk a bit. A first in the family.
[C.viii., A.xi.]

Equally we therapists can flash our latest reading.
D.vi.   A woman who came with a long struggle ahead to think for herself, arrives from a previous therapy with an interpretation she’s been given and passes it onto me as if it’s some truth of herself. In fact its in fashion at the time, though the woman probably doesn’t know that: “Your problem is you fail to recognise the difference between your urethra and your vagina” she is told. She is an experienced nurse in a gynaecology department. [A.ii.]

D.vii.   Will you agree to leave alone my mother, my father and good breasts? I’ve had a bellyful of those already – not that I understood half what my previous therapist said.

D.viii.   “Don’t talk to me as if I was a person”, she has to tell me. She might have said you are missing me and merely talking at me.
It isn’t easy to speak only to meet the other. When we don’t resist temptation to engage people with our notions about them (even though these are likely to be meaningless comments or a serious distraction) they can be mystifying, to play a part in establishing our power, or encouraging a false knowingness.
Since the enterprise is for the patients to connect with themselves, the exchange seems most reliable when it takes on a life of its own in their language.
Sometimes what has been denied bursts forth with disconcerting force.

D.ix.   During “psychotic episodes”, language bubbles up in her and overflows on the bus or with anyone she passes on her way. She speaks volumes and can’t hold any of it together. When she is once again manageable to herself and housemates she has limited connection to what was said and we are back, trudging slowly towards the startling truths in it.

It can be disconcerting to leave people to find their own solutions if you watch them take serious risks but we are not there to interfere, “for their own good”.
People in extremis can still be working out what they need to do, if we don’t interrupt (this is one of the crucial points made by R. D. Laing).

D.x.   “Even at my craziest a small corner of me recognised that while I was driven by a frantic search for where he was hidden, I was also working my way to face the fact that I’d never find him. Eventually I sent off for his medical records, half knowing that proof he was dead would arrive in the post. And then the madness would have to end.”
She’d surfaced, badly injured, from a coma to be told her young husband was killed in the crash. Friends and family had been through the initial shock she’d been unable to share. The disjunction was too great and she convinced herself of a conspiracy until she was ready for sorrow.

Unlike presentations of our work, thought in therapy is not linear and does not have systematic coherence. In practice we go over and over the same territory, seeing it differently. We criss-cross in each way that opens up. Main themes recur, are revived, relived and augmented. We may find more meaning in what we have previously heard, or clarify what seemed confusing.
The facts of a person’s life don’t alter – “sent away to school at 2” – but their way of speaking does. A person who arrives fixed on something, or someone, to blame, including themselves, may let the accusation find a different place, provided its not too entrenched.
Presenting problems begin to fade from sight if the focus shifts.
Any story of the process is constructed after the event.

D.xi.   I went to where I could be left alone in silence under a sheet. I needed to find my way with the enormity of it. I assumed it safe to do so.
Everything I thought I knew seemed to have been wiped out – proven to be an illusion – so how could I begin to speak while I only had old expressions? Let alone challenge those who came at me complacently with their pre-packed solutions?
“Shock” the doctor said, insisting on pills I didn’t want. “Please leave me. I need to stay with it,” – but he knew “over exposure” from too long in the water and “shock” at a near drowning.
True, I was exposed to more than I’d faced before and shocked out of previous expectations of myself, to see I was not as I’d presumed.
Why should I ever agree to put it all behind me, as “a nasty business best forgotten”, if I’d been returned to something precious? It seemed the fullness of my life depended on not obliterating this tough gift.
I went under a sheet to stay with what needed absorbing – a subject in waiting, barely aware of being an object of interest. Others in the student hostel had a newspaper grasp of the event and wanted gory details. But I was too immersed to meet where they were shaping up an anecdote of the event. For me it had no form as yet and their words bewildered. What did they mean by “accident”, when all of it made too much sense to be referred to as “accidental”?
Deep in the sea there’d been an enclosure that felt complete, until life abruptly thrust me out to surface in fragmentation.
There in the water was mother’s death and longing to sink with her, yet I was taken up and driven to swim for survival. I could only submit to a force that seemed beyond any will I’d experienced before. And yet . . .
I sought a place of refuge to take it in. They could not begin to engage with what it meant to me but were ready to interfere, “for the best”, presupposing to know what was good for me.
It took a long time to find this space, where you don’t intrude with any agenda I can spot.
Something in me knows what to do and I can trust that.
Other professionals en-route here were too caught up with their own ideas of help. They encouraged me to paths that were approved and in the end I went, just to prove myself to them, and in despair at losing too much of myself.
Friends are puzzled at what I gave up for this and don’t see that without an opportunity to relive and articulate – going back to deep water and surfacing to make some sense – I was living shut out of the best of myself.

There are triumphal resting places to stop and look, admiring what can be said, yet words remain a limitless play of no winning.
Pushing oneself to find what can be put into language brings its own follies but so does that too ready shrug of acceptance at what can’t be said.
It is through serious attention to thought, we glimpse the inevitability of frustration at being immersed and unable to step outside language to take any overview. In On the Way to Language (Heidegger, 1971), Heidegger writes, “the essential nature of language flatly refuses to express itself in words – in the language, that is, in which we make statements about language.”


Psychoanalytic ideas, like all thought, are also a product of historical forces. Despite intention, these ideas have played out to provide capitalism’s requirement for mobile, detachable selves; it generates personal stories and histories to carry and define who we take ourselves to be.
A “self” may not be an entity we can construct, nevertheless we regularly meet an expectation to cater for those in search of a stronger self-identity.
“I need support. My confidence sometimes goes shaky.” She is in her early twenties, advising the police on race relations and her certainties don’t always support her!
There is a prevailing preoccupation with self-worth, self-confidence and self-assertion.
Mobility generates new questions and produces a convention for replying to the unanswerable – who are you? – where do you come from? – what are you doing?
We have become so rational in accounting for ourselves with a tangle of assertion and pride. In tune with advertising, we embark on selling ourselves.
While the Maori would give a long genealogy to place themselves, we are more likely to display how far we consider ourselves self-directed. All our history can never be spoken, but something of how we see ourselves is.
Although therapy is often asked to fortify a self and is, rightly, accused of encouraging an excessive attachment to oneself (whether one’s own view of things or one’s own desire or emotions), it remains a potentially subversive space. The demand is not what is met and therapy opens the possibility of facing the limits of one’s own perspective, or the confines of a mind that cannot take hold of itself, as well as showing how far we are from any mastery of a self.
The subtlety with which what therapists take to be manifest can be addressed, depends only partly on the therapists skill and also on how far the patient will take their awareness.
Probably none of us is as thoughtful as we like to believe, but therapy generates frustration and most people paying for the hour begin to hear themselves – even those who started with an assumption that they’d pass the listening to a therapist.

E.i.   As a child I used to dream waking to go to the toilet. All the detail would be accurate and I was sure I’d walked to the bathroom.
I still behave as if I can imagine the world as I desire it to be.
[A.xv., B.iii.]

E.ii.   She looks for tiny signs, proving life is fated – that things are meant to be.
She might be able to read omens and predictive dreams but she may be seeking a way to take control rather than submit to what was done long ago over which she had no say.
It isn’t easy for her, or me, to distinguish between these two.

E.iii.   He left when I was 8 and didn’t say he was going. Mother made no attempt to make sense of it to us.
I told versions to myself and friends, trying to cover the gaping cracks of uncertainty and to bandage unsightly scar tissue.
Basically I felt so unworthy if he’d left, and my presentations kept me just above that.

In therapy she traced him, only to find he was dead, depriving her of a sustaining hope of eventually getting to the definitive narrative that would finally catch “it”. His life and desertion of her must always elude any account of it, but “how do I give up forging illusory connections to feel better about myself?” she asks. [A.iv.]
Therapists also seem driven to illusion in asserting the value of what we do – too readily talking as if it is psychotherapy that has worked out the causes of human suffering or has the answers for it.

E.iv.   She comes each week in a state of fury with herself. The hour with me increases it. She bangs her head on the wall trying to force herself back to a place she once knew. The psychiatric treatment has left her shut out of her mind she insists, but also wonders if “perhaps I put up this barrier to myself? There has to be some way back! You could at least show me where to find the door” she rages. [A.xviii.]

E.v.   Even if I was to crawl here on bended knee, there can never be forgiveness for some nameless crime, hidden in shame but always there behind me.
Somewhere the irredeemable was done and never spoken – not once put in words.
I wasn’t raised a Catholic, yet beneath any apparent confidence lies this tidal wave in me, beginning in no definite crime and unable to fit any name, yet threatening to overwhelm.

E.vi.   Life seems to just slip by if I don’t keep phrases about it to hold. [A.v., C.ix.]
Life passes; words, however, can be kept.
Thought shifts and unfolds but we are inclined to give it shape as solid as these letters on a page.
We can say things we barely know.

E.vii.   I failed to take in he was dead. Of course I said he was and used the proper expressions but they would not sink in.

For some there is the beguiling pull of what we can’t put our finger on – perhaps an elusive question we should be asking about our body or mind?
Therapy can seductively play into the necessary uncertainty, with false promising of getting to the bottom of ourselves, or of finding the base for attributing meaning to our lives.
Meaning in history, whether private or public, derives from wide ranging sources, depending partly on what is in fashion. Where we attribute meaning is a matter of faith.

E.viii.   I seem haunted by a possibility of wholeness I vaguely recall. Or perhaps its only an idea. It niggles so that even if I came across a tiny bit of illumination, I can’t be satisfied – I crave all the lights on full.

Through being in language, human presence becomes unglued and divided. We become subject to the appearance and concealment of ourselves (Agamben, 1993 and 1999). We unexpectedly find something crucial of ourselves in symbols, dreams or symptoms.
Occasionally words fall into place before us and we find we have moved into them. People speak of finding a poem which affected profoundly, long before its relevance became visible. Other times, words come much later, bringing to light what has already passed.
A symbol which speaks to us brings a double energy, from that sudden surfacing of what was previously submerged and the delight of recognition. We are taken back as well as forward – making it obvious temporality is peculiar and not linear. The satisfaction and beauty is never diminished any time we are in the presence of one of those rather rare moments, when something simply drops into place between the two of you in the consulting room.
The sense that not just the future is hidden from us, takes people to many forms of divination (as well as therapy). If not at Delphi, we still come across occasional oracles to disconcert, by revealing a different order of things from the usual rationality. Premonitions and some dreams also disconcert.
The conscious/ unconscious split is both a recognition of a profound truth apparently always known to man and, too readily, a corruption of it into decipherment and decoding, as if we are simply a puzzle to ourselves which could conceivably be worked out by some authoritative grand master.
As soon as we slip towards believing therapy can decode “the unconscious” the practice becomes quite different, for we introduce expertise. The symbolic is of an entirely different order in which, as the arts show, there is talent and occasionally impressive ability but never conquest.


Language is what we share (along with an all too human propensity for self-deception) yet each of us has a distinctive and recognisable voice. Furthermore, we each draw words idiosyncratically from that collective pool. The variations are fascinating once people become a speaking subject, rather than subject to their “condition”. What can be difficult in listening to “victims”, or those locked in symptoms, is the degree to which they are reduced to sounding much the same.

Voice, like breath, comes through the body and is easily constricted. A voice at odds with the rest of the person, or not passing freely, raises a question. A whining tone or an effusive, breathy sympathy immediately tells us something, even if we can’t specify.
The therapist as much as the patient arrives in the room embodied and the physical presence of each will influence the encounter (despite the best endeavours of believers in the blank screen.)
Our tone of voice, expression and general bearing is almost certainly as important as our choice of words. Our background is visible in our voice, as is something of our temperament.

Because we have the language to claim too much, it is hard to keep straight how far we are at the mercy of our own natures and flesh, as well as external events.
We get only glimpses of those orders to which we are subject, but never a hold on them to establish a base.
It is easy to imply completion, with full clarity, might be a possibility – to tread through the ashes of reason proud to account for ourselves.

F.i.   As my familiar shape returned after the birth so did proper sentences. During the pregnancy I panicked – what I’d taken for granted seemed to have vanished and, although I’d hear myself that some part of the sentence was in the wrong place, it just kept happening.

F.ii.   Why don’t I remember that it is the same each menstrual cycle? I’m convinced everything is just dropping away – love, my life, the lot – and duly record my misery, yet I’m always hopeful again by the end of the week.

F.iii.   My memory has so many tricks and I’m a sucker for them. Any take on the past generally reflects my current physical state. Whenever the pain comes back everything looks entirely different.

The atmosphere in the consulting room can be crucial, though usually people refer to it only towards the end of therapy. Just as our impact on the chemistry – whether pleasant or grim expression, or sense of humour and responsiveness – may barely be spelled out. How little of it can be addressed in any account of what is going on?
Nevertheless vocabulary used by therapists encourages sloppy thought – the term “pre-verbal” is used as if we can have expressions to hand to speak confidently of what is not in language and over used words, like “containment”, imply we know the significance and can speak of what our presence offers.

F.iv.   Her smile is irresistible and my features melt into a heartfelt response.
Who can grasp what passes in our exchange of smiles?
Is there any need to begin to do so?
Yet it is undoubtedly an important aspect of what is going on.

F.v.   She came back after being abroad for years and didn’t say she remembered one word I’d spoken but that she’d never forgotten my laugh. I dreamt it while I was away and remembered it exactly, she says with pleasure. [A.ix.]

Long before we speak, we respond to people about us – all our senses alert to gauge situations – and we continue to go by the nose after we add the wonder and confusions of words. Although all of it is drawn on, there can never be coherence in the way we do so. As with any art form that attempts to attribute significance, what comes to mind can surprise – “where did that come from?” – since we draw on more than we can know and intuit much of our way with what might be happening. Sometimes a wild hunch is apt, equally often it shows more about us than the patient; we learn to hold it till we think we recognise which is which. (Therapists have, rightly, been accused of false certainties over “child abuse” or over what is claimed to be going on in consulting rooms, and of false promises of expertise, in attempts to gain power and recognition. Listening to one another we constantly hear assumptions of comprehending more than is possible; speculation runs away with us. Then there is the pleasure of presenting therapeutic skills whereby a momentary clarity within a session becomes a knowing account.)
We cannot but rely on trying to read what our imperfect bodies tell us.
To assess where the body is shaping thinking, or where notions of the self override, so that whatever the body might show cannot be registered through a haze of assumption, parallels the other difficulties for both therapist and patients in psychotherapy.
How do we speak to what might be happening without misjudging – through believing ourselves too knowing or worthless – in control or a victim? Siegfried Sassoon, writing of his time with Rivers during the First World War, addresses this:

Even Rivers could not cure me of the youthful habit (which many people never unlearn at all) of being conversationally dishonest. All he could make me do was to make me feel uncomfortable when I thought about it afterwards, which was, anyhow, a step in the right direction. (Sassoon, 1937, p. 72)

Therapists may keep quiet till they believe they have seen clearly and not reveal all their confusions, but we have no way to discard our muddles to go into our work rendered safe for the task.
There is the idea that if you never speak of yourself you leave appropriate space for the patient – as if it is a matter of technique. While it’s certainly true many of us are eager to talk and prefer no interference, the understanding any therapist takes into the room plays its part. How we make sense of what we are offering is integral to the practice. If a therapist believes that the past is what it is being played out in the consulting room, or that the hidden and declared meaning of what is said does relate to themselves, their belief is likely to shape much of what unfolds.
It is not just any illusions we have of ourselves, it is whatever pictures we’ve made of what therapy can do, or did for us, that come into the room if we do.
Submitting to the limits of what can be said and of what we can know of another, as well as judging straight what it is that we are seeing rather than what we are believing, is a great difficulty for all of us.


Although questioning the language used in the way we speak of our work and in the training of psychotherapists has been addressed more systematically by other contributors (Gordon, 1999), I conclude with a few points about preparing ourselves and others to practice psychotherapy.

Helping someone to see what has, hitherto, been imperceptible requires discernment and, there, none of us have cracked it.
Paul Klee: “art does not reproduce the visible but makes visible.” (Klee, 1961, p. 76)
A good artist shows us something more of the order of things – therapists, more modestly, have only to be midwives to patients seeing more of themselves.
We take responsibility for the frame that usually stimulates a discourse. The practice cannot reveal final truths about the patient, or human nature, but with experience we hopefully acquire greater ability to make space for others, very different from ourselves.
To take up the place of therapist is to trust oneself to speak honestly to what seems to be happening in the room. Few of us are perceptive enough to appreciate how often we fail to do so.
Our own experience of listening to ourselves in the presence of another is fundamental preparation. However, only some of our masked motives, or plays for sympathy, will have been faced – only part of our self-inflation likely to have been unravelled.
As we meet strong emotions many therapists vaguely hope their good hearts are more important than clear heads, as if the human heart was ever a reliable instrument.

G.i.   He came with vivid dreams that were powerful and strange.
When he left the room, part of his sad story stayed stirring me.
All of it seemed more than could be digested.
It grew more difficult to speak as the room, at moments, filled with surges of unspoken longing.
I didn’t doubt some of it was his but what if it was also my own?

We put ourselves in extreme situations with some people and, of course, we make mistakes, especially when we are too quick to think we know what is being shown. Although, thankfully, people hold us back – “don’t speak to me as if I am a person” – we can’t rely on that and many are seducible into the exchange we stimulate from ideas of our own. Notions we have taken up in training of the direction the conversation “should” go almost inevitably foreclose.

G.ii.   She was extremely ill with a recurrence of cancer but announced, “I can’t die before I know who has lived!”
She wanted long term psychoanalysis although this seemed highly unlikely and against all medical odds. After some months I decided we “should” address her deterioration – otherwise I might be “colluding in a denial” of the illness, which she did not mention after the initial session.
I asked if she’d given any consideration to arrangements she might want with me if she could no longer get to my room, as it was already problematic.
With a ferocity I’d not seen, she snapped she didn’t come to me for her cancer, everyone else was interested in that.
Twelve astonishing years later, as we spoke freely of her death, she could tell me how nearly she came to giving up in despair at that moment, when she heard I did not share the possibility she had found for herself in my consulting room.
She had, she said, felt expectant, knowing she planted bulbs of herself in the room and felt certain she’d stay alive to see the flowering. Which is what she did.
“I felt I was finished, if even you were saying to me your illness is all there is.”
That dogged determination of hers, to re-connect to herself before she died, could be obliterated, she realised. At the time her rebuke was sufficient for me to give way. Maybe she knew better and, besides, my heart went out to her on first meeting; I thought she would soon die so was prepared to break whatever “rules” I was still carrying with me from various supervisors.
As I stopped blocking her path, she got on with what she’d come to do. [C.vi.]

If we set up a power struggle to dictate the shape of what should be seen, we slip into dogma – the very thing therapy attempts to shift.
Given that human beings are not reducible to one system which attributes meaning, what sort of training best equips us to make space for another’s attempt to make more sense of this life?

The biggest problem in preparing students for the work is to hold them back long enough to get a proper gauge of its intricacy, without erecting false hoops to put them through. (During training we were told it takes at least 10 years to make a half way decent therapist and probably longer to find one’s own style. However it was only all those years later I began to experience what Laing was trying to convey.)

Perhaps the best we can do is challenge assumptions. It is, however, easier to give students new beliefs than to challenge the many which already clutter them.
In training, as in therapy, those taking on responsibility lead the way. If we stimulate students to think, instead of passing down the finished form of theories, they are more likely to be able to do the same.
The teaching faculty demonstrates the extent to which each is serving understanding more than themselves and whether they can provide a serious challenge to those in training, or are presenting, for agreement, some completion of beliefs about their work.

If a range of exchanges are possible, is it our nature or training which makes us tune into certain rhythms or patterns?
There seems to be a question of whether therapists can trust a healing discourse will unfold without a theory suggesting what should take our attention. (At the start of my practice I was more comfortable with personal history, but have seen enough people come and find the basic view of themselves and their situation shift without discussing their childhood.)
The opening up of vision to a fuller span of the generative force of life, may be a noble possibility in therapy, as in art (Klee, 1961), but what qualities help us in this endeavour?
Ordinary abilities such as perspicacity and sense probably can’t be taught, while any clarity over our place in the scheme of things, or the limits of personal perception, come under wisdom rather than any academic study. Although it is possible some therapists grow more thoughtful in certain respects, we maintain the specificity of our history, nature and body and keep our blind spots and drawbacks, as family and colleagues will be quick to spot!

How we do justice to the complexity of what goes on in therapy is an obvious conundrum. Exchanges about the practice tend to degenerate to the merely anecdotal, or resort to jargon and meta-statements.
Just as the living tradition of literature has frequently and shamelessly been reduced to an object of analytic knowledge – a means for it to be displayed – so, sadly, is the practice of psychotherapy becoming subsumed by endless papers and books, which, rather than preparing us for the work of being with one another, appear to inform, giving knowledge of patients as objects.
The value for someone of being able to shift a perspective that seemed locked, cannot be conveyed to answer a challenge for evidence or proof.
The urge to make more sense for oneself of what is going on, which is what brings most of us to therapy, must remain not just at the heart of the practice but in the ways we speak of that practice.


I have drawn on experience, mostly but not always, from the context of therapy, (my own as well as from those who come to work with me). There is one comment from a cousin.
I have not attempted an account of anyone’s therapy but have drawn out single comments, or aspects, to illustrate an issue for the purposes of this chapter.
Except where I had made notes for myself at the time, to think over what was said, the vignettes are in my words, from memory and from my sense of things.
I have not taken from the therapy what was necessarily of interest to the other person; the therapy is theirs, this presentation is a different work.
The longer passages are included with the permission of the subject. One is now dead; however we talked over the themes used here and she gave me license to speak of what is written in [C.vi.] and [G.ii.].
Although most of the short pieces are not taken from encounters in progress, any that are have been discussed. Where recurring themes are addressed, in several cases what is represented is an amalgam. In others, details have been omitted or slightly altered to protect identity. One is imagined to capture something of what seems often repeated.
I wish to acknowledge appreciation for the range of influences during my training at the Philadelphia association: in particular the late Hugh Crawford, as my first supervisor, whose distinct pleasure in language and etymology encouraged me in my own, and R.D. Laing who drew me to the P.A. with the hope that I might be helped to think without being told what to believe and who, later, showed one way it might be done.
I also have to thank the late Hugh Crawford for giving me the experience of watching him work in one of the P.A. households and for helping me to see that what confounds eventually can be elucidated.
Above all, I am grateful to John Heaton who, over many hours of conversation, brings his rigorous mind and philosophical reading as a foil for my different way into thinking.
The work, thankfully, constantly confronts me with questions and ways to see I am still making too many assumptions.

•   •   •  

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