In my work with clients I do my best to share my thinking – for example: why it is I ask a particular question, or why it is I think someone is stuck in behaviours that can’t be shifted. I always aim to work collaboratively, sharing my informed ideas with clients, rather than imposing them as ‘answers’. My ideas may be rejected in whole or part, or land with a clunk that seems to fit. I may have a hunch that something is being rejected defensively, and decide to come back to it at a later date – I’d come clean about that though.
I can’t ever really know what goes on inside anyone else of course – good therapists can make good guesses though, as we are trained to tune into other people’s experiencing through subtle ways. We should never opine definitively and I wince when I see therapists in films and TV do so. So given that I’m open to discussing what I’m doing in the consulting room, it’s no surprise that I often get into the nitty gritty of the psychological work involved in therapeutic change. I’m often asked, something along the lines of, ‘Ok, so I now know my thinking/behaviour that is getting in the way of things is a product of the past. What next?’ Insight can be enormously helpful, but, in my experience, tends to get us only so far.
But how to describe the next step defies neat explanation. How can we turn toward ourselves in distress, ‘tune in’ rather than be submerged, and then sift out what is an ‘appropriate’ response from the extra ‘charge’ brought by the past? The short answer is that it tends to take a lot of practice, and some of that we can do together in sessions, but most of it will need practice ‘outside in the world’ (I like to think I’m in the world too). When we are flooded with tricky feelings – anger, rage, self-loathing – it’s a tough call to approach these feelings rather than be at their behest. Especially as feeling tricky feelings are often so visceral. But if we prime ourselves to be our own detective or ‘inner therapist’, it may help to train us to begin a new awareness – mindfulness meditation is a fantastic training ground for this too.
I still have to do this, despite years of my own therapy. I travel back into historical emotional states, regardless of how well I know what is going and having a strong desire to stop. But while these unfold inside me, I have learned to sift out the familiar old software – ‘this is what it felt like when X happened, and X is not happening any more’ – then I can attend to that part of me that is still, annoyingly, yapping at my heels. But as I continue to attend, in a kindly soothing way (ie with compassion for my earlier hurt) little by very little, it makes things feel a bit better.

I’m not offering a panacea here but a method to work with entrenched patterns – this is much of what makes up my work today.