Talking as therapy

Most of the time, people come to therapy because they want something to change - the way they feel about their lives, the way they live - and many only take this route as a last resort, after other options failed to yield the desired outcome.

The process often begins with some hesitation, and scepticism about how 'just talking' could make a difference is rarely entirely absent. At the same time, there is from the start an unspoken knowledge that what is on offer is the opportunity to engage in particular kind of talking – where one can be heard, not feel judged, say something never told to anyone, or put into words something as yet unknown but troubling. What is at stake is a certain kind of talking that can only happen with a certain kind of listening.

Such talking makes possible the inscribing of one's own story and the exploration of those things that do not add up, of questions never asked or left unanswered, of fleeting impressions that do not fit in with what one's life ought to be, and leave in their wake a persistent unease. This does not correct the past, does not repair the trauma or airbrush memories. Instead, by constructing a spoken history, such speech offers the chance of finding a new way to live with what was there before, and therefore to engage afresh with one's experiences and desires. For this to happen, one needs to relinquish rigid established modes of seeing the world and oneself, thus allowing for the possibility of new connections to emerge, for new configurations to develop and adjust. Sometimes what changes is the very sense of pressure that one ought to change in order to fit in with some ideal or set of expectations. At other times, something more becomes possible, such that long buried wishes can be pursued, new desires can arise, be expressed and explored.

This kind of 'talking cure', as initiated by Freud starting with the late 1800s, works for two main reasons. One is that speech and language is what we are born into, our only means of articulating our own position in relation to those around us. The other is that the psyche is a kind of space whose particular layout cannot be accessed and known directly, but whose configuration can nevertheless be traced through speech. This is a space riddled with recurrences but also with turning points, marred by gaps and discontinuities. It is the space of our dreams, and one never hears of a boring dream. Rather, the introduction to it almost always begins with 'I had a really strange dream...'. This is indeed a strange space, it is Other but ours, too, inasmuch as we can open up and follow new pathways of words, thus tracing its surface and bringing about new movements in our experience of and with it. The kind of talking I refer to is not just about finding answers, but also – and more importantly – about working out a way of dealing with that which has no answer.

This matters because something is missing, something is always missing. For some, at times, having a witness to one's own story is enough. For others, the quest goes beyond sense, towards finding a way to circumscribe what continues to elude and to trouble. Beyond making sense, and telling a story, talking can become a way of putting words around what remains impossible to comprehend and explain, a little like building a light fence, not to protect but merely to demarcate a perimeter, simply to mark in some way the location of something nameless but present. Like the charting of the unknown or unknowable on olden maps: here be dragons.

Sooner or later, the limitations of words and of speech become apparent: for some things, there are no words; for others, the words are not right; for others still, the words available are as if they belonged to someone else rather than to the speaker; at times, the words give another story away, they say something other than what was intended. We cannot say everything, but by saying something about what was, to start with, unspoken and unknown in the usual way, a lot can change.

One way or another, such talking comes to its natural end not because everything has been said, but because enough has happened for the one who speaks to become able to make the most of themselves – not for or in opposition to someone else, but in recognition of what is uniquely theirs and of what matters to them. This is not to say that, by the end of therapy , nothing is missing. Indeed, the fact that something is not there, that we seek it out and pursue it is exactly what operates as the very engine of life, of creation, and of enjoyment. So it is not a question of doing away with the sense of something lacking, but rather of finding more life-enriching ways of pursuing this eternally elusive satisfaction.

Anca Carrington, PhD, is a psychotherapist who trained at the Tavistock Centre in London, after a career as an economist, both in academia and the civil service.

After several years of working in the NHS, first at the Tavistock and Portman NHS Foundation Trust, and then at the South London and the Maudsley NHS Foundation Trust, she now works full-time in private practice.

She has a particular interest in Lacanian psychoanalysis.