Many people mistakenly believe that therapy, particularly psychoanalysis and its descendant psychodynamic psychotherapy, encourages self-absorption. The reality is starkly different. Far from indulging narcissistic tendencies, meaningful therapeutic work illuminates the path away from them, offering a chance to build genuinely connected and fulfilling lives.
The Internal Struggle and the External World
For countless individuals, internal traumas and unconscious conflicts create significant barriers to engaging with the world and other people in a healthy, ordinary way. Without the capacity to process difficult emotions, people often resort to harmful coping mechanisms.
These can include excessive use of screens, substance abuse, gambling, self-harm, workaholism, or sabotaging relationships. This behaviour is frequently a defence against feelings that feel too overwhelming to tolerate, pushing individuals into more dangerous territory.
This state is described as an ordinary but devastating narcissism, where a person becomes trapped, unable to form meaningful connections with themselves or others. When we are blind to our internal world, we cannot look outward to find solace and meaning in community, nature, work, and love.
The Fight for Accessible Therapy on the NHS
While psychotherapy is sometimes criticised as a privilege for the wealthy, this perspective ignores the crucial need for and existence of affordable options. Reputable clinics and training organisations often run low-fee schemes, and the British Psychoanalytic Council's website now helps therapists advertise reduced-fee vacancies.
However, the provision of sustained psychodynamic psychotherapy on the NHS has been consistently diminished over decades, leading to very limited availability today. Every cut to this highly effective, evidence-based treatment forces the health service to act against its own stated values of equality, quality care, and patient choice.
These cuts make a mockery of the principle of parity of esteem for mental and physical health. It is an unacceptable situation that demands louder opposition. The author, an NHS psychotherapist herself, calls for public action, asking: Who will join me?
Building a Better Life From the Inside Out
The transformative power of this kind of therapy is profound. The author credits psychoanalysis with saving her marriage, enabling her to become a mother, and allowing her to do her job effectively. Without it, she believes she would have remained shackled by brittle intellectual defences, unable to build a fulfilling life on the emptiness she sensed but could not confront.
The goal of therapy is not a one-size-fits-all solution. For many patients, discovering what a 'better life' means to them is a central part of the therapeutic work. The core message is that this opportunity for profound personal growth and healing should not be dictated by financial means. If we aspire to build a better society, effective psychological therapies must be available to anyone who needs them.
