By the time people eventually come to see me they may feel very broken. It is as if they have lost their essential self and no longer know who they are, if they ever did.

Of course we all want to be fixed but it may not happen in the way we envisage. It may take some sort of breakdown from which we need to be put back together differently because who we were no longer works; the pieces no longer fit in the same way.

This often leaves people feeling completely out of control and in a desperate attempt to regain it they may become over obsessive or the opposite, giving up, hiding away and feeling unable to make even the simplest decisions.

To understand what has happened may mean looking at both the past and the present. There is often a current trigger, perhaps a break up in a relationship or a death which leaves a person feeling alone and abandoned. Again.

This trigger causes a recurrence, often of something that has happened in the past which has never been fully resolved. The person has adapted and managed to keep a lid on things but over the years there has been a build up until the trigger event; the house tumbles down and Humpty Dumpty falls off the wall.

So how do we begin the re building process?

The truth is there needs to be an acceptance that nothing will ever be quite the same again because the pieces no longer fit.

For things to change there has to be a fundamental shift in the person’s thinking and feeling. He will need to recognize, understand and work through the initial hurt and feelings of terror, loss, and abandonment alongside the current situation, trying to keep both past and present hurt separate to aid comprehension and avoid being overwhelmed.

This may take some time.

Finally, when the process has been worked through, the pain felt and released, acceptance and tolerance of the situation can happen. The person sees that relationships have changed and whether it feels better or worse it will be different. This allows some peace.

If the process of working through the pain has some resolution the person begins to understand that their hurt was real and justified in the circumstances.

Humpty Dumpty can then be put back on the wall but the way he sits will be different.

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