One of the overriding needs of the MD is for someone to talk to. In the first instance we may talk to our families and friends, but our families and friends are not always good listeners. In any case, they often already shoulder the task of looking after us, and they have their limits. Further, we may have difficulty in discussing our deepest and most personal problems with someone so close, especially as they may themselves be part of the problem. So we need to turn elsewhere.

A psychotherapist or counsellor is a trained listener, unshockable and unjudging. He or she will not usually be medically qualified and will be unable to do anything about our body chemistry, though normally happy to work alongside a doctor or psychiatrist when this is helpful. But at the very least a therapist will be able to offer us a fresh perspective on ourselves, reflecting back at us an understanding that we may not have reached on our own. This in itself helps to lower our inner tension. He or she may be able to help us come to terms with ourselves by enabling us to see more clearly the causes of our problems. And always, always, everything that passes does so in the strictest confidence.

Some counsellors - those termed 'psychodynamic' - are trained to bring to light the activities of the subconscious. When the problems of the subconscious become conscious we can begin to deal with them, neutralise them and in doing so grow in self knowledge and perhaps also in self respect. Note however that a good therapist may well choose to proceed very, very cautiously with an MD because of the terrible risk of getting it wrong and "upsetting the applecart".

Psychotherapy is not solely the preserve of the rich. Most therapists will at the first interview try and establish the client's ability to pay and will charge accordingly. At least one of the larger counselling organisations boasts proudly that no one is ever turned away on account of their lack of money.

My own experience has been that the process of being loved, listened to, understood, cared for and supported by someone outside my family circle has turned my weekly consultation into one of the high spots of my week. As I have passed from one crisis to the next it has meant more than I can say to find in my own therapist a friend and sympathiser with whom to share my journey. And in looking back over the last four years it is clear that I have changed immeasurably and for part of this my therapist must take the credit.

Martin Mosse, 31 December 1993.

"Pendulum", Winter 1994.