Long, long ago, a supervisor taught me a list of the five things to talk about in psychotherapy: I think her more traditional list might have included “work” and “sex-life” – it’s gone a bit foggy – I kept forgetting her items and, eventually, unconsciously, filled in the blanks and reorganized the list to better suit my own approach.

The Past. The Present. Dreams. Intimacy (& The Therapy Itself).

It became a way to orient myself in the room, points on my compass.

These are the realms to explore, the ground to cover in therapy.

Most people arrive for their initial session planning to only visit one realm, and hoping to avoid many, if not all, of the others.

Some therapies explore only one or two areas, some spend years in a single zone. In my own therapy, around the fifth year into the process, I said to my analyst:
“I think I am finally done telling you what happened.”

Better late than never – ready to enter the room, and the present.

It doesn’t matter where we start, we will arrive at the central conflicts no matter which route we choose – all paths lead up the same mountain.

But sometimes we get stuck. Hit an impasse, cling to neighborhoods we are overly familiar with, avoiding all uncharted territory.

A broken record sensation emerges:
“I feel like I’m just talking about the same old things..”

Our real needs have crossed the borders and are hiding out in one of the other dominions.

Pick one, any one of the other realms, travel out of your comfort zone – onto stickier, messier, unknown territories, and explore the wild regions in order for the work to come alive again.

The Past:

This is the land of our ancestors, of childhood, a place where small people live among giants. Family trees grow here, planted in soil shared by many other trees. This is therefore also the realm of historical, generational, socio-political, cultural, national and biological inheritances, of formative forces and events, from in and outside of the family.

We don’t visit this land to judge or blame the inhabitants, we pass through to understand where we come from.

When we travel through this country, my function is to empathize with the forgotten child that you have most likely “adult-ified” in your recollections, to help you rediscover what a child’s age-appropriate needs are, to recall your first language.

The templates for most of the survival mechanisms you use, effective or not, were forged here. We will need to understand what tools you relied upon, who you inherited them from, and who taught you to use them.

Some learn a set of survival skills in the forest and then move to the desert, suddenly lost and helpless. Others, unable to leave their childhood world, struggle to launch and relocate.

In order to move to other lands, to approach the realm of Intimacy or live in the Present, we need to know about our inherited world, how it works for us, how it limits us, and how to forge new tools.

The Present:

This is where we live most of the time – the land of work, school, house-holding, industry, things to do, annoying bosses, disobedient children, speed-dating, messy roommates, and conflicts with our immediate environment.

This is also the realm of devastating crises, of life-altering diagnoses, of recent trauma, of fresh bereavement (although death also takes us quickly to the past, and to the land of dreams), divorce, job-loss and the ever-persistent stress.

Many focus on it exclusively, as the safest, most public, most conscious and obvious part of ourselves. When it is in disarray or disrupted, we are unable to rest, to work. This is where our symptoms trouble us, or trouble others.

This is where our personae lives, where we wear masks and uniforms, this is where our ambition is fed, or thwarted, where our status and power are inflated or threatened.

The therapist’s role in this leg of the journey is manyfold: offering support, shoring up healthy coping, teaching mature self-care and communication skills, being an “objective observer” to “bounce things off of” (mirroring), watching for emotional patterns and interpersonal habits.

If we have spent sufficient time in the past, it is easier to place present thoughts and feelings in a larger context, making way for more self-understanding and self-compassion.


If you would like to forge a deeper relationship with your own psyche, strengthen your intuition, discern more about your unknown Self, this is the place to start. We can include day-dreams, fantasies, wishes, and the ideas and images which float up during meditation, or artistic, creative symbolism. If you are the type: psychic impressions, oracle readings of any sort, religious visions, lexio divina, signs from God or the spiritual realm, synchronicities of all kinds, also reside in this province.

This is the realm of symbol and imagery. This is how we access the land of primary process – this is the soup, the collective and personal unconscious. Here there is no-sense, and nonsense. This is where all of our irrational, preverbal, archetypal bits are stored. No opposites, no linear time or order, no cause or effect. Everything is masked, coded, costumed, and cloaked. Our dreams and unconscious imagery compensate for our conscious socialized identity, reach for unfinished business, point out blocks and obstacles, personify unacknowledged aspects of ourselves, and sketch out pathways for our future growth.

My tasks in this area are clear: to help you to amplify and explore the multiple, even paradoxical, meanings associated with the symbols you have produced. The symbols may have meanings that are personal to you: “I’ve always been terrified of spiders” as well as collective to our culture or our species: fear of being tangled in fate’s web…

There is often rich guidance to find here: directions, reminders, instructions, warnings, clues, solutions and inspirations.


Intimacy is another realm entirely.

Sexuality lives here, of course, but so does any emotional, personal transaction – between friends, partners, and family members – that demands that we be openly vulnerable in front of another.

This is where raw honesty, the most primal hungers, and terrible, excruciating exposure reside.

This is where we are laid bare, with only our teeth and nails for protection.

Approaching intimacy is difficult and hazardous, frightening and exhilarating. We sense we are entering an entirely new world of communication. We may say things out loud and carefully, that we were sure we would keep private forever. We fear we might die of exposure.

There are terrible clashes, where starved, naked, terrified people approach each other, ready to fight, ready to run, and show each other their raw hunger and deep wounds seeking tenderness, wishing to be seen and fed.

Some fear they will be devoured by cannibals. Others, that their own scarce supplies will be stolen. Many focus so exclusively on the hunger of others that they forget to feed themselves. Some steal and run.

And sometimes, miraculously, deep alliances are formed after many cycles of approach and retreat. Wounds and hungers are met, tenderly and with respect. Mutual satisfaction is negotiated. Shame is conquered. This is where we see and hear what is most vulnerable in the other, and meet it with our own undefended need.

And a way is found to feed, to rest, to heal deeply and fully together.

The Therapy Itself:

The therapy office rests in the crack between the worlds. I may unwittingly embody characters, or be drawn into rituals with you from any of the realms.

Any of these worlds can emerge in the treatment room, and do. That is what the therapeutic space is for.

But when we take time to talk explicitly to each other about the therapy itself, we are actively practicing rites from the realm of Intimacy.

We stop together, locate ourselves on the map, decide how the journey is unfolding. We expose our feelings for and on behalf of each other. Needs, specific to our relationship, are expressed, heard, and negotiated. We may adjust our pace, sort out our differences of opinion or our conflicting desires and instincts to head in diverging directions. Angers, hurts, failures and disappointments between us are acknowledged. Appreciation, closeness, trust, and affection are earned. Other characters from the past, the present, and the land of dreams, may cast their shadows here – as both of us work to sort out our projections onto each other. We talk about how we are functioning as traveling companions, and decide who should drive and who should navigate for the next leg of the journey.

The purpose of the entire journey is this: To become brave and confident orienteers, to chart as much of the undiscovered country as we can, ever-mindful that vast stretches of wilderness will always remain.

copyright © 2011
All rights reserved Martha Crawford