Acknowledging and affirming a person’s vivid experience and the struggle towards recovery - and simultaneously seeking to modulate or attenuate the intense distress and confusion that is part of the process - requires a difficult and time elusive balance.

It is not simply to be unafraid of otherness - it is to seek out and attach value to otherness and in this way to extend ourselves and assert our humanity.

We need to be willing to accept the need for change in the way we see ourselves and the way we behave towards others.

One critical step in this process is to re-imagine the symptom not merely as a sign of a pathological process but as an endeavour to find meaning and regain control. This would entail acknowledging rather than dismissing these often bewildering symptoms.

And just as therapist and patient must negotiate their hopes in dialectical conversation with one another, we, too, have to nurture between us the most fragile of cargoes, with the retaliation that what each of us does in our lives on a moment-to-moment basis will ripple through the ages. There has to be a revolt and a sincere engagement with it - failing which there can be no shared hopes, only selfish ones.