Accordingly, the chapter explains why the sick behaviour of individuals can be a reflection not of chemical imbalances or dysfunctional childhoods, but of the degree of sickness prevailing in any given society. It argues further that the negation of universal human needs such as creativity, sociality and autonomy generates alienation in its technical sense, giving rise in turn to all manner of relational disturbances. The chapter maintains that the cultivation of hope, which, like all other emotions can be approached intersubjectively, depends on our capacity for recognising and responding to the psychological and material needs of our fellow South Africans.

When someone comes into my consulting room for therapy, I’m on the alert for signs of the soul’s condition. I will hear many stories and some complaints about life, but I see my job as caring for the deep and usually hidden life of the soul. This orientation is essential. You can’t do real psychotherapy without it. Often what is called therapy looks more like life management than soul care. You can rearrange your life, but that is not the same as giving your deep soul what it needs and craves.

But the struggle to become a person and to have a genuine relationship can hold people together, perhaps more effectively than a desire for happiness and unbroken togetherness. I’m not saying that a relationship should be painful but that the happiness sought for might be deep and complex, not superficial and simplistic. Therapists who aim at simple happiness for a couple in their care may either feel frustrated eventually or misguide the couple toward an ideal of superficial togetherness.

But, as important as it is to understand the sources and details of one’s pain, understanding is rarely enough. My patients come to therapy wanting the burden of their accumulated experience lifted. Yes, they want to make sense of their lives, but that is not usually their fundamental or exclusive aim. First and foremost, they are trying to get over their accumulated trauma in order to feel less fearful, isolated, forlorn, helpless, alone, anxious, or depressed. They might not be able to say it so clearly, but they are reaching for things

beyond thought, trying to make contact with essential capacities that have been sacrificed in their efforts to adapt, adjust, comply, cope, or conform.

James Hillman has observed that depression may be a special problem in a society hell-bent on happiness. But let’s examine this connection more closely. It is possible to imagine that the situations life offers may not be happy ones and yet may be the most desirable of all.