The mention of Kuan Yin was spontaneous; I did not know whether Jack was familiar with her, and, when he was not, I needed to explain her to him. This took some time and threatened to overwhelm the session, taking him away from his feelings and into his intellect. But I wanted to turn around Jack’s long-standing sentiments of never having been enough. If he could imagine himself, even for a moment, as the healer, I hoped this would begin to offset his unquestioning identity as someone who needed to be healed. His slightly off-balance reaction to our interchange suggested some degree of success. Instability is sometimes a sign of new possibilities.

Reflecting on this session, I am reminded once again of the concept of the mind object, both Beth’s and my own. By focusing too much on the particulars of Beth’s food issues and trying too hard to make a change in her behavior, I was getting drawn back in to her closed world instead of helping her break out of it. I had lost track of Michael Vincent Miller’s essential point and was therefore, not surprisingly, sacrificing innocence for experience.

In some way, this is what I want to convey to April. We all wish we could just eliminate the dysfunctional parts of us. In pushing against what we do not like in ourselves, we get more knotted up. The shame, discomfort, embarrassment, and pain just reinforce the hold the whole thing has over us, and, in the process, we over-identify with an aspect of ourselves that does not need to define us so completely. Seeing this overidentification clearly is what I think of as insight.

But her self-criticism was learned. How she learned it, and who she learned it from, we do not know. Therapy could take a good deal of time trying to get answers to these questions, and the answers might be interesting and even potentially helpful, but it is much more important, I think, that April understand that she could learn to pull back from a complete identification with the self-critical voices in her head.

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.