The stories I hear are often littered with the "if onlys"

"It sounds like a cliché, but I think I always knew what I wanted to do. I spent so much of my childhood playing at making ideas into things. I did brilliantly in my design and visual arts exam. And then suddenly, just when my teachers were encouraging me to take it further, it was all over. My father wouldn't hear of it. It was medicine or medicine. That's what you did in our family, not the wishy-washy art-school stuff. And so that's what I ended up doing."

I am sitting with a man in his thirties. He sounds numb with sadness, as if the telling of his life is coming from some small faraway part of himself. In abandoning his teenage plans to study art and design, he feels he has also abandoned an essential liveliness within himself, and as he talks about his outwardly successful life as a doctor, his words are coated with an unbearable ache of regret.

There is something utterly heart-rending about regret. The stories I hear are often littered with the "if onlys" of a regretted decision: the wrong path taken, the wrong lover embraced. Often, as with the man above, it is as if a line is drawn in the narrative of a life story, dividing the before and after. Before the regretted action, or inaction, all was hopeful and possible. After it, life skidded off on to the wrong track.

My work as a therapist is to both accept and challenge this notion of regret. The acceptance is of the reality of the sense of regret, and the suffering that accompanies it. What I challenge in the tales of regret is the sense that because a job, or person, wasn't embraced at the right time and place, all is irretrievably lost.So now, 15 years after taking what he feels was the "wrong" decision, can this man recover anything from a path not taken?

Without wanting to sound tritely optimistic, I think that the answer is yes, a lot. A lot can be recovered because a lot is still waiting to be realised. In their experience of regret, people often make the mistake of giving too much power to the "object" they feel they have lost. Their failure to embrace something in the external world makes them feel robbed of something within themselves. Too often they then give up on the quality within themselves that was animated by an external trigger. So the man above, after choosing medicine, took it for granted that his creative side was thwarted for good, and simply proceeded to ignore it.

And yet the part of him that was enlivened by "making ideas into things" can't have vanished overnight. Or even after 15 years. On the contrary, this frustrated part of my patient's nature was very much present in his sadness.

What my patient needed to do was challenge the idea that all had been lost in the mists of time. Instead, he needed to focus upon recovering and re-kindling the part of him that quickened into life all those years ago when he was on a different track. Initially the idea of salvage was anathema to him, and met with a lot of resistance. But some months into our work together he took a risk and signed up for a course in sculpture and design.

Today, a couple of years on, he has just finished building a shed in his garden to accommodate his art materials and "work in progress". I doubt he will ever give up his medical career, but by recovering within himself what makes him feel alive, he has substantially reduced being haunted by regret.

Elizabeth Meakins is a psychoanalytic psychotherapist in private practice. None of the above clinical material refers to individual cases.