A man in his mid-forties arrives in the consulting room. It is our first meeting. He looks around awkwardly, as if he doesn't quite know how to place himself in this unknown space. He takes a seat and begins to relate how he found his way here. I listen to details of his frustrating journey. I wait, quietly, and he falls silent. I can feel that he is struggling to know how to begin. How will he find a way to talk about why he needed to make the journey to this space?

Our eyes meet and he breaks the silence. "It's difficult to explain to you why I'm here. I don't really know how to explain it to myself. I have a successful job, a successful marriage; I play as full a role as I can in family life. I take the kids to swimming lessons, play football. I spend time with my wife. We have an active sex life, a good social life.

"And yet...increasingly, I don't feel I'm a part of that life. Increasingly, I live with this terrible sense of not really being present in what I'm doing. I go through the motions. I watch myself playing the part. It's got a lot worse recently, and sometimes I can't even play the part. I just sit and stare at it all. Am I depressed? Am I going mad? Am I about to have a breakdown? I tried to tell my wife and she just said I was over-tired. I know that's not it. But I don't know what it is. It feels as if I need to do something to change the way I'm feeling, but I don't know how to."

Over the weeks that follow this first meeting I learn about my patient's life, past and present. He describes a hectic life, with every nook and cranny crammed with activity. And everywhere in his life are the outer signs of the success that this activity has brought him. And yet, as I learn more about the boy that he was before he became the man that he is, I note an important discrepancy.

His childhood and early adolescence was full of time spent with his inner life. By that I mean that he was a dreamer who used to spend happy hours in imaginary conversations with himself. As he grew older, and the demands to converse more with the external world increased, he discovered he could adapt to this surprisingly well. He had a strong intuitive sense of what people wanted, and a natural charm, and he used these to instinctively fulfil what the world of others desired. This ability to adapt to external demands worked so well that he became the successful man that he described himself as being.

However, it worked at an accumulative cost, and his current depression was the price he was paying for that cost. He had become so increasingly adept at conversing with the external world, that he had mistaken this way of relating for the whole rather than just part of himself. For years he had ignored the side of himself that in childhood had been his mainstay. He had got out of touch with his equal need to relate to his inner as well as outer world.

In his autobiography, Memories, Dreams, Reflections, Jung describes a similar predicament. Fairly early on in life he recognised the existence of what he called his two personalities. "No 1" personality was the side of him that successfully related to the external world. "No 2" was his private, inner relationship with his Self. What Jung did so importantly and emphatically was to insist that space must be given to both aspects. The conflict between these two sides, he argued, "has nothing to do with a split or dissociation in the ordinary medical sense. On the contrary it is played out in every individual."

As the man above discovered, in this extroverted and frenetically paced culture of ours, our relationship to the outer world is too often perceived as the be all and end all. What Jung's work offers is a healthy way to redress this imbalance that avoids the need to pathologise psychic pain. In today's climate of quick-fixing, it is for me a way of working that we can't afford to do without.

Elizabeth Meakins is a psychoanalytic psychotherapist. None of the above clinical material refers to any specific individual cases