Tales from the Therapist's Couch

Dear Diary: You are the only one who understands me

It is exactly four years ago today since Marion Milner died, pen in hand, at the age of 98. Although less widely known than Freud, Jung or Klein, she is, for myself and many others, one of the most significant psychoanalysts of the 20th century.

"My life was not as I would like it ... I was drifting without rudder or compass, swept in all directions by influence from custom, tradition, fashion... was there no intuitive sense of how one should live, something like the instinct that prompts a dog to eat grass when he feels ill?" So begins Marion Milner's most famous work, her diary, A Life of One's Own. In it, through free writing, dreams, drawings and painfully honest introspection she learnt to pay attention to the neglected parts of herself, and discovered ways of living that shifted her unhappiness. Written when she was in her twenties and living in London between the two World Wars, it is an extraordinary record of self-analysis. After completing the journal, she was so astonished by the depths of what she had been able to learn about herself that she went on to become a psychoanalyst.

As I listen to people in my own consulting room, I often think of Marion Milner's writings. Analysis can feel very much like a reflective diary space. I once worked with a man who wrote copious letters to me between every session, letters that he never posted and only rarely wanted to share. As a young child, he had for several years been an elective mute. Although it was a long while since he had verbally retreated from his external world and hidden behind a wall of silence, he still felt withdrawn, unable to live confidently from his own authority. Something remained unvoiced and curbed.

The letters that this man wrote were a way of breaking through some invisible wall and gathering together into one place what remained muted, neglected. It didn't matter that, although written to me, I rarely saw them. He wasn't writing or talking to me about himself. He was talking to himself about himself, both between and within sessions, because he had at last found a space where it was safe to do so.

It is not that I was redundant, that I was no part of this process. Quite the opposite, in fact. Sitting with him, I often felt like the mother whose presence is needed, somewhere in the background, for the child to get on with the serious and solitary business of play. My being there was helping him to experience what he had never known as a child: how to feel contentedly alone while in the presence of another.

This man was far from being alone in bringing written material to analysis. On other occasions, people have shown me poems, paintings, notebooks, journals and even actual childhood diaries. Outward expressions of the inward process of self-discovery, they are all part of the ongoing conversation that happens in therapy not just between analyst and patient, but just as importantly, between the person seeking change and their many selves.

Ours is a culture of specialisation and expertise, and like many professions, psychoanalysis is often guilty of cloaking the ordinary in obscure, jargon-riddled language, propagating the myth of the analyst as "the one who knows". Too many people have an idea of psychoanalysis as a place where something is done to them, some higher knowledge imparted when they are ready to receive it. The pity of this is that it can breed a pattern of dependency, which in turn lessens people's trust in their own self-understanding and intuitive sense of direction.

Psychoanalysis needs to make itself more accessible and show itself for what it is: a space where someone can feel free to explore what they have become and why, to consider the reasons behind choices made (or why it is impossible to choose at all), a conversation between two people about issues affecting us all. Where is joy? What am I here for? How am I choosing to live my life? If this were so, there would be less compliance to an esoteric body of knowledge, a pseudo-science of the psyche.

Marion Milner's life and work are a welcome touchstone in the maelstrom of psychoanalytic theory. With clarity and deep humanity, the message that shines through from all her writings is that, whether with or without the help of an analyst, we each have the need to recover an intuitive sense of how to live rather than rely upon others' frames of reference. We all have the capacity to live a life we can trust and call our own.