This is a composite vignette created from recurring themes in my work. It does not describe any one client. Personal circumstances, biographical details and the sequence of the work have been changed or omitted. Its purpose is to illustrate how I work, rather than to report a particular person’s story or promise a particular outcome.
When life has shaken us to our core, the first glimmer of hope is precious—but it should not be mistaken for the end of the process. Often, it is the sign that healing has begun and that the deeper work is now becoming possible.
In this composite vignette, a person comes to counselling while facing two profoundly destabilising experiences: a serious illness and the discovery of a betrayal within an important relationship. Their trust in their body, their relationship and the future they had imagined has been shaken. Familiar ways of understanding themselves and their life no longer seem to provide solid ground.
The work takes place within a time-limited arrangement. This means that our immediate priority is to create enough support for the person to speak about what is happening, experience their feelings in the presence of another and begin finding some ground beneath their feet.
Anger is initially in the foreground. I do not regard this as something that should be quickly calmed, explained away or replaced with a more acceptable emotion. Anger can be a response to injury, injustice and the sudden loss of control. It can also carry grief within it: grief for lost trust, lost safety, changes to the body and the future that may no longer unfold as expected.
My Gestalt approach involves staying with what is present rather than rushing the person towards reassurance, acceptance or a solution. Together, we attend to their words, silences, bodily responses and shifts in emotion. I offer a relationship in which anger, fear, vulnerability and grief can be expressed and witnessed without the person having to protect or take care of me.
My ability to remain present with these experiences was also informed by facilitating groups and thematic workshops for people affected by cancer during my psychotherapy training. This helped me understand something of the emotional and existential territory that serious illness can open: questions about mortality, identity, dependence, dignity and what it means to continue living when life has changed unexpectedly.
As the work develops, the person begins to feel steadier. They can name more of what they are experiencing, recognise the courage with which they have already faced significant adversity and make some immediate decisions about their life and relationships. These are meaningful developments and deserve to be recognised.
However, becoming more stable is not necessarily the same as having worked through everything that has happened. When the most acute distress begins to recede, there may be a temptation to conclude that therapy is no longer needed. Sometimes this is the right decision. At other times, early relief creates the stability from which deeper grieving and integration can finally begin.
In this vignette, the person feels ready to stop as the immediate crisis eases. Their decision is respected. At the same time, I share my view that more sustained psychotherapy could provide the time needed to remain with the different layers of loss and change. We consider the difference between feeling well enough to continue with life and having had sufficient opportunity to understand and integrate what has happened.
No one should remain in therapy simply to satisfy their therapist, and therapy should not continue without purpose. Nevertheless, an ending deserves thoughtful consideration. Feeling better can be a reason to recognise progress, review the work and decide together what is now needed—not necessarily a reason to leave immediately.
There can be courage and dignity in allowing someone to stand beside us while we face experiences that have altered our lives. Sustained therapeutic work can offer more than relief from the immediate crisis: it can provide the time and relationship through which grief is gradually lived, meaning is reconstructed and a changed life becomes more fully one’s own.
