The business of change
Change is often what brings people into therapy. It might be the death of a loved one, the end of a relationship, a serious or terminal diagnosis, or the loss of a job – the list is endless. These changes are frequently imposed from the outside and rarely welcomed. Yet whether change is chosen or forced upon us, coming to terms with it is unavoidable.
Change is also woven into the natural rhythm of life. Teenagers stepping into adult responsibility. The shifts of middle age, including the loss of youth and, for women, fertility. The physical frailty and loss of independence that can accompany older age. These transitions are inevitable, even when they are difficult to accept.
Alongside these external and developmental changes, there is another kind – quieter, deeper, and often harder to detect. It is the subtle inner call for change. A still voice that speaks of longing. It asks us to notice what we have neglected within ourselves, what remains dormant, unexplored. It points to the vast potential we carry but often ignore.
Most clients arrive in therapy already aware of this inner need, even if only unconsciously. They may sense that certain behaviours, reactions, or ways of being no longer serve them. Yet powerful defences often form around these patterns, making change feel threatening or out of reach. In the consulting room, this struggle is rarely expressed directly. Instead, it emerges through unconscious processes – through transference, bodily sensations, dreams, fantasies, and fleeting images or metaphors. These subtle communications can easily be missed in the moment and only understood later.
However it appears, change tends to provoke resistance. Our need for safety and security pulls us toward what is familiar, even when it harms us. We cling to what we know – jobs that drain us, relationships that cause pain, habits or addictions that damage us. It can feel safer to hold onto the wreckage than to risk swimming toward something unknown, even when survival depends on it.
Therapists sit at the centre of this tension. We work within the space between the pull toward something new and the forces that resist it. It is not a comfortable place to be. Growth requires loss – there is no emergence of the new without the ending of what came before. This is demanding, often exhausting work for both therapist and client.
And this work does not happen in isolation. It unfolds within a wider world that is itself in constant flux – politically, economically, socially, and environmentally. Climate change is no longer distant; its effects are increasingly visible. Many people are living through a cost-of-living crisis. War has returned to Europe. Expansionist ideologies are gaining traction in global powers. Populism is on the rise, alongside the appeal of leaders who present strength but are often driven by narcissism, division and the pursuit of power.
In this context, change is not optional. It is already happening. We can resist it, or we can find ways to accept and engage with it. Resistance may at times be necessary – particularly when change threatens the wellbeing of individuals or communities. But ultimately, acceptance tends to offer a more sustainable path. Not because it guarantees happiness – happiness is always fleeting – but because it allows for something deeper: the possibility of growth, resilience and a way of living that honours both what is emerging and what has been lost.
This is an edited extract from an editorial first published in Private Practice, March 2023, published by BACP©