It feels strange to realise that this month four years ago, we were in the first of what would become three national COVID lockdowns. One reason it feels distant is how rarely the pandemic is mentioned now. When it does appear in the media, it is often in the context of government narratives – COVID, alongside the war in Ukraine, cited as an explanation for ongoing economic difficulties. Updates on infection rates, once a daily fixture, have largely disappeared from public discourse, both here and globally.

While psychological theories and models have an important place in both training and practice, they are not the heart of what happens in the room. At its core, therapy is about meeting our clients where they are in their experience. This calls to mind a well-known reflection from Carl Jung who, alongside Freud, is one of the founders of the psychotherapeutic tradition: ‘Learn your theories as well as you can but put them aside when you touch the miracle of the living soul.’¹ Written in 1928, Jung’s insight continues to resonate. So too does Freud’s The Ego and the Id, published just a few years earlier, which remains one of the foundational texts of psychoanalytic thinking.

In The Age of Anxiety: a Baroque Eclogue, published in 1947, W.H. Auden wrote:

‘We would rather be ruined than changed
We would rather die in our dread
Than climb the cross of the moment
And let our illusions die.’¹

As I write, representatives from eight South American governments are gathering in Brazil to discuss the future of the Amazon rainforest¹ – a vast region roughly twice the size of India, and one of the planet’s most important systems for storing carbon. Despite its critical role in regulating the Earth’s climate, the Amazon has long been treated as a resource to be exploited, often with little regard for sustainability or for the rights of its Indigenous peoples.

Climate change is no longer a distant threat. It is unfolding at a scale that presents a challenge to us all. If we were to think of the planet in medical terms, it would be in a critical condition – surrounded by emergency teams, urgent interventions, and specialists working to stabilise it.

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.