People suffering from depression or despair have an acute need for therapy and counselling. How can therapy meet those needs, particularly when it is less a commodity and more a relationship? What does this mean exactly?

Therapy won't do it for you; it won't solve your problems, provide a cure or administer a corrective or medicine-like dose to change your state of mind or the conditions of your life. From short-term counselling, or symptomatic counselling, to depth or major psychotherapy, which takes place over many years, as well as all stages in between, this is the case. The client, or patient, cannot just appear and put time into therapy; they are required to participate in a real, motivated way with purpose, application and persistence. This is not a simple matter, because we are human beings with a mix of conflicts, sub-personalities, voices disagreeing and modifying other voices and different points of view; we are a melee, an Hieronymus Bosch picture of what the Buddha called suffering.

In the middle of all of these conflicting forces, the client has really got to want to change. One of the stock answers in the psychotherapy field when change does not occur is resistance. But it is rather simplistic, patronizing and belittling to offer up resistance as the great sine qua non of the therapeutic endeavor and aspiration, because it represents the obstacles or blocks without which therapy has nothing to work with. We need to have respect when an individual makes a choice, from whatever level of their consciousness, to persist in the emotional-behavioral patterns they have learnt as adaptation for survival.

It is always a matter of choice. Consciously or unconsciously, we are choosing all the time and that is one of the essential insights for effective therapy work. After all, if we weren't responsible ultimately for what's going on in our lives then we wouldn't be able to change. Since we are ultimately responsible we can do something about it through therapy, self-discovery and awareness practices.

And this requires our conscious cooperation, because therapy does not provide a cure, like medication may claim to for instance, or exert an active force on us, the passive recipients of therapeutic healing. Rather we have to participate and do at least as much as the practitioner we are consulting. As clients we may have to do more. It's a joint practice.