Tales From The Therapist's Couch

"What I want to stop most is the binge eating. I hate myself for it so much. I've managed to keep it under control for up to a month before now. When I'm stressed, the strain of not giving into the urge to stuff my face is huge. I'm so tired of this battle, this endless fight for self-control. I'd give anything to feel free of it."

Listening to this woman's description of her struggle with food, I am struck by her longing to be battle-free. Of course, psychotherapy purports to be about the resolution of neurotic conflicts such as the one she is suffering from. But does she really imagine that if she can shift the symptom and control it more than it currently controls her, her life will be untroubled by inner conflict? It's certainly a longing often expressed in therapy: a longing to end the disquiet of facing the gap between the person we like to think of ourselves as being and the person we so often are. But aren't we all fundamentally in conflict, and so in battle with our many selves?

For the woman above, the conflict between her warring selves has become focused upon a specific symptom: uncontrollable overeating. All her energy is directed towards the control she longs to have and the craving she is unable to quell. The battle is ceaseless, tiring, demoralising. Other people's battles are often similarly object-related: the desire to quit smoking, drinking, drugs or a love affair, and the equal desire to light a cigarette, pour a drink, get another line of coke, make the illicit phone call.

Equally prevalent are the more existential conflicts that lie barely a scratch beneath the surface. The conflict between the person we feel ourselves to be in moments of quiet reverie and the person we become when in our social worlds. Or the conflict between the person we feel our work, or marriage, or economic situation has limited us to being and the person we know we could become.

The anguished cries of longing and uncertainty that such conflicts give rise to are part and parcel of the world of psychotherapy. Because they are part and parcel of life. Freud's whole body of work was built upon the notion of conflict and conflict resolution. His argument was that if we understand what has triggered the conflict and so created the symptom, then we can dissolve its power. The insatiable hunger of the woman above was, for example, not about her need for food. Her craving was for a different kind of succour that she was tricked into believing she could satiate by binge eating. Hopefully, over time, an understanding of the emotional need behind the physical appetite will lessen her symptom's tyranny.

I say "lessen" and not "end" because the notion of conflict resolution that so many people long for is a dangerous one to buy into. Surely the idea that any of us can be free from conflict is bound to end in tears? Isn't conflict one of the things that makes us human? So maybe it's important to get a handle on the idea that inner conflict is here to stay. Which doesn't mean we have to give into it, or that we can't shape it. It just means that it's part of who we are. The best way forward with inner battles is to stop hoping we can be shot of them and start instead to understand what purpose they serve.

Elizabeth Meakins is a psychoanalytic psychotherapist. None of the above material refers to specific individual cases

Elizabeth.meakins@independent.co.uk