Many people think about going to therapy but relatively few actually do. It’s a scary step to take, crossing the threshold of the consulting room door, into an unknown world bound by confidentiality and filled with mystery.

Turning up at my door can be particularly difficult because it’s at the top of three flights of stairs. People are gasping for air and clutching at their chest as they reach the landing. They tend to feel the need to explain themselves then, to apologise for their lack of fitness. But the sense of shame and confusion often runs much deeper. When people come to therapy, they are usually feeling like a failing human being.

Ben, a man in his 40s with a young family, took a moment to place his coat and scarf on the chair in the corner before reluctantly coming to sit opposite me. “You’re going to think I’m crazy,” he began. “I mean, I’m a rational person, I know how the world works, but I just can’t get myself to do things at the moment. I missed the deadline for my tax return, I didn’t get to parents’ evening at school, I couldn’t even answer the door to a neighbour the other day.”

I could hear the anguish in his voice.

“What is wrong with me. This isn’t normal, right? Am I going mad? I must be going mad.”

Typically people will arrive in this state of confusion, distress, embarrassment. Once they have described as best they can what has been going on for them, like Ben, they will pause. They might look at me uncertainly for a moment, trying to gauge my response. Then they will ask, “Is this normal?, am I normal?”

I asked Ben about his life. He was happily married, he said, was lucky enough to have a healthy new baby. What did he possibly have to complain about? As an after-thought he mentioned his dad had died the previous year, just before the birth of his son. Suddenly the atmosphere in the room changed. The sense of grief was palpable.

It emerged that Ben had struggled all his life to make his father proud. Nothing he did was ever good enough. He had hoped to finally win his dad’s approval by presenting him with his first grand-child, but that longed-for moment had been lost forever. His dad had died a month before his son was born. Ben began to recognise how devastated he had felt, not only to have lost his father, but to have lost the opportunity to introduce his new son to him. His ensuing distress and anguish began to make sense. He stopped judging himself so harshly for the things he couldn’t do at the moment, and found some understanding for himself.