chapter  4
11 Pages


Meaning-making is intrinsic to all therapy, from folk remedies and Shamanic rituals to psychoanalysis itself. All rely on an explanatory framework bringing order to the intrinsically inchoate experience of illness, whether physical or mental (Holmes and Bateman 2002). An explanatory framework, or ‘formulation’, both is anxiety-reducing in itself and provides the scaffolding for the mutual exploration that follows once attachment anxiety has been assuaged. A symptom or troublesome experience is ‘reframed’ (a term originating in systemic therapy) into a new explanatory system or model, which helps make sense of the sufferer’s mental (or physical) pain. The use of the word ‘sense’ here acknowledges that meaning transcends mere cognition and ultimately derives from bodily experiences.