Clients often come into therapy carrying a kind of suffering that they don’t feel allowed to name because from the outside, nothing is obviously wrong. If this is you, you might have the career, the relationship, the stability. You might be coping well by most measures. And yet something feels hollow. Like you are performing a life rather than living one. Like the person going through your days is a carefully put-together version of yourself, not quite the real thing. The Jungian analyst James Hollis has a name for the moment that feeling becomes impossible to ignore. He calls it the Middle Passage.

One of the most common hesitations I hear from people who are considering therapy but have already spent years reading, reflecting, and trying to understand themselves is that they start to worry that they’re too self-aware for therapy. They might have even been told this in the past by other therapists. Most of the clients I’ve spoken to with this worry have been working towards change for a long time and are sometimes still searching for the perfect insights that will change everything - or they’re confused as to why their understanding hasn’t translated into change.

London does something particular to loneliness. It gives you just enough social life to make the gaps feel like personal failure. There are people everywhere, always, and yet the city is also extraordinarily good at keeping people at a polite, manageable distance from one another. You can live in the same flat share for a year and never quite know your housemates. You can have thirty acquaintances and not one person you would call at eleven on a Tuesday night. You might have moved here from somewhere else, built something that looks like a life, and still find yourself quietly wondering whether you will ever find your forever people; the ones who actually know you.

Studies have found that chronic emptiness can occur across a wide range of psychological difficulties, including depression, trauma-related difficulties, eating disorders, anxiety, and personality difficulties. Some researchers have therefore argued that emptiness may be better understood as a transdiagnostic phenomenon: an experience that cuts across traditional diagnostic categories rather than belonging to any single condition.