There is a group of interconnected concepts around the theme of transition and change that I wish to mull over as a way of setting the scene for the chapters that follow. Other key players in these associated ideas are the roles of play and creativity in the process of change, together with thoughts about the part that living with paradoxical experience plays in this process. All of these ideas spring from the clinical experiences described in the following chapters.
The starting point of my thinking is the question of whether it is possible through therapy to help patients to have a greater sense of continuity of being in their lives-that is, to feel internally more joined up, despite many internal and external disruptions and traumas. Is it possible to change the sense of life being full of uncontrollable and traumatic events that cannot be digested, a life which feels chopped up into traumatic fragments, into a personal narrative that, despite the irreversibility of these events, can begin to make some sense and have a feeling of continuity? The end product will hopefully be a person who has become more able to integrate these experiences into his or her life. The ideas in this chapter, and the clinical examples and discussions in the next three chapters, suggest that one of the processes which can aid this greater integration is an awareness of the potential of working with transitional experiences.
Clinical observation, detailed in the next few chapters, suggests that enabling the patient to dare to play with ideas, and to live with paradox during these potentially mind-blowing times, could help what might be felt to be a massive discontinuity in life to feel more like a transition. This makes me think about how more ordinary transitions in life are negotiated. Ordinary growing up is full of these transitions-going to nursery, starting primary school, moving on to secondary school, leaving school, getting a job, leaving home and so on. All of these external changes will be greatly enhanced, or made more difficult, depending on the internal capacity to approach change in a positive rather than a fearful way. The idea of movement is implicit to these thoughts about transition and change. People who can't change are stuck internally and externally, repeating patterns of