What principles define how you live?
Monday, 13th October 2025
The prompt arrived this morning like an unexpected guest – courteous but probing, the sort who settles into the good chair and waits patiently for an honest answer. What principles define how you live? I’ve spent the better part of the day turning the question over whilst attending to the usual Monday concerns: telephone consultations, case notes requiring my signature, a particularly difficult conversation with a young woman struggling with the aftermath of loss.
It occurs to me that principles are curious things – not quite rules, which feel rigid and prescriptive, nor simple values, which can float about rather abstractly without ever touching ground. Principles, I think, are the architecture beneath daily decisions, the load-bearing structures one rarely examines until pressed to do so. Mine, I suspect, have been assembled over decades from disparate sources: my parents’ contradictory legacies, my training, my failures, and those rare moments when one glimpses something true.
The first principle – and perhaps the one that undergirds all the others – is the conviction that people deserve to be witnessed. Not merely observed or assessed, but truly seen in their complexity, their contradictions, their stubborn refusal to fit neatly into diagnostic categories. This understanding didn’t emerge from textbooks, though my psychiatric training certainly reinforced it. Rather, it came from growing up the youngest in a household where Mother‘s exuberance and Father’s quiet attentiveness created a particular atmosphere of acceptance. They witnessed each other – her bold leaps met by his steady regard, his contemplative silences answered by her gentle curiosity – and in doing so, taught me that genuine presence might be the most profound gift one human can offer another.
In my practice, this translates into a discipline of listening that goes beyond clinical technique. When someone sits in the chair across from mine and begins to speak – haltingly, defensively, or with that peculiar brittleness that precedes breaking – I try to meet them without the armour of professional distance. Certainly, I maintain appropriate boundaries, but within that framework, I strive to see the whole person: not merely symptoms to be managed, but a life being lived with whatever resources they’ve managed to assemble. This witnessing, I’ve found, often accomplishes more than any intervention I might devise. People know when they’re being catalogued versus when they’re being comprehended, and the latter makes space for transformation in ways the former never can.
The second principle might be described as a commitment to sitting with discomfort rather than rushing to resolution. This runs counter to the American impulse – and I am, despite everything, deeply American – to fix, solve, and move efficiently towards closure. Yet in the consulting room, and increasingly in my own life, I’ve learnt that some things cannot and should not be hastily resolved. Grief, for instance, operates on its own timetable, indifferent to our preferences. Trauma doesn’t heal according to neat therapeutic stages. Even ordinary ambivalence – about relationships, vocations, the choices that shape a life – often requires prolonged consideration rather than premature decision.
I think of the guest room upstairs, where Mother’s things remain largely untouched eighteen years after her passing. Yesterday’s reflection on postponement might have suggested failure, but today I wonder if it isn’t actually an enactment of this principle. Some tasks demand ripeness, a particular emotional preparedness that cannot be manufactured or scheduled. Forcing oneself through mourning work before one is truly ready serves no one. Better, perhaps, to acknowledge the discomfort of incompletion and trust that clarity will arrive in its own season.
This principle extends beyond personal grief. In my work, I resist the pressure – from insurance companies, from patients themselves, from the broader culture’s attachment to efficiency – to move too quickly towards symptom reduction without adequate attention to underlying patterns. Sometimes the most ethical response to suffering is not immediate relief but patient accompaniment whilst someone learns to bear what cannot yet be changed. This requires a particular kind of courage, both from the patient and from myself – the courage to remain present with pain rather than anaesthetising it prematurely.
The third principle concerns the proper balance between inheritance and self-authorship. I am my parents’ daughter in ways both obvious and subtle: Mother’s curiosity lives in my persistent questions, Father’s steadiness manifests in my reliability, their combined legacy shapes my capacity for both warmth and discernment. Yet I am also distinctly myself, forged by choices they never made, shaped by historical moments they could not have anticipated. Honouring this tension – being shaped by the past without being imprisoned by it – strikes me as essential to living with integrity.
This principle proves particularly relevant in psychiatric practice, where I encounter daily the complicated inheritances people carry: family patterns of communication or silence, cultural expectations about emotion and expression, intergenerational trauma that shapes behaviour in ways the current bearer may not fully understand. Helping someone recognise these influences whilst also claiming their own authority to decide what to carry forward and what to set down – this seems to me the heart of therapeutic work. We are neither blank slates nor predetermined outcomes, but rather beings engaged in the ongoing negotiation between what we’ve been given and what we choose to make of it.
In my own life, this manifests as a continuing conversation with my parents’ legacies. I inherited Father’s propensity for quiet observation, yet I’ve learnt to speak more directly than he typically managed. Mother’s adventurousness calls to me from her remaining belongings, reminding me that caution, whilst often prudent, can also constrain. The task is neither to replicate their choices nor to reject them entirely, but to extract what serves whilst gently declining what doesn’t.
The fourth principle, and perhaps the most difficult to articulate, involves maintaining faith in possibility without succumbing to naive optimism. My work requires me to hold simultaneous truths: that people can change, and that change is extraordinarily difficult; that healing is possible, and that some wounds never fully close; that hope matters, and that false hope can be its own cruelty. This paradox demands what I can only describe as clear-eyed compassion – the ability to acknowledge reality’s hardness whilst still believing in human capacity for resilience and growth.
I see this principle tested regularly in my consulting room. When someone arrives defeated by depression, convinced that improvement is impossible, I must somehow convey both acknowledgement of their suffering and confidence in their eventual emergence from it – not through platitudes, but through steady presence and the patient work of identifying small, achievable steps. When someone describes patterns they’ve repeated for decades, I must hold the tension between honouring how entrenched these behaviours have become and believing they might, with sufficient support and effort, learn different ways of being.
This principle also governs my relationship to my own limitations. I am fifty-eight now, not young, increasingly aware of roads not taken and adventures postponed perhaps permanently. Yet I resist the temptation towards either regret or false resignation. Instead, I try to maintain curiosity about what remains possible, even as possibilities inevitably narrow with age. This requires a particular discipline: neither clinging to youthful fantasies of unlimited potential nor prematurely foreclosing on legitimate desires for continued growth and experience.
Finally, there is a principle I’ve only recently begun to articulate, one concerning the necessity of tending to one’s own internal landscape with the same care one extends to others. For years, I poured my attention outward – towards patients, towards community needs, towards the legitimate demands of my practice – whilst neglecting my own emotional maintenance. This imbalance served no one; I cannot offer authentic presence to others if I’m depleted, cannot model healthy boundaries if I consistently override my own needs, cannot encourage patients towards self-compassion if I refuse it to myself.
This principle doesn’t excuse selfishness or justify withdrawal from service. Rather, it acknowledges that effective caregiving requires sustainable practices of self-care, that compassion extended only outward eventually exhausts itself and curdles into resentment. In practical terms, this means I now protect time for solitary walks along the harbour, for reading that serves no professional purpose, for the occasional evening spent in companionable silence rather than in service to others’ needs. These aren’t indulgences but necessities, the fallow periods that allow for continued fruitfulness.
Looking across these principles, I notice certain patterns. Most privilege process over outcome, presence over efficiency, complexity over simplicity. They reflect, perhaps, a temperament more comfortable with ambiguity than with certainty, more interested in questions than in premature answers. Whether this represents wisdom or merely a sophisticated form of avoidance remains an open question – one I suspect I’ll continue exploring for whatever time remains.
The evening light is fading now over the harbour, October’s particular slant of gold washing across the water. Soon I’ll close my notebook, attend to the modest rituals of supper and evening reading. But the question lingers, as good questions do, asking me to notice tomorrow and in the days following whether my actual choices align with these articulated principles, or whether I’ve simply described the person I aspire to be rather than the one I am. Perhaps both versions are true simultaneously – another paradox to hold, another tension to inhabit rather than resolve.
Catherine
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