By Toby Clark
They might say something like, I don’t feel like myself anymore.
Or, I’m not really sure who I am.
Sometimes it is less clear than that. Just a quiet sense that something inside feels disconnected. Life may still be moving forward on the outside, but internally, things feel flat, confusing, or strangely distant.
For some people, this feeling has been there for years. For others, it appears after a relationship breakdown, a period of stress, or a series of difficult experiences. Whatever the path, there can be a sense of having lost something important. Not necessarily motivation or happiness, but something deeper. A sense of being fully present in oneself.
In psychotherapy we sometimes understand this as a disturbance in the sense of self.
The approach I use in my work is called the Conversational Model. It was originally developed by Robert Hobson and later expanded by Russell Meares. In the United Kingdom it is often referred to as Psychodynamic Interpersonal Therapy. Although the name may sound technical, the heart of the model is something quite simple and deeply human.
It begins with the understanding that our sense of self develops in relationships.
From the earliest moments of life we begin to understand who we are through our interactions with others. Being seen, understood, responded to, and emotionally held by those around us allows the self to gradually take shape. Through thousands of small relational experiences we develop a sense of being a person who exists, who matters, and who belongs in the world.
When these relationships are largely attuned and supportive, the self tends to develop with a sense of coherence and continuity. We may still encounter difficulties in life, but we retain a relatively stable sense of who we are.
However, when relationships involve repeated misattunement, emotional neglect, shame, or overwhelming experiences, something different can occur. Certain aspects of experience may never fully find words. They remain confusing, unspoken, or difficult to think about. Over time this can lead to a sense of fragmentation or disconnection from oneself.
People often describe this in everyday language. They may say they feel numb, lost, or emotionally overwhelmed. Others describe a sense of drifting through life without quite feeling present in it. Relationships can feel confusing. Emotions may feel difficult to understand or regulate.
Meares described this experience as a disturbance in what he called “personal aliveness.” It is the loss of that natural vitality that comes from feeling grounded in oneself.
Therapy within the Conversational Model aims to restore this sense of aliveness.
Rather than focusing only on symptoms, the therapy focuses on understanding a person’s lived experience. It pays close attention to how a person experiences themselves, their emotions, and their relationships. Importantly, it also attends to what is happening in the present moment between therapist and client.
Hobson described psychotherapy as the process of “finding a language for experience.” This idea sits at the centre of the model. Experiences that were once confusing, overwhelming, or unspeakable begin to find words. As they are spoken and received within a safe relationship, they can gradually become more understandable and integrated.
The therapy itself unfolds through careful and attentive conversation. Not simply talking in a casual sense, but a thoughtful exploration of experience together. The therapist listens closely not only to the story being told, but also to the emotions, meanings, and relational patterns that are emerging in the moment.
Often the most important moments in therapy are quite subtle. A feeling that has never quite been understood before begins to take shape in words. An experience that once felt isolating is met with recognition. Something that once felt chaotic becomes clearer and more connected.
Over time these moments accumulate. Experiences that once felt fragmented can begin to come together into a more coherent sense of self. People often notice that their emotional world becomes easier to understand. Relationships begin to feel less confusing. Life may start to feel more vivid and meaningful again.
Importantly, the aim of therapy is not to erase painful experiences or pretend they did not happen. Difficult experiences remain part of a person’s life story. What changes is how they are held within the self. Instead of feeling overwhelming or disconnected, they become integrated within a broader and more stable sense of identity.
Many people describe a gradual return of something they had not realised they had lost. A sense of presence. A sense of vitality. A sense of being more fully themselves again.
In this way, the Conversational Model remains true to its name. It is a careful and deeply human conversation in which experience can be spoken, understood, and integrated. Through that process, people often rediscover a sense of connection with themselves and with the world around them.
If any part of this resonates with your experience, therapy can offer a space where these feelings can be explored safely and at your own pace. Often the process begins simply with a conversation.