We all need to be heard and held in such a way that something new can be born in us. I try to listen to my patients in that way. I listen for signs of the distant past and the present moment. I pay attention closely to what is happening between us in the room, in our minds, in our dreams and fantasies. I bring my years of meditation practice into the relationship so that we can both pay as much attention to the silences as to the words. As we change and grow in this process, feelings of loss and shame can be transformed into a sense of ordinary humility and compassion for ourselves and those who are close to us. This is difficult work, it requires commitment and openness, and the rewards can be profound.