Recently I was walking to a session with my psychoanalyst when I realised I had just put my hand in my pocket to take out my house key.

Something I have learned from experience, as a patient in my analyst’s consulting room, and as a therapist to patients in my own consulting rooms, is that to build a better life you have to make your unconscious conscious.

One of the many things my analyst is helping to bring into consciousness for me is how, without realising it, I act as if it were me who is the therapist, and she who is my patient, rather than the other way around.

Session by session, micro-interaction by micro-interaction, she observes and interprets the ways in which, despite myself, I seek to escape my own position of being the patient, attempting to use her as a pawn in this unconscious chess I play. Often when she offers me her thoughts about this, I immediately reject them – I don’t want to know.

It has taken a long time, but I can see now that I am recreating with her the dynamic I have carried since my early years, of feeling that I was the grownup taking care of everyone else – the one holding the key – rather than the child who needed care and worried about her poorly dad. This was a way to feel in control of a situation that was quite overwhelming and frightening for me.

This dynamic that shapes many of my relationships – of seeking to be the one who offers care and never the one receiving it – is so hard to lay to rest because it protects me from awareness of my own vulnerabilities. It is far more comfortable than actually being in touch with my own needs – but it comes at a cost. Because the part of me that does need attending to, that yearns for care and attention, goes neglected.

When this comes alive in my analysis, and I realise how I’ve been pushing her away, it is particularly galling. I am literally paying my analyst to show me how I’m not letting her help me. But I know it’s money well spent; this understanding is essential for me to build a better life.

As a psychotherapist, I’m also the pawn who can recognise how I am being used by the patient to play out the dynamics that underpin their internal world. It is an astonishing moment when a patient realises the patterns that haunt so many of their relationships are emerging in the consulting room with me – but this time, in a space and with a person where things can be understood and worked through, and a better life can be built. The patient can begin to make different, more conscious choices. They can find some agency in their own lives and, to use Freud’s analogy, become the horse rider choosing their own path, rather than letting the horse decide.

This insight and understanding can be life-changing – but it is only part of the work. Because making the unconscious conscious is not about knowing something. It is about feeling something. And that is much more painful.

Feeling vulnerable, in need, not in control, yearning for something that I’m unable to provide for myself … I’d rather write about it than actually feel it. Rather cling to the belief that I am the one holding the key to the consulting room. And that’s why I’m still in analysis.

I have seen my own mental health transformed, my mothering grow, my marriage saved, my work mature, as I’ve begun to understand my own unconscious dynamics so that I don’t feel overwhelmed by them, don’t have to repeat them, can take support when I’m offered it and ask for help when I need it. And it is an enormous privilege to accompany my patients on their journeys towards understanding.

This was one of Freud’s gifts to humanity: the realisation that psychological difficulties are rooted in our unconscious; that some of these difficulties can be transferred and come alive in the relationship with the therapist, be brought into consciousness and worked through. The consequence for many is that mental anguish is transformed into what he called “ordinary unhappiness”.

I still find it shocking when people dismiss and diminish Freud’s contribution to psychology. He was far from perfect, and I do not agree with some of what he said (mind you, neither did he). Fortunately for us, his work can offer us some insight as to why we might reject his recognition of the unconscious (he was the first to coin the term “psychological defences”). Perhaps it is a way of getting on top of something we are not in control of and that we find frightening and overwhelming.

I suppose it is nothing more than the resistance Freud faced in his own time, when he began to understand that each of us holds within our mind a dynamic unconscious, driving us to repeat past experiences. That to build a better life, we must come to understand this about ourselves; otherwise we are destined to walk around as if we own the place, continually reaching for a key we do not possess – much like Freud’s beleaguered horse rider, who “is obliged to guide his horse in the direction in which it itself wants to go”.

• Moya Sarner is an NHS psychotherapist and the author of When I Grow Up – Conversations With Adults in Search of Adulthood