ABSTRACT
Not long ago, my patient Jimmy told me that he had ‘found himself acting out in Soho’, in London. I challenged this statement as, surely, there must have been a series of events and decisions that took him there. Jimmy lived in Streatham, about 10 miles away from Soho. He would have had to take a bus, choose a destination, change to the underground, decide upon a direction to walk in and, once there, he would have had the option to turn around. The process of getting from Streatham to Soho involves a series of thoughts, feelings and behaviours. Of course, Jimmy was on automatic pilot and was unaware of this. He had repeated the process so many times that the steps involved were built into his system. His acting out patterns had become automatic and out of awareness.
