I see a lot of American students in my medical practice. They’re good for me: they keep me young and sharp. I hope I give them equal value in return.

She has real talent. In particular she has practical skills that I like. I like having her working with me on our staff. I am not a trade unionist: I don’t want to bring her down to my level. I admire her and will see if I can learn from her.

‘In my own country I wouldn’t tolerate the medical services that I have just received in the NHS’, she said. Gosh.

I will not do what the government want me to do. I don’t want their bribes (grants), nor their recommendations (diktats). I don’t want to do things their way. I refuse. I have ideas of my own.

It wasn’t until I had completed dictating it that I realised that I had in fact written a business plan. I was simply putting together the sort of information that I know banks want. I know perfectly well that none of the future projections will work out exactly as I have laid out and as I hope. The bankers themselves must also know this to some extent. The charade is played out in order to satisfy the demands of the lending committee. As with members of any other committee, nobody wants to take individual responsibility. Therefore a structured formula has to be followed.

But real life isn’t like that. New opportunities turn up out of nowhere. Things go wrong unexpectedly. Laws change. Markets change. Staff change. Any businessman knows that: we learn is all from experience. Those of us who are still left standing after all the mayhem of early business life should be the ones who are trusted to take things forward. Nowadays bankers themselves believe that they can be businessmen. Dream on, brothers, dream on. Keep your bits of paper and leave the true originators to do the real work.

“I did have a pretty strict teacher in elementary school. I had a scary time, forgetting my homework, giving the wrong answers or being called upon when I didn’t know the answer. It seems like there was always some level of fear during my school years. If it wasn’t related to classroom work it was always something else. There was always a fear of being guiltily or being found out. I remember once, when the teacher was sick for an extended period of time, there was a substitute male macho teacher who had a habit of putting the boys down in front of the girls or showing himself up in front of the girls. I remember him beating several boys because they had not been kind to the girls. My father knew the principal of the elementary school because my brother had been to the same school four years ahead of me. For some reason there is a feeling of dealing with teachers or the principal as if they were gods. I feel some sense of fear was instilled in me, not only by what I observed but also through the behaviour of my parents. I was led to believe that these people couldn’t be let down or disappointed. I just feel that it’s so unfair that I lived all of my life under so much pressure. I don’t think I deserved it but I didn’t do anything about it. I don’t feel that fear should be a part of motivation to do things or for performance.”

Or for guiding patients towards getting better in a treatment centre.

In The Times these puzzles get progressively harder during the week. I can beat the target time for Monday and Tuesday and usually on Wednesday but the rest have me struggling. Sometimes I get them done in time but more commonly not – and by Saturday often not at all. Who are these guys who set those targets and who are the guys who achieve them?

The consultant specialist giving this morning’s post graduate lecture qualified as a doctor in 1997. My private practice GP colleagues and I looked at him in amazement. We may be accustomed to our children teaching us about computers, but this young man was talking to us on our own subject. My only reassurance was that the two doctors sitting next to me are at least ten years older than me.

Did he really believe that after twenty one years of running a treatment centre, I wouldn’t see it coming?

I watched some DVDs made from old films of Moreno himself conducting psychodrama sessions. Marcia Karp, who trained with Moreno and who has seen me in action, told me that I don’t do “real” psychodramas. I think what she meant was that I don’t do full scale sessions taking the patient back into childhood to see the “status nascendi” (the place where the psychological change began). That’s true: I know how to do it and I have done it many time but mostly I work in the present and future. On these DVDs so did Moreno. It was Zerka, his wife, who influenced the older Moreno to go back to the past.

It was interesting for me to see the man himself do what I have learned from his books and from others and from watching other psychodramatists in action and from trial and error myself. For one man to have created sociometry, group therapy, psychodrama and a lot more is absolutely staggering. I am privileged to work in his shadow. He deserves an equivalent place in psychotherapeutic history to Carl Jung and a greater place than Freud and Adler or any of the others. Fitz Perls (who established Gestalt Therapy) and Eric Berne (who established Transaction Analysis) were both pupils of Moreno yet their place in psychotherapeutic history is more assured and their followers more numerous. I think the reason for this is that psychodrama is more practical than theoretical, more spontaneous and creative, and therefore more difficult to do.

Yet the basic elements of psychodrama are very simple, even though profound in their capacity to reveal and guide. Moreno was a genius, the father of truly effective therapy. In particular, he should be remembered for his injunction “don’t talk about it, show me”. That should apply not only to patients but also to therapists.