Tue, Feb 19, 2013 - Page 12 News List

Book review: The Examined Life: How We Lose and Find Ourselves

Stephen Grosz’s collection of case histories makes a subtle but powerful case for psychoanalysis

By Alexander Linklater  /  The Guardian, London

Some might question the propriety of revealing so much of the confidential encounter between doctor and patient, even with names changed. But the case history is the indispensable foundation of all clinical psychology — whatever the discipline — and it is currently in danger of being neutered in mainstream practice by computer-formatted records, institutional correctness and the box-ticking diagnoses of cognitive therapy. Without the written case, individual histories cannot be shared and all that’s left are brief assessments, research-findings and methods learned from manuals.

Not that psychoanalysis emerges here as a redemptive cure. In fact, Grosz’s stories reveal both the strengths and weaknesses of his profession. The most obvious problem of sitting (or lying) in a room with a therapist and talking (or lying) about yourself is that there can be neither corroboration, nor contradiction, of the account you provide.

I’m not sure whether Grosz is being ironically self-aware when he describes the reasons men see prostitutes, for example, or whether his next remark is itself a kind of Freudian slip. “Of course, prostitution is a monetary transaction and this inspires fantasy,” he writes. Well, psychoanalysis is also a monetary transaction and it, too, can inspire fantasy.

The job of a good analyst is — of course — to observe the contradictions in any account and to help the patient to observe them too. Patient and therapist have entered into an agreement and a relationship. In this way, the patient may emerge from the cocoon of subjectivity to cope better with the real world. But the lack of any witness-check in psychoanalysis is further exposed when a case history is turned into a published story. Because now there are three people in the room: patient, therapist and reader. What if the reader disagrees with an interpretation?

“Emily’s parents had made her the problem so that they did not have to deal with problems of their own,” Grosz writes at the end of one brilliant and touching story. While reading it, his analysis struck me as the result of convincing psychological detective work. But that’s because I was reading it more like fiction, assuming the author’s knowledge of his characters. In reality, an analyst cannot achieve such authority. Although Grosz had spent a long time with Emily, the only evidence he gives of her parents’ problems is a few brief exchanges. Maybe he was right about them, maybe he wasn’t. There’s no way to tell.

That’s an inherent doubt which applies to any one-on-one interview or investigation, therapeutic or otherwise. It does not detract from the good-humored wisdom of these stories, or the case they implicitly make for the value of the psychoanalytic encounter. Indeed, Grosz dedicates a chapter to the illusion of any definitive conclusion. “My experience is that closure is an extraordinarily compelling fantasy of mourning,” he writes. “It is the fiction that we can love, lose, suffer and then do something to permanently end our sorrow.”

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