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Good psychoanalysts must believe that people are capable of change – but only at the expense of inevitable loss. (Bob Wands/AP)
Good psychoanalysts must believe that people are capable of change – but only at the expense of inevitable loss. (Bob Wands/AP)

Listen closely and you’ll find great drama on the therapist’s couch Add to ...

It’s not a fashionable thing to say in the era of happy pills and cognitive behavioural reprogramming, but I am a proponent of old-fashioned psychoanalysis.

I don’t mean group therapy or life-coaching or (most unhelpful of all in my personal experience) couples counselling. I mean good old-fashioned, one-on-one, straight-out-of-a-New-Yorker-cartoon Freudian psychotherapy.

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It’s a commitment, having your head shrunk. It requires certain petit bourgeois furnishings: a spare, well-lit room containing a bookshelf, a battered leather wing chair and a daybed with a tufted cylindrical pillow; a psychotherapist taking notes and an anxious, reclining urbanite. The former says little, the latter says much, and occasionally, no one says anything at all – sometimes for a precious quarter of an hour at a time. Repeat for 50 minutes, three to five times a week for a minimum of three years at eye-gouging expense to the client, and there you have it – a regular course of vintage Viennese-style analysis.

Hardly anyone does it any more and the reasons are obvious. It’s expensive and time-consuming and it doesn’t actually solve your problems so much as bring them into glaring high resolution. Having said that, I think there are few things in life more worth doing, and finally someone has written a book that illustrates exactly why.

The Examined Life by Stephen Grosz is not an argument for psychoanalysis so much as a fascinating meditation on the insights that can be gleaned from a life spent administering it.

Grosz, an American psychoanalyst who trained at Berkeley and Oxford, has spent the last 25 years of his career working as a talk therapist in London, U.K. He has logged more than 50,000 hours talking to patients, most of whom he sees for 50-minute sessions four or five times a week.

Grosz believes, as every good psychoanalyst must, that people are capable of change – but only at the expense of inevitable loss. “Loss and change are deeply connected,” he writes in his preface, “there cannot be change without loss.” And he proceeds to show us why and how through a series of stories: about the single woman who has paranoid delusions someone is trying to murder her because it makes her feel less alone; about the compulsive liar whose mother made him a co-conspirator in silence on the subject of his own childhood bedwetting; about a suicidal depressive whose need to shock is so strong he fakes his own suicide – just to see what his therapist will do.

Like the grandfather of his profession, Sigmund Freud, Grosz is a storyteller at heart, a psychological dramatist interested in human-life-as-narrative, complete with prologue, build-up, denouement and satisfying twist-ending. Attaining the self-awareness to build a credible narrative of one’s own life story, he believes, is the key to overcoming pain and effecting personal change. To this end, he quotes the author Karen Blixen, “All sorrows can be borne if you put them into a story or tell a story about them.” But then he goes on to ask the deeper, psychoanalyst’s question: “What if a person can’t tell a story about his sorrows? What if his story tells him?”

This got me thinking about Tony Soprano, perhaps the greatest fictional analysis patient of our time and a character who struggled valiantly – and often violently – between telling his own story and letting himself be told by it.

This essential human tension between our intentions and our impulses, between the way we want to be and the way we actually are (the age-old power struggle as the U.S. psychologist Jonathan Haidt would describe it “between the elephant and the rider”) is why tales of people deep in psychoanalysis are so endlessly compelling. From the pain-stricken men and women on In Treatment to much of Woody Allen’s oeuvre, to the star-crossed lovers in Silver Linings Playbook or even the long-suffering patients of Arrested Development’s absurd Dr. Tobias Fünke, the best drama probes the painful gap between what we want and what we have, who we want to be and who we actually are. In that void there is pain and violence and misery and anxiety and laughter – which is to say, all the stuff that dreams (and stories) are made of.

In this sense, all great drama is therapy and all therapy is great drama, in turn. When it comes down to the struggle to understand and interpret human experience, the distinction between absolute truth and absolute fiction is decidedly unhelpful – there are only better or worse versions of the narrative. (Anyone who’s ever had a blazing row with a loved one must surely grasp the idiotic-yet-irresistible impulse to prove themselves empirically correct about a matter of the heart.)

We trade stories of other people’s lives and our own, both “real” and fictional, not just to entertain, but to understand our own experience. And enchanting as they are, these stories can alienate us too.

In describing his profession, Grosz uses the philosopher Simone Weil’s metaphor of a wall between two prisoners who learn to communicate by tapping. “The wall is the thing which separates them, but it is also their means of communication. Every separation is a link.”

Our stories – be they books, movies or our own childhood memories – are that wall. Stories are the key to the possibility of lasting change. They are the force that binds and the force that separates us – not just from each other, but from the apes.

 

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