by Stephen Grosz
Published by Chatto and Windus, London 2013 ISBN 13: 9780701185350

Reviewed by Mary Peyton MIAHIP

How often have you been challenged by a client, wondering what this therapy business was all about, is it in any way useful, or indeed, in the aftermath of a difficult day’s work, wondered yourself what it is all about? These moments of humanness, which we all feel, and hopefully have learned to wonder about to inform us about the work, are offered a salve in this book The Examined Life by Stephen Grosz.

While it is written by a psychoanalyst about psychoanalysis, its relevance for psychotherapy is immediately evident and has much to offer both to the practicing therapist, student of psychotherapy, and anyone interested in the world of psychotherapy. Confidentiality being a central tenet of the process, he changed details about clients so as to render them unrecognizable. While there are many questions we could ask about the publication of casework, it is difficult to imagine a more real way of illustrating the process, and it says something that we are all grateful when an experienced therapist offers us their thoughts and ruminations. He brings to life in a very ordinary way, avoiding jargon for the most part, the world the client and therapist step into with every session. And when the odd word appears, e.g. splitting, it is explained simply, “the bigger the front the bigger the back”.

The author Stephen Grosz, a psychoanalyst in private practice and lecturer in The Institute of Psychoanalysis and in the Psychoanalytic Unit at University College London, speaks of the issues we face on a daily basis in a way that is full of heart, warmth and understanding. He captures deftly and compassionately issues from the point of view both of the client and the therapist. He speaks of his own vulnerabilities in a way that not only students of counselling and psychotherapy will find reassuring but also ‘long in the tooth’ practitioners will recognise, and takes the relating between the client and therapist as his central theme. It is a book that demonstrates the courageous commitment to ingestion (or not), digestion and thoughtful feeding that goes on, and offers a wholesome alternative to the increasing pressure that is being brought to bear for the creation of manuals of psychotherapy, the quicker fix, the step-by-step guide.

It is not a book without realism. The client who is not ready for therapy or indeed may never be in a place to choose this particular path is represented, missed sessions, sessions not paid for, alongside the client who is in there for the long haul. There is a lovely piece on his connection with nine-years old Thomas who has had a multitude of diagnoses attached to his name, none of which give any clue as to the difficulties this child has met, or even attempt to attach any meaning to his way of relating. Thomas resorted to spitting as his means of communication and continued relentlessly until its meaning was named. There is also a thoughtful story on grief which is curiously apposite with the recent arrival of the DSM-V (2013) with its relentless efforts to quantify normal grief. Quoting Grosz:

.…….closure is an extraordinarily compelling fantasy of mourning. It is the fiction that we can love, lose, suffer and then do something to permanently end our sorrow. We want to believe we can reach closure because grief can surprise and disorder us – even years after our loss. (209)

He also speaks of the boring client, the pathological liar, the one who got away, and parents’ envy of their children and indeed therapists’ envy of their clients. It exudes empathy from the beginning with vignettes on Beginnings, Telling lies, Loving, Changing and Leaving. It will leave the reader touched, thoughtful, enriched and perhaps more compassionate for themselves as well as their clients. My words do not do justice to the richness this book offers. I would simply urge you to have a look for yourself.

Reference:

Diagnostic and Statistical Manual of Mental Disorders (2013). (5th edn.) Washington DC: American Psychiatric Association.