Her paranoia shielded her from the catastrophe of indifference.

The Examined Life: How We Lose and Find Ourselves, by Stephen Grosz

I’ve long been sceptical of therapy. People who’re not actually in need of psychiatric care, who don’t therefore need medical intervention, pay strangers relatively large sums of money to listen to their problems. It feels, well, self-indulgent. I’m also not particularly persuaded of its efficacy. As best I can tell there are no clear metrics for success or failure, treatment takes years and how can we tell who feels better due to their therapy and who simply from the passing of time?

Given my feelings on the topic I’m not a natural reader for a collection of what are effectively case studies. Normally I doubt I’d even have heard of this book, let alone read it, but John Self of The Asylum recommended it in a recent review (here) as a book that he loved. He spoke of its “formal perfection” and quotes Grosz’s agent’s letter to prospective publishers which said “Think Carver, Cheever, Calvino, not Freud, Lacan, Jung.”. Strong stuff. I may not care much about therapy, but I care a great deal about good writing. Besides, I’m as prurient as the next person, and the temptation of dipping into other people’s lives is always a powerful one.

Examined Life

First things first, this is a very well written book. Grosz has a clean prose style which slips past almost unnoticed, but which is worth savouring (I’ve started drinking bourbon recently and in a way it reminds me of that – easy drinking but packed with complexity and flavour). He’s a master of the insightful one-liner, though I suppose one would expect him to be (“It is less painful, it turns out, to feel betrayed than to feel forgotten.”).

The stories, because in the end they are all stories told to Grosz and told to us by him in turn, are well chosen. Grosz groups his case studies under certain themes, Beginnings, Telling Lies, Loving, Changing, Leaving, with five or ten or so accounts in each. I’d challenge anyone to read the whole book and not find at least a few of them having real emotional impact.

Lily was quiet for a moment. ‘My last night there I had a strange dream. It was a nightmare actually. What happened was upsetting, but I didn’t feel upset.’ In the dream, Lily was in a group of people standing by a lake. She watched a small girl swim out to a wooden raft – the girl struggled but was able to make it and to pull herself up. There was a flash of lightning and a clap of thunder. The girl was in danger, but no one was concerned – where was the little girl’s mother, her father? Lily asked her parents to watch Alice and she swam out to the girl. The lake was black and choppy; it was a struggle to keep the girl’s head above water. When they got back on to the shore, Lily lifted the girl out of the water, and then saw that her parents were standing there alone – Alice was nowhere to be seen. Lily was sure that the last bit – Alice was nowhere to be seen – must have been about the tucked-away photograph. But what about the rest of it?

People in therapy seem to have dreams like that all the time, at least if television and movies (and this book) are anything to go by (and surely they are, would Hollywood lie to us?) I’ve never had a dream like that in my life, so rich with meaning. Mine are fragments of events of the day, memories filed and processed. Perhaps I should be grateful for that, because what underlies this dream  is terribly sad. Alice is Lily’s nine month old daughter. Lily has just returned from a trip to visit her parents. Her mother “hugged me he way she always does, … She closes her eyes and pats my back – as if I have fleas.”

Lily’s parents have little interest in her life. Their house is full of photos, but none of Alice. When Lily says she’ll send them some her mother tells pulls one out from where it was tucked away in a drawer. It’s that night Lily has her dream, emotions she won’t express in words erupting through her sleep.

Grosz notes that Lily turns her account of her visit home into a series of comic vignettes, the comment about patting her back as if she had fleas being one of them. The jokes allow her to talk about her relationship with her parents, but in a way that insulates her from feeling the pain of their indifference. They act too as a way of bringing him to her side – by laughing he shows that he agrees with her and understands her perspective.

And then she said, ‘ I was remembering my breakdown at boarding school, the experience of calling home in the middle of the night from a payphone behind the dorm, the bugs buzzing around the fluorescent light. I was crying hysterically, “Please can I come home, please can I come home?” and being told, “No, you can’t come home.” Then, as things got worse and worse and worse, I forced myself to stay. But something had changed in me. My breakdown was like a furnace and what burned away was any belief in my own feelings.’

As I listened to her memory, I also heard her dream, the girl was in danger, but no one was concerned – where was the little girl’s mother, her father? 

She went on. ‘Even now it’s very hard for me to trust my feelings. But when you laugh it means you believe my feelings, my reality. When you laugh, I know that you see things exactly the way I do – that you wouldn’t have said no, you’d have let me come home.’

The subtitle for The Examined Life is “How we lose and find ourselves”. For Grosz, we lose ourselves every day in small ways through lack of thought. We find ourselves through simple humanity, mostly by talking. For his patients that means talking to him, but he’s not arguing that everyone needs therapy. He’s arguing instead that we need each other. As he says in his preface: “It’s about our desire to talk, to understand and be understood. It’s also about listening to each other, not just the words but the gaps in between.”

I didn’t love The Examined Life as John did. The excerpt above perhaps illustrates why. Grosz has a tendency I’ve seen often in those touting evolutionary psychology, a tendency to present what is essentially a plausible “just so” story and then to stop there.

So, a patient’s behaviour reminds Grosz of how they must have felt as a child in a particular situation, and perhaps it is reminiscent of that. But the fact that we can craft a story connecting an experience then to a behaviour now, does that mean there is a causal link? If we dug deeper might we find other experiences equally similar? Might we find other stories equally persuasive?

There’s a neatness to these stories which doesn’t ring entirely true to me. In a way it’s an unavoidable neatness. Grosz is using his accounts to illustrate particular points. Some stories are only two pages long, and there’s a limit to how much complexity he can pack into any given narrative and still maintain focus on the reasons he included that narrative. Still, I was left with a nagging doubt – just because we have an explanation for something doesn’t mean our explanation is right.

There’s also a question about the kind of truth that’s being told here. I have no reason to doubt that Grosz is an honest broker in terms of passing on real stories from real patients (with names and details changed to protect anonymity, as he says upfront). As he notes though of a patient who uses prostitutes, “prostitution is a monetary transaction, and this inspires fantasy.”

Therapy too is a monetary transaction, and one in which people seek reasons for their sorrows which may ultimately not exist or be so complex that they may as well not exist. People finally leave therapy having found a narrative for their life which helps them make sense of it, is that narrative true though? Perhaps it doesn’t matter, or perhaps it’s more important that a narrative be useful than that it be accurate.

Despite my caveats, I did enjoy this book and I do recommend it. Grosz does have some real insights here. A passage on parenting (I’m not a parent) broadened out to a wider point about attention that seemed to me both at the core of his book and profoundly true (in a book I wouldn’t generally regard as profound, but then I’m not sure what I do regard as profound, if anything, perhaps Camus – clearly I’m still a teenager at heart).

[We dole] out empty praise the way an earlier generation doled out thoughtless criticism. If we do it to avoid thinking about our child and her world, and about what our child feels, then praise, just like criticism, is ultimately expressing our indifference.

How can we expect a child to be attentive, if we’ve not been attentive to her? Being present, whether with children, with friends, or even with oneself, is always hard work. But isn’t this attentiveness – the feeling that someone is trying to think about us – something we want more than praise?

I rationed myself to one story a day, and that worked well for me. The impact is greater when read that way, and I think if you read several in a row the whole would be diminished. That’s true taking the book simply as a literary work, but it’s also true of it because of its subject matter. Grosz is deeply sympathetic to his patients, but their narratives are ultimately ones of loss and sorrow and given it’s real loss and real sorrow here I’m not sure how much of that I’d want to swallow in one go.

If you’ve read this far and not read John’s review you should, it’s as good as his reviews always are and he connected much more with this book than I did. Another review well worth reading is that of Bibliofreak, here. Biblio is much more critical of the book than John was, and in all honesty I’m closer to Biblio than John on this one, but I don’t regret reading the book and the call at its heart that we pay just a little bit more attention to each other is one that resonates as strongly for me as it did for John.


Filed under Grosz, Stephen

14 responses to “Her paranoia shielded her from the catastrophe of indifference.

  1. Actually I believe in ‘the talking cure’ and think it can work if a) the patient recognizes a problem and b) has a desire to change. I could give lots of reasons why I think therapy has a place in society: a neutral, rational voice, an arena for safe discussion, learning what is abnormal and off the radar, Unleashing problems, etc. These days, therapy seems to have been replaced with pills.

    So I can enjoy books such as this, but at the same time, I agree that sometimes the stories seem a little too neatly sewn together. Not that I’ve read this, but I’ve read several in the genre and I’ve noticed the same sort of thing which can be annoying after a while as it injects an unreality into the stories.

  2. I’m sceptical, but that doesn’t mean I don’t think it can work. I’m not qualified frankly to make that assessment. Certainly I prefer it to pills, which I think should be saved for those who are actually ill – have some issue with brain chemistry rather than a softer issue with trust or commitment or whatever.

    The reason to read it is mostly the writing, which is good. I may post up over the next day or so a full story from the collection, they’re short so it’s not giving away a significant portion of the book and it would illustrate his style. It’s a luxury one has with short story collections and similar, that doesn’t work with full novels.

    The neatness as I say is perhaps unavoidable, but also false. It’s not fatal, but it is an issue.

  3. I recommend this to some I work with after I heard him interview on guardian podcast a couple of months ago as she is studying grief counselling and it seemed to be a book she may get something from ,my worry is it maybe the right thing to do open the files of the people he saw but he said he had changed enough to move from who they were and just get the base of what they discussed etc ,I m not sure it appeals to me in someways I have my one views on these fields after some interaction via work ,all the best stu

  4. They could no doubt identify themselves, but nobody else I think could identify them. There is a long tradition of therapists publishing case studies, so while I admit there’s a potential issue there I don’t think he’s doing anything unethical.

    If you read it I’d read it for the writing, for essentially a collection of short stories.

  5. I’ve read this a couple of months ago but it left me a bit unfazed. I didn’t even feel like reviewing it. I still might but I’m not sure. I find some of the case studies interesting but it also illustrates why psychoanalysis does very rarely work. Other forms of therapy do work very well but neurotic people often are too much in their heads already and psychoanalysis tries to solve everything rationally. It’s good that they try to understand what went wrong but as a cure it is seldom effective.
    I read and reviewed The Good Psychologist, a novel written by a therapist and professor last year. He uses Cognitive Behavioural Therapy. I think this type of therapy is quite effective.

  6. Max: For damaged/troubled people, I vote for therapy every time.

    Anyway the “neatness” of the ending is an issue I think. I mean, really, can all cases be like that?

  7. Many thanks for a thorough and perceptive examination of the book. I will admit that I have an ingrained skepticism about these kind of books — which is why I simply do not read them. On the other hand, I do appreciate reading the thoughts of other who have undertaken the chore for me.

  8. Caroline, I liked it but I don’t think it’s an essential read – I won’t be urging Kevin in a moment to change his mind for example.

    In the end I have to leave it to those who think therapy might help them to make their own minds up on it. For me it seems overly introspective. I also wonder if perhaps a little suppression might not be such a bad thing. But then, I am British.

    Guy, no, but this is in a sense an exercise in storytelling as much as anything else. Perhaps more than anything else.

    Kevin, I have the same scepticism and read this because of John’s review. As noted, I doubt I’d even have been aware of it otherwise. I’m happy to have served the role of summarising it sufficiently to let you know you can skip it, certainly I always appreciate it when I read reviews that put me off a book. It’s not as if my TBR pile needs adding to after all.

  9. Max: On the other hand, I am intrigued by your sideways reference to your new taste for bourbon, a libation that certainly is not to my taste (and I do like a good whisky). Perhaps you might offer some thoughts in a later post.

  10. leroyhunter

    Interesting. I wonder how much your scepticism coloured your view of the writing qua writing? I get the sense you found the vignettes a little pat or contrived, which is a contrast (but a bridgeable one) to John’s view of them as satisfying and unified.

    Personally I’m not convinced it’s one I need to read. Although, the “stories based on real-life cases” approach paid off in a big way in the 2 volumes by Von Schirach that I’ve been banging on about whenever I get the chance.

  11. Well, I don’t feel compelled to read it.

    I admit I share your views about therapy. For me, it’s like surgery. I’d go for it if it were vital or required for my health but I’d never engage to it to have a nicer nose. Not everything needs to be fixed. I remember reading a review of a book about a woman who repeated an unfortunate pattern in her relationships and the blogger exclaimed that it was time for her to start a therapy to have this problem fixed. What if this woman doesn’t want to get “fixed”? She’s not ill, after all. She just has issues, like anyone and her issues, my issues, your issues also make that we’re different and interesting.

    I have a personal question for you, and it applies to myself too. You spend your days buried in law. For me, it’s a very analytical way of reasoning, every conclusion is backed up by a text (law, jurisprudence…) It’s a very deductive way of thinking : “I analyse the situation. I find the rules that apply to it. I deduct my recommendations to my client”. Not a lot of room for speculation or trusting intuition. Do you think it makes it harder for you to engage with less demonstrative thinking?
    I work in a different field but this certainly applies to me. In my work, there is no room for things that don’t add up. So when I read about interpretation of dreams, of therapy cases, I’m naturally sceptical. I can’t help questioning my reaction and I wonder in what sense what I do affects my abilities to think beside analytical paths. (The same question came to my mind when I read Sleeping Patterns by JR Crook)

  12. Matthew (Bibliofreak.net)

    Max, very pleased to find you weren’t blown away by this. I read it before reading John Self’s review and was surprised to find he enjoyed it so much more than me – normally a sign that I’ve missed something! That opinion seems, at least, to be mixed reassures me that I’m not completely out of step on this one.

  13. Kevin, I’ll do a post on my path to bourbon, which actually does start with a novel, at some point in the not too distant future.

    Leroy, contrived would be harsh but a little pat perhaps. Of course, one person’s pat or contrived is another’s satisfying and unified. As you suggest, perhaps different reactions to the same traits in the book.

    Von Schirach?

    Not everything needs to be fixed. Quite so Emma. The question I think is whether something is making you unhappy, whether it’s frustrating your life. If so then perhaps it needs addressing and therapy might be for some a way to do that. If it’s just part of your life though, then there’s a risk you’d be fixing the youness of you. Like you say, our issues are part of what makes us, us.

    I’m a commercial lawyer working in infrastructure. I very rarely look at a case (I have read one this year actually, but that’s pretty unusual). I do get of course updates internally on developments I need to be aware of, but everything I do is contract so it’s much more a question of knowing the principles and capturing the deal on paper.

    As such it’s not always as analytical as you might think. A lot of it is intuitive, particularly where points touch on issues outside my area. Something might smell to me like an IP issue, or I might have a feeling something could raise tax law questions. If so I approach an internal specialist and bounce it off them. Usually I’m right, but no client would want me giving them IP or tax advice – I’m expensive and not an expert on that area. Part of my role is to spot when others who are specialists in that way need to be brought in.

    How do I do that? Experience mostly, but then intuition is I think in large part assimilated experience. Similarly a large part of what I do is negotiation, trying to balance what the sides want in a way that hopefully comes out with something everything can live with. There’s no texts there.

    Most of the time in my field there aren’t rules to apply. There are simply various parties with different goals and concerns, and a need to match those in a way that benefits my client. That often means floating ideas, and as I say I rely heavily on intuition. If I were a different kind of lawyer though perhaps the issue you flag would arise for me. As it is it doesn’t though.

    Matthew, I think we’re on a very similar page on this one. I enjoyed it, but I didn’t love it and if Grosz writes another I may well not read it.

  14. I agree with your statement above: if it makes you unhappy, then it’s worth doing something about it.

    I guess I read too many legal memos with 1) situation 2) what the law and jurisprudence say 3) what you could/should do, with plan A and plan B and if I get lucky, plan C. Writing and negotiating contracts is quite different, indeed.

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