Stephen Grosz is a psychoanalyst who has worked in the United States and Britain. Over his career he has been ‘sitting with patients for thousands of hours,’ he writes. Occasionally he has used his notes and observations for addresses at clinical seminars or for contributions to psycho-analytical journals. But this is the first time he has consulted his files in order to publish a book for the general reader.
‘This book is about change,’ he tells us. Naturally his troubled patients are seeking change, though they sometimes shield themselves from his professional intrusiveness. There is the risk, too, of change being for the worse — for the consultant as well as for the patient. These sessions are a learning process for both of them. Some of the most sympathetic passages in the book chronicle moments of the author’s disquiet when he is left with a sense of ‘failing both my patients and myself’ or when he is confronted by someone who is irrevocably damaged.
For British readers there is the occasional off-putting Americanism such as ‘different than’, or the assumption that everyone has a ‘mom’. But Grosz is an able writer, engaging, frank and with many penetrating insights. His short, succinct chapters have both the tension and the satisfaction of miniature detective or mystery stories. We are introduced to people telling blatant yet self-revealing lies, shown extraordinary everyday happenings, ingenious acts of transference and surreal episodes, such as the woman who, asked to lunch at someone’s home, arrived with a ‘removal van containing all her clothes and possessions, including some large pieces of furniture’.
Grosz invites his readers into his consulting room as a silent and invisible audience. So we also learn what he has learnt: that achieving success often involves loss; that people like to use boredom as a form of aggression; that the eager promotion of self-esteem in children may well lead to laziness; that silence is valuable and can be interpreted; and that the only real time is the present (‘the past is alive in the present . . . The future is not some place we’re going to, but an idea in our mind now’).
Anxiety, anger, loneliness, lovesickness, the fear of failure, separation and the sense of not being heard are some of the conditions that lead people to his consulting room. Grosz listens: therefore he is. But who is he? The reader is introduced to him in his two pages of acknowledgments at the end of this book. These are crowded with more than 70 people including three generations of his family, members of staff at his literary agency and publishers in several countries, also journalists and other writers, many colleagues in hospitals, clinics, institutions, universities and units. The impression is given that he is never lonely, separated, lovesick, unseen or unheard. The acknowledgments are by way of being a professional CV, testifying to his well-being and success.
Towards the end of their careers and in the event of their sudden death, psycho-analysts usually designate another member of their profession to ‘dispose of any confidential notes or correspondence’, Grosz explains. Although the identities of his patients are concealed and some details changed in this book, the essence of his confidential notes will already have been published by the time the originals come to be destroyed.
The situation is in some ways similar to that which surrounded Diane Middlebrooks’s biography of the American confessional poet Anne Sexton in 1991. Middlebrook asked Sexton’s psychiatrist for her confidential tapes and was given them because Sexton’s family wanted the nature of her infidelity, incest and the alcoholism that led to her suicide understood by the public.
At the time this was considered a controversial arrangement that in no sense created a precedent. Has Stephen Grosz asked permission from his patients? After all, some of them, reading this book, may well recognise themselves. At the end of his acknowledgments Grosz writes that his ‘greatest debt, finally, is to those who cannot be thanked by name — the patients whose lives have shaped this book’. These are his last words and they leave an unwritten and unanswered question over what is nevertheless a stimulating book.
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