Controversial confessions

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 .