I started this blog in 2013 to share my reflections on reading, writing and psychology, along with my journey to become a published novelist. I soon graduated to about twenty book reviews a month and a weekly 99-word story. Ten years later, I've transferred my writing / publication updates to my new website but will continue here with occasional reviews and flash fiction pieces, and maybe the odd personal post.
Fictional psychologists and psychotherapists: 12. The Art of the Imperfect by Kate Evans
The conventions of psychotherapeutic practice have evolved to ensure the physical and psychological safety of both therapist and recipient and not for the creation of a page-turning novel. While some aspects, such as supervision and personal therapy for the therapist, have the potential to enhance character and plot development, others serve to minimise the jeopardy and tension that is often required for a good story. As I’ve discovered through my reviews of novels in this series some writers blur the boundaries through lack of knowledge, but even a former psychotherapist and a practising clinical psychologist have relaxed the rules of therapy when turning to fiction. Having discussed the limitations of the fictional therapist and how to overcome them with former psychotherapeutic counsellor, Kate Evans, on Twitter, I was intrigued to see how she had tackled the issue in her own debut novel.
St Petersburg, March 1914: Avrom Rozental has travelled to the city to take part in the World Chess Championship. Due to the fragility of his mental state, his minders have referred him to Dr Otto Spethmann, a renowned psychoanalyst. A widower with an adolescent daughter, Dr Spethmann is becoming overly involved with a new patient, Anna Petrovna, a society beauty and daughter of the powerful Zinnurov, nicknamed The Mountain. The psychoanalyst is also a chess player, engaged in a remote game with his friend and celebrated musician, Reuven Kopelzon, who he has never yet defeated. He considers himself one step removed from politics, until his office is raided and he and his daughter imprisoned on suspicion of concealing information in relation to a dual murder.
Zugzwang is a term used in chess to refer to the state in which a player is reduced to utter helplessness, obliged to move, yet every move is guaranteed to make his position worse. Replete with parallels between the logic of the game, the practice of psychoanalysis and the sociopolitical shenanigans of a country on the brink of revolution, there are many zugzwangs in the novel, leading to a climax in which Dr Spethmann is faced with an impossible choice between different kinds of love.
Fictional psychologists and psychotherapists: 10. Don’t Stand So Close by Luana Lewis
When Stella hears the doorbell one dark winter’s afternoon, she ignores it. After all, she isn’t expecting anyone to call and she herself never leaves the house. But her visitor, inadequately dressed for the blizzard conditions, is persistent. Reluctantly, Stella lets her in.
Torn between suspicion and compassion, Stella is ill-equipped to handle the duplicitous teenager who wants to see her husband. Does Blue need protection or is she out to do the couple harm? How much of what she says can be believed and is Stella strong enough to face the truth?
Moving back and forth between Stella’s present dilemma, a series of undated therapy sessions, and a complex case at the Grove Road Clinic two years earlier, the reader gradually realises what’s at stake. We come to appreciate the depth of fear that has led to her withdrawal from the world and the danger that still lurks at the heart of Stella’s supposed safe haven. This is an engaging psychological thriller about vulnerability, trust and webs of deceit, in the manner of How to Be a Good Wife.
In the midst of my writing, when I’m floored by a factual question to which neither Google nor my encyclopaedic husband can furnish the answer, he tells me to make it up. After all, it’s fiction I’m creating not the instruction manual for launching a rocket to Mars. While close attention to detail lends our work credibility, we should also cut ourselves some slack. It would be unreasonable to expect us to get everything right.
I’ve often wondered, as I’ve picked fault with my nine fictional psychologists and psychotherapists, if I’m being overly harsh. (I’ve wondered about that even more after reading a Catholic priest’s condemnation of John Boyne’s excellent A History of Loneliness in The Irish Times.) Surely it’s the story that matters above all else? While I’d defend the writer’s right to offend, many would prefer not to perpetuate unhelpful stereotypes. As M Kelter describes in his post Why Fictional Therapists Suck, inaccurate portrayals of psychotherapists in fiction can do real harm by putting people off accessing the help they need.
So how do you create a credible fictional psychotherapist? While I can’t offer the definitive guide, I can suggest, based on my reading and on my experience as both therapist and therapped, some pointers:
9 fictional psychologists and psychological therapists: 9. The Delivery Room by Sylvia Brownrigg
The delivery room is the moniker Mira Braverman‘s husband, Peter, ascribes to the office in their North London flat from which she operates her psychotherapy practice. Over a period of just over a year, the reader bears vicarious witness to the trials and tribulations of her patients while Mira struggles to prevent her own pain intruding upon the therapeutic hour.
This is a beautiful novel about what it is to be human: about birth and death; grief and yearning; and the boundaries between public and private. It’s about conflict, from minor misunderstandings to the fragmentation of nations and all-out war. It’s about national identity, about insiders and outsiders and the risks entailed in genuinely getting to know another human being. Like therapy itself, it’s a gentle novel woven with textured detail, absorbing and gripping while proceeding patiently, eschewing formulaic tropes and attention-grabbing gimmicks, towards some deeper truth.
The narrative progresses from multiple points of view. Although, at least initially, I balked at the head hopping, it’s successful in both adding layers of nuance to the story and in highlighting one of the most interesting aspects of the therapeutic relationship. Each of Mira’s patients meets a plump woman in late middle age with an Eastern European accent, but what they make of this varies with their own personalities and needs. One perceives her as maternal; another sees a Russian or Czech intellectual; the one who comes closest to seeing her as she really is snipes at her for being a Serbian at the time of the Balkan conflict. Yet there’s a touch of humour in their different assumptions about the abstract painting hanging on her wall.
9 Fictional psychologists and psychological therapists: 8. By Blood by Ellen Ullman
Who can say they’ve never dreamt of being a fly on the wall, eavesdropping on the intimate exchanges between people who don’t even know we exist? Such an opportunity presents itself to the unnamed narrator of this unusual and multi-layered novel when he rents a room in an office block right next to a psychotherapist in 1974 San Francisco. A troubled, and troubling, university professor on enforced leave from his post, and veteran of decades of unsuccessful therapies, he is obsessively drawn to the unfolding story of the young woman to whom he refers as “my patient”. Adopted as a baby, her journey to discover the identity of her birth mother takes her, via Israel, from affluent 1930s Berlin to the horrors of Bergen-Belsen. As a reader, I also became engrossed in her tragic story but, in keeping with the parameters I’ve set myself in this series of reviews, I’ll now turn my attention away from the content to the process of its telling, packaged as it is within a series of therapeutic encounters over the course of around sixteen months.
This was one of the most credible fictional accounts of psychotherapy I’ve discovered so far. Alongside the mind-blowing personal discoveries, were the sulks and silences, the tedium, the long hard graft for both patient and therapist in their search for the truth. While some might find the fly-on-the-wall approach introduces an unnecessary distancing from the patient’s narrative, it works well as a way of exploring the process and rituals of therapy. His observations, such as this on the Christmas break:
9 fictional psychologists and psychological therapists: 7. Therapy by David Lodge
Oh, Professor Lodge, if only you’d named this novel A Narcissist’s Diary or perhaps Tubby’s Dodgy Knee. But Therapy! The title’s crying out for a place in this series, and you know what that means. Yes, I had to read the thing, and think about it, and I so hate doing negative reviews (and I am doing so only in the knowledge that you are big enough to take it/be totally unaware that I live and breathe on this earth). Yes, I could’ve bailed out when I realised your title encompasses a broad church of therapy: physiotherapy; aromatherapy; acupuncture and a rambling form of cognitive-behaviour therapy for which the dreadful manualised Improving Access to Psychological Therapies might have been especially invented – but I’d already paid for the book.
I hardly cared that your narrator’s bungled attempt to clarify the difference between a psychiatrist and a cognitive-behaviour therapist (p15) had me longing to introduce you to Sally Vickers, whose novel, The Other Side of You, featured my last therapist but one. In fact it was almost a relief to be jolted out of my stupor by the subsequent revelation (p212) that said cognitive-behavioural therapist was licensed to prescribe antidepressant medication, outing her as a psychiatrist (or some other kind of medical doctor) after all. Yet I’d have gladly renounced my pedantry in exchange for a spark of connection with character or story to lift me above the morass of ennui.
9 fictional psychologists and psychological therapists: 6. The Good House by Ann Leary
I hadn’t known of this book until I won it in a goodreads giveaway, but what a wonderful freebie it turned out to be. Not only did I find the most endearing alcoholic narrator it’s ever been my pleasure to meet, but another flawed therapist for this series.
Peter Newbold is a psychiatrist. As Salley Vickers makes clear in The Other Side of You, this doesn’t automatically qualify him to practice therapy. I don’t know if Dr Newbold has had the requisite additional training – he’s published a book on attachment issues, so clearly knows about a bit more than diagnosis and drugs – but, if he has, it’s not enough to prevent him blurring the boundaries between his professional and personal lives. I’d like to be able to tell you that his behaviour is unbelievable, but sadly some psychiatrists do feel entitled to play by their own rules, even nice chaps like Peter.
We see Dr Newbold through the eyes of the narrator, Hildy Good; not a patient, but the estate agent from whom he rents his office. Perhaps through having known him as a child, perhaps through her own mistrust of experts on the psyche, Hildy is far from in awe of his profession:
I can walk through a house once and know more about its occupants than a psychiatrist could after a year of sessions. (p1)
In some respects, her own intuition, honed through a party-piece she learned from a “clairvoyant” relative, is more accurate than Peter’s, except, perhaps, as regards her own problems, and, in the final analysis, where it really is a matter of life or death.
The Good House offers the reader a fairly low-key version of a therapist: Dr Newbold is only one of a wide cast of vulnerable characters muddling through as best they can. Just like real life.
For another perspective on this novel, do pop across to A Life in Books. For the next post in this series I’ll be commenting on Therapy by David Lodge.
This being my 99th blog post, I'm delighted to be able to bring something a bit special for my centenary: I'll be answering the questions set for me by Norah Colvin as part of the Liebster award.
I’d welcome your feedback and, in the meantime, let’s have some 'house' music from Talking Heads.
9 fictional psychologists and psychological therapists: 5. The Other Side of You by Salley Vickers
The Other Side of You is about an encounter between two people; an encounter that, in different ways, saves both their lives. A serious suicide attempt has brought Elizabeth Cruikshank to the hospital where David McBride works as a psychoanalytically orientated psychiatrist. Shrouded in her despair, David is unable to make any progress with his patient until, recalling a painting by Caravaggio, he acknowledges their mutual stumbling humanity. In the course of a mammoth therapy session, Elizabeth shares her story of the love lost and found and lost again that led to her attempt to take her own life.
9 fictional psychologists and psychological therapists: 4. Regeneration by Pat Barker
Regeneration commences Pat Barker’s lauded First World War trilogy, dramatising a real-life encounter between the poet Siegfried Sassoon and WHR Rivers, an anthropologist, neurologist and psychologist working with shell-shocked soldiers at Craiglockhart Hospital. In July 1917, Sassoon, an army officer, has published a declaration on the injustice of the continuance of the war and is refusing to return to the front. Partly to avoid the negative publicity that might arise from his being court-martialled – and presumably shot – for disobeying an order, he is sent to Rivers for treatment. Over the ensuing months, both men come to change their positions in relation to the Declaration and their respective roles in the conduct of the war. In a parallel process over 250 pages, readers are challenged to consider their positions, not only in relation to war, but also about the ethics of psychological and psychiatric intervention that stifles protest by enabling people to function in an insane world.
9 fictional psychologists and psychological therapists: 3. The Memory of Love by Aminatta Forna
Adrian Lockhart is a British clinical psychologist who has fled his failing marriage to work in a psychiatric hospital in Freetown, Sierra Leone, shortly after the civil war. Adrian is no knight in shining armour; even he wonders what he can offer a country where the entire population has been brutalised, and his efforts are impeded by structures he can't possibly understand. Yet this reflective outsider is an ideal literary vehicle to explore what remains of humanity in the aftermath of war.
While Adrian's ineffectiveness is no great advert for clinical psychology, I find him one of the most convincing fictional psychological therapists I've encountered so far. This might be down to the author's expertise in creating plausible characters, as well as her good sense in seeking professional advice, as noted in the acknowledgements. (As I mentioned in the introduction to this series of posts, psychologists and psychological therapists are appealing to writers, but can be hard to get right.) Although I've never worked abroad, or with those blunted by war, some of Adrian's experiences reminded me of the challenges of working as a psychologist in longstay psychiatric institutions in Britain, with the sense of overwhelming need and not yet having the right tools or structures to meet them. Perhaps the best he can do is listen to the stories of those able to tell them, and bear witness to the tragedy around him.
In that context, the ending didn't work so well for me, when he offers his friend, local surgeon Kai Mansaray, a potential remedy for the trauma that prevents him sleeping. It might be a case of letting the psychology dominate the story rather than support it: while the treatment, EMDR, is a recommended intervention for post-traumatic stress disorder, and one that a suitably trained psychologist might practice, the somewhat mechanical method seems quite a shift in tone from Adrian's previous approaches. However, those with a more immediate experience of trauma work may disagree with this reading and, either way, it's a small point in a psychologically astute and deeply moving novel.
More war trauma with the next in the series, I'm afraid, when I review Pat Barker's take on the treatment of shellshocked soldiers in the First World War in her 1991 novel, Regeneration. But I'll be posting on some jollier topics before then, starting with my reading pile in four or five days time. If you can't wait that long for something on the lighter side, check out this style blog for a very different take on the spirit of the people of Freetown, Sierra Leone.
9 fictional psychologists and psychological therapists: 2. The Rapture by Liz Jensen
In Liz Jensen's apocalyptic climate-change thriller, Gabrielle Fox is a new psychologist in an adolescent forensic mental health unit. Taking up the post on the rebound from a personal and professional crisis of her own, Gabrielle is no match for the disturbed and disturbing teenager with whom she becomes entangled. Bethany Krall, a matricidal religious maniac (PS– not her actual diagnosis), is about to embark on a psychological and geographical journey and is determined to take Gabrielle along.
Gabrielle's backstory is compelling, drawing the reader in, but I found her professional persona somewhat confusing. She is described as a psychologist but she’s come to replace a
psychotherapist and the nuts and bolts of her work would position her more as art therapist. As mentioned in the introduction to this series of posts, such subtle distinctions between the various professions can be difficult to untangle from the outside, and may not matter so much to the average reader, but for me it was as jarring as a switch of point of view mid-scene. But setting these brand distinctions aside, her credibility as any kind of mental health professional is questionable and, I'm afraid, detracts from an otherwise page-turning plot.
9 fictional psychologists and psychological therapists: 1. The House of Sleep by Jonathan Coe
As I said in my introduction to this series of posts, psychologists and psychological therapists are intriguing fictional characters, but can be tricky for writers to pull off. How much that matters will differ from one reader to another.
The House of Sleep is set in a clinic and research centre for sleep disorders that was previously a student hall of residence. Although it relies on a number of coincidences to reunite the characters from the past, it's a cracking read.
Somewhat wisely, Jonathan Coe doesn't show us clinical psychologist Dr Chloe Madison going about her work, although we do hear some rather raucous laughter from the other side of the door, which I thought she explained rather well. Less well justified – i.e. not at all – was her need to live in at the clinic, leaving me quite concerned for her ability to maintain her professional boundaries, especially when her relationship with her main colleague, the psychiatrist Dr Gregory Dudden, was so poor. This might account for why, when she had concerns about his practice, instead of raising them with the Royal College of Psychiatrists, she tried to get a journalist to investigate. (Yes I know she's just a fictional character, and it probably worked better for the plot, but it made me anxious.) In this context, the fact that she found her job through an advert in the British Journal of Clinical Psychology, a research publication, rather than the appointments memorandum of The Psychologist where real-life psychologists tend to look for new posts, matters only when I'm being especially mean.
Knowing little about Lacanian psychoanalysis beyond its complexity, I loved his set piece on Russell Watts's presentation to the psychiatrists on his analysis of Sarah, one of the point of view characters in the novel. The analyst had come up with a profound but extremely partial formulation of her difficulties, presented with a blatant disregard for confidentiality and a marked phallocentric bias. I'd be interested in what a Lacanian practitioner would have to say about the privileging of intellectual understanding over practical application – would they feel as prickly as I did with the clinical psychologist, or would they be able to see the funny side?
Finally, like many in the helping professions, although few would be so consciously aware of it, Dr Madison is using her work to fulfil some of her own psychological needs, but to spell out how would spoil the book for those who haven't read it. But let's face it, however much I harp on about the professional issues, it's those underlying vulnerabilities that draw us to a character.
I'll be posting next in this series in a month or so on The Rapture by Liz Jensen. In the meantime, do let me know what you think.
When I began my training nearly 30 years ago, nobody had heard of a clinical psychologist. Now you can't get away from them; they even pop up in novels. And why not? A psychologist, or a therapist, as a character can be the ideal vehicle for accessing interesting situations or states of mind. Yet there are lots of potential pitfalls for the writer uninitiated into the intricacies of the various psychological professions. Just as I'd be sure to misrepresent details of the life of a postal worker, based on my reminiscences of my student days on the Christmas post, there are aspects of any job that only an insider can know.
It's a tall order to complete a novel without a single factual error and, in my opinion, it's the internal validity that matters overall. Yet if I set my novel in your front garden and lovingly described a pond with goldfish and water lilies where you had a magnolia tree, it would probably put you off, however good the story was. That's how I'm feeling about some psychological therapists in novels.
Maybe it's because I'm reading especially critically at the moment as part of my effort to improve my own writing but, when the wind blows in a certain direction, I can be rather picky. So I'm doing this little series to get things off my chest – and to promote discussion if anyone's interested. But before we start, let me clarify that I'm offering this from the perspective of a psychologically-informed writer rather than a professional psychologist – that's a bit of me that I gave up a little while ago.
Look out for the first in this occasional series: two for the price of one (a clinical psychologist and a Lacanian psychotherapist in Jonathan Coe's The House of Sleep).
But before that, I'm hoping to bring you more short stories as well as a piece on the end of childhood to complement my interview with Gavin Weston that – through the power of Facebook and Twitter – brought loads of extra visitors to the site at the end of last week.
Meanwhile, your suggestions for psychological therapists in novels would be welcome.
entertaining fiction about identity, mental health and social justice
Anne Goodwin's books on Goodreads
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GUD: Greatest Uncommon Denominator, Issue 4
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The Best of Fiction on the Web
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2022 Reading Challenge
Anne has read 2 books toward their goal of 100 books.
Annecdotal is where real life brushes up against the fictional.
Annecdotist is the blogging persona of Anne Goodwin:
slug-slayer, tramper of moors,
author of three fiction books.
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I don't post to a schedule, but average around ten reviews a month (see here for an alphabetical list),
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