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:

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.

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:

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.

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.

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.

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.