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About the author and blogger ...

Anne Goodwin’s drive to understand what makes people tick led to a career in clinical psychology. That same curiosity now powers her fiction.
A prize-winning short-story writer, she has published three novels and a short story collection with small independent press, Inspired Quill. Her debut novel, Sugar and Snails, was shortlisted for the 2016 Polari First Book Prize.
Away from her desk, Anne guides book-loving walkers through the Derbyshire landscape that inspired Charlotte Brontë’s Jane Eyre.
Subscribers to her newsletter can download a free e-book of award-winning short stories.

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Psychoanalysis, friendship and failure: Jott by Sam Thompson

10/6/2018

8 Comments

 
The world poses impossible questions and the future is in darkness, you have no claim on health or peace or the way that you feel things ought to be, you are required to live without knowing what comes next, you must carry on in hope as best you can, and you must begin by attending to one another.

Despite differences in lifestyle and temperament, the friendship between Arthur and Louis, begun as pupils at an Irish boarding school, has endured through university in Dublin to early adulthood in 1930s London. Arthur, a junior psychiatrist, has always been overshadowed by his friend, an unpublished writer with the flair and determination to live by his own rules. While Arthur is shy and socially awkward, Louis can charm anyone, including Arthur, such that the psychiatrist often finds himself sacrificing his own needs for the sake of his friend.
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This intelligent and engaging novel was inspired by the author’s grandfather, a psychiatrist and lifelong friend of Samuel Beckett who helped the latter research his first novel by taking him onto the wards. Beckett aficionados will find much delight in the novel’s meta-fictions, beginning with a shared title with the Beckett-character’s own novel, extracts from which are shared towards the end. I’ll leave that strand to reviewers more competent in that area – yes, I enjoyed Waiting for Godot, and was surprised how funny it was, but can’t claim to have understood it – and focus on the themes of failure, psychoanalysis and psychiatric hospital care.
 
Fraudulent identity and failure
 
Failure is an appropriate theme for a novel fictionalising the writer famous – at least
among contemporary writers – for the phrase Ever tried. Ever failed. No matter. Try Again. Fail again. Fail better. Although we witness Louis’ bouts of despair at his own limitations, it is Arthur’s apparent failure in every aspect of his life – professionally, at home, in his friendships, and even in his own therapy – that makes for the novel’s crisis. This isn’t without humour, such as when he companies his wife to a meeting of the Women’s Liberation League and only just manages to resist mansplaining (p177):
 
he wondered whether he should say something, not for his own sake but for the good of the meeting, because the mood was becoming feverish and it was surely counterproductive for these women to approach their cause in such a confrontational spirit.
 
Nevertheless, Arthur’s sense of inadequacy, which has dogged him since childhood, is deeply poignant. Perhaps he’s felt that the trappings of professionalism would save him, but he finds himself humiliated in both major and minor matters. His patients get worse, the nurses don’t respect him and the administrator finds time to chat to his junior colleagues but is always busy when Arthur is around (p198):
 
If a doctor’s signature was all the nurse had wanted, she could have asked either of them, and hadn’t she been closer to Arthur as she came into the room … And yet she had walked by as if it were assumed that even his signature on a form was not quite to be trusted. Perhaps this was one of those incidents that pierces deeper than you know at first, so that afterwards as the minutes go by you gasp and grit your teeth and then gasp again as you realise that here is going to be another memory that will never stop mattering, a lesion that doesn’t heal.
 
In myriad ways, Sam Thompson articulates that sense of fraudulence anyone in the helping professions must find a way to manage. Interventions fail to affect the desired improvement, or even make things worse. As the psychoanalyst Tom Main wrote in his classic paper The Ailment (1957), anxieties about the fragile boundary between sanity and madness leads to treatment deployed for the sake of the staff rather than the patient, a tendency satirised in Louis Molyneux’s (the fictional Samuel Beckett) novel.
 
Unfortunately Arthur feels constitutionally destined for imposter syndrome, the only alternatives modelled to him are haughty emotional distancing or the cruelty of his friend’s “helpless integrity” (p261). He even recognises the phenomenon in his own analyst (p210):
 
a limited man who cultivated his psychoanalytic mystique to seem impressive but had no better idea than his patients of how to live. His tricks were cheap, and once you had learned them he was at your mercy, yours to manipulate and fool.

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1930s psychoanalysis
 
While my reading suggests that
ineffective therapists are more common than effective ones in fiction, Sam Thompson’s exploration of therapeutic failure is more thoughtful than most. After a promising start in medical medicine, Arthur has surprised his colleagues by moving into psychiatry, driven by an interest in the still relatively new and exciting discipline of psychoanalysis. (Melanie Klein, whose theories came to dominate British psychoanalysis, had moved to London in 1926 – and might be the speaker at a lecture Arthur and his future wife attend.)
 
Although psychotherapy isn’t routinely practised in any form at the hospital where Arthur has his first psychiatric job, he’s given permission to work with one of the more difficult patients, a largely silent man diagnosed with dementia praecox (now known as schizophrenia) called William Walker. Of course Arthur struggles with the countertransference (p82-83):
 
Small shivers went through his hands. Some psychosomatic discomfort was not necessarily a bad thing: it meant that significant events were taking place at the unconscious level of the analysis. Sweat crawled inside his shirt. The trick, as ever, was to turn the interaction to therapeutic ends … Don’t become defensive. If you assume that silence is hostility, that’s what it will become. Think instead that sitting here in silence may be the only form of communication open to Walker today. Never forget what an enormous task it is for someone in his situation to speak in a way that others can understand.
 
Unfortunately, Arthur’s patience is not rewarded. When – boundary violation alert – he accedes to Louis’ request to sit in on the sessions, the patient effectively sacks him in favour of his friend. Louis meets Walker for an hour a week over several months until, having acquired all the needs for his novel, abruptly stopped seeing him. Even Arthur, with his limited experience, knows that therapeutic endings need to be more sensitively managed, although he ends up doing something similar himself.
 
Although there’s scant support within the hospital for Arthur’s therapeutic endeavours, he does have the dubious benefit of a training analysis (with – second boundary violation alert – the analyst he’s found for his friend). Sessions are conducted, not in Venn’s consulting room, but while tramping around the London streets. This might be a reason for Arthur finding the sessions inauthentic, although he also blames himself for neglecting to disclose a piece of biographical information right at the start. Later (p46) he rationalises that he can make this information the gift that will convince his analyst that progress is underway.
 
The sterility of this particular analytic pairing is underlined in this novel by some astute observations of the “preposterous enterprise” itself (p40-41, 43, 253):
 
Our profession wants to think of itself as a science … and no-one will admit that we are in fact an organised religion. Cults of personality, deference to authority, rampant factionalism, ruled by doctrine and dogma.
 
rebellion was useless, because the rules of analysis would always prevail, making denial into evidence more positive than confession … He had stumbled into a world that, for all its institutes and clinics and conferences and learned publications and distinguished careers and bitter rivalries, might as well be the delusional system of a paranoid psychotic. Having no basis in anything real, it was only pretending to exist.
 
Arthur still had his doubts about the enterprise, with its simple faith that to put a name to your cage was to make yourself free.
 
1930s mental health care
 
Mental health care, apart from private psychotherapy, is delivered within hospital settings in the 1930s. Although Arthur is employed within institutions catering to the less disturbed patients, for whom there is hope of a cure, he doesn’t encounter some grisly treatments, including the “wet pack” (p165), which I’m glad to say I hadn’t come across before.
 
He finds his visit to the large “lunatic asylum” particularly discouraging: the inmates dressed in clownish uniforms; the doctor’s role reduced to pen pushing; the lack of privacy, except in cases of unmanageable violence when patients confined to single rooms, sometimes for weeks on end. This warehousing of human distress is such that “anyone might go insane for want of anything else to do” (p216). Arthur fears he (p215):
 
would fare poorly as a patient, he knew, because he was not nearly good enough at reading the intricate, unspoken signals that governed the social life of a ward like this: the near invisible insults, bargains and kindnesses that made the difference between peace and violence.
 
Fortunately for him, he’s not obliged to find out, although he does have a momentary experience of what psychosis might be like (p123):
 
it was as if he had slipped on the step between the dream and the waking world, so that he scrambled out of bed not knowing where he was, not knowing his name, only knowing that it was an emergency and he must take action at once … He was surrounded by a jumble of forms, bodies in space without meaning. He had forgotten the words for the electric lamp burning above, the darkness beyond the glass and for his own hammering heart muscle.
 
As you’ll appreciate, if you’ve persevered this far, I found much of interest in Sam Thompson’s second novel, making it another contender for my novels of the year, as well as a welcome addition to
my list of fictional therapists. Thanks to JM Originals for my advance copy.

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Some of these themes arise in my own fiction, with Steve, the dodgy narrator of my second novel, Underneath, experiencing a psychotic-like interlude evoked by a stressful visit to his family and what will hopefully become my third novel, Matilda Windsor Is Coming Home, set largely in a longstay psychiatric hospital around 1990, but influenced by events stretching back to the 1930s.

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That’s where I’ve gone with this week’s flash fiction challenge:
man glisten proving as difficult for me as for my character Henry, whose most recent 99-word story featured homecoming cranes.

Man glisten in the madhouse

In some ways, Henry found it reassuring. This was a madhouse after all. But the poor man, boogying to a solitary rhythm, would attract derision outside. Someone should restrain him. Was it light reflected from the Christmas tree, or was that glitter in his hair? Was there alcohol in the punch?

At least Henry’s role would be minimal: passing the patients’ gifts to the Mayor. Then home to sanity. Yet his face froze as glitter-man sashayed over, grinning as he offered his hand. “Thanks for coming, Santa, Santa’s Elf. I’m Clive Musgrove, charge nurse. We spoke on the phone.”

Thanks for reading. I'd love to know what you think. If you've enjoyed this post, you might like to sign up via the sidebar for regular email updates and/or my quarterly Newsletter.
8 Comments
Norah Colvin link
11/6/2018 12:03:46 pm

Although this one appears to have themes I'd enjoy, Anne, and you say it is a contender for one of you best reads of the year, I'm not sure that it appeals to me as much as I would have thought. I think the ideas seem a bit deep, a bit complex for me. Or maybe that's just because it's getting late and I've already read some articles with complex ideas this evening.
When you gave the second warning about boundary infringements, I was amused at the name Venn as, with my divergent (scattered) thinking, I thought immediately of the mathematical diagrams and how appropriate the name was.
Never mind, I am very much enjoying Nietzsche's story. Thank you for that recommendation.
I was a bit confused with the appearance of Alistair early on in your review, until I realised it was probably a mis-heard Arthur. :)

Reply
Annecdotist
11/6/2018 02:49:15 pm

Thanks for reading anyway, Norah. It might be my enthusiasm for the themes and links to theory that made the complications, rather than Sam Thompson’s writing. To me it seemed quite accessible, but what do I know? I hope my review doesn’t put potential readers off.
Thanks for noticing Alistair – strange to find it muddled with Arthur given the extra syllable – but can correct it now.

Reply
Norah Colvin link
15/6/2018 07:55:37 am

Oh dear. I came back to reply and see I forgot to comment on your flash, which I found most amusing, and a perfect response to the 'man glisten' prompt. I could just imagine the look on Santa's face, and of course, a third witness would have found it equally unsettling/amusing.
I'm sure your review wouldn't put any genuine potential readers off.

Reply
Annecdotist
15/6/2018 04:54:54 pm

Thanks, Norah, I am enjoying Henry’s prejudices.

Reply
Norah Colvin link
17/6/2018 07:28:19 am

As am I. :)

Robbie Cheadle
19/6/2018 07:19:34 pm

I thought this was very interesting, Anne. I have a son who suffers from PTSD and OCD. We have been seeing a new psychologist for cognitive behaviour therapy treatment. It has been difficult for him as Greg has 18 triggers to most patients 2 or 3. I had a chat to him and I sensed he was a bit despondent. I told him that we are seeing improvements every day, small but they are there. It will just be a longer road to success. I also liked your flash. Thought provoking indeed.

Reply
Annecdotist
20/6/2018 09:10:29 am

Thanks, Robbie, and sorry life’s so difficult for your son. And sorry for you feeling you had to cheer up the therapist – he ought to have his own supervision for that!
I don’t know if you’re aware that I used to work as a clinical psychologist? I have a whole series of posts about fictional therapists, but not many that address CBT, which I imagine is less engaging on the page.
I hope you’re able to make progress with your son’s treatment.

Reply
Dr. Len Bergantino link
12/12/2020 12:44:27 am

There in this manner gives off an impression of being a reverse relationship amongst recuperation and psychotherapy; the more psychotherapy, the more modest the recuperation rate.

Reply



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