Wanting to say one more thing

Stephen Grosz has condensed his experience of some 25 years as a psychoanalyst into this compelling and insightful book, “The Examined Life – How We Lose and Find Ourselves”. It consists of 31 short chapters, most of them about a particular patient with a particular problem, which touches on more general themes, e.g. how lovesickness keeps us from love or how a fear of loss can cause us to lose everything.

He is good at explaining the work of a psychoanalyst. In the preface he says that he has altered some details in the interests of confidentiality, but has stayed close to the facts. Reading a chapter sometimes feels like being an invisible observer present in the room. “My job”, he says, is “to listen, then check what I’m hearing against my emotional reactions” (p. 175). “Listening properly is hard work but what we crave from others more than praise” (p. 22). Then the analyst has to find useful questions. But it is also important to help patients to find the right words, for them to put their feelings into words and to try to make sense of their lives.

Just as it is important for the analyst as therapist to find the right questions for the patient, the analyst as author has to find the right words for the reader. Grosz avoids silting up his prose with the psychoanalytical jargon that muddies the writings of many of his colleagues. He mentions only two or three of these terms and explains clearly what they mean. “Transference” he says is “how we all construct each other according to early blueprints” (p. 201). The essayist and novelist, George Orwell, remarked that avoiding jargon is good, not only for the reader, but for the writer as well, because it forces the writer to consider what the jargon really means.

Accounts of therapy are often self-congratulatory success stories, but Grosz is quite prepared to admit that he got it wrong with some patients. He also points out that analysts have anxieties as well, usually about whether they can handle what the patients bring into the room. They sometimes collude with their patients to keep the most disturbed and disturbing feelings out of the room. If the therapy has reached an impasse, it is often because the deadlock serves a purpose for both the patient and the analyst.

Many of the chapters illuminate the darker recesses of our psyche. Some people, for example, prefer to feel threatened by others rather than feel ignored by them. After we have lost someone dear to us, our longing for closure is the false hope that we can deaden our living grief. Even when we have a success, “we may be undone if we don’t foresee that winning is also losing” (p. 133).

A recurring theme is the necessity of change. Because “change is loss” (p. 124) we are reluctant to change: “We resist change. Committing ourselves to a small change, even one which is unmistakably in our best interest, is often more frightening than ignoring a dangerous situation. We are vehemently faithful to our own view of the world, our story. We want to know what new story we’re stepping into before we exit the old one” (p.123). One of Grosz’s patients said that change was fine, but “not if it meant changing”. We need to give up the delusion, Grosz suggests, that we can live a life without change and loss. Sometimes change can come about, not because we try to change ourselves, but because we “repair our relation to the lost, the forgotten, the dead” and acknowledge that they are losses (p. 114).

I found a number of the chapters very moving. I will mention only two of them.
In “How Anger Can Keep Us from Sadness” he describes how he treated a boy with high-functioning autism, or Asperger’s syndrome, who kept spitting at him in the sessions. Grosz suggested that the boy was trying to make him angry and that if he was angry this meant that he wanted the boy to change and still believed that whatever was broken could be fixed. Grosz then asked him what was broken and, after a pause, the boy said: “My brain’s broken, stupid”. He went on to talk about some of the other children who were younger than he was, but could do things he couldn’t do because their brains worked and his brain was “wrecked”. He looked straight at Grosz and said “It’s really sad. Isn’t that really, really sad?.” Two days later he spat at Grosz once more, and then never again.

In the final chapter Grosz tells us that when his son once became ill he found it very difficult to persuade him to take the antibiotics he needed. That night he woke up from a dream about trying to catch a lizard, which then disappeared into a dark space between two rocks. Eventually he remembered a young man who was HIV-positive and was refusing treatment for pneumonia. The young man came from the Lizard, a peninsula in Cornwall. In the first session he tried to get him to take medication and come into hospital. The young man returned and told him that, yes, he needed to look after himself, but, instead of treatment, he would take a break and go to Rio for Mardi Gras. Grosz never saw him again, but heard a few months later that he had died. He remembers how helpless he felt with this patient, and with his son the previous evening, and concludes: “Now, so many of the patients I saw when I was young are gone or dead, but sometimes, as when waking from a dream, I find myself reaching out to them, wanting to say one more thing”.

Paul Crichton, London
10 February, 2013

Grosz, S. (2013) The Examined Life   How We Lose and Find Ourselves, London: Chatto and Windus.