Deception, self-deception, and the fallibility of memory are central issues in psychotherapy. Freud first accepted and then rejected the literal truth of patients’ childhood memories, concluding that these accounts were fantasies that the patients believed to have actually happened. “The 1930 Olympics” takes the issue of remembering-what-never-happened even further. It presents a patient who, as a form of resistance, consciously lies to—and deceives-his therapist. (13 pp.)
Download Tag: Psychotherapy Fiction
An Astrologer’s Day
In “An Astrologer’s Day,” R. K. Narayan dramatizes the work of an ancestor of the healing professions. Gurus, witch doctors, shamans, astrologers, fortune tellers, and faith healers derive their authority and their capacity to influence others from both rational and nonrational sources. The rational basis of authority derives from the knowledge, experience, and skill that practitioners bring to their work. The charismatic origins of their authority can be traced to the child’s faith in and obedience to powerful parental figures. No one completely relinquishes the primitive belief in the possibility of merging with the calmness, infallibility, and omnipotence of perfect parental figures. In this story, Narayan demonstrates the artfulness, common sense, exquisite timing, and luck that this astrologer shares with psychotherapists. (12 pp.)
Psychiatric Services
Countertransference, the therapist’s emotional reactions to the patient, is potentially one of the therapist’s richest sources of information. The therapist-in-training learns through sound supervision that understanding personal feelings can clarify the meaning of the therapeutic process. The supervisory relationship, like the therapeutic relationship, is fraught with hazards and requires a sense of safety and trust if problematic feelings are to be brought to full awareness, accepted, and used therapeutically. In this story a psychiatric resident is anxious and confused because of her empathic involvement with a patient. Her supervisor, instead of helping her to understand that these feelings are the price one pays for practicing the “impossible profession,” increases her sense of powerlessness by his arrogance and presumptuousness. (31 pp.)
End of a Game
The course of individual psychotherapy, by its very nature, excludes significant others in the patient’s life. The excluded spouse, especially, is vulnerable to feelings of anxiety and uncertainty. In “End of a Game,” Nancy Huddleston Packer depicts the anguish of a spouse, Charles Andress, who is outside the therapy experience. He agonizes over his wife’s relationship with her therapist and, like a jealous lover, envisions the therapist as a competitor. As can often happen when the outsider consults the therapist, Andress feels demeaned, ignorant, and embarrassed. With his wife he feels inadequate, plagued by the question “Why isn’t my type of love healing?” (31 pp.)
The Ordeal of Dr. Blauberman
Lillian Ross’s short story reveals a psychoanalyst’s flaws and shortcomings. Dr. Blauberman’s personal alienations and his envy of the patient result in controlling, judgmental, intrusive therapeutic work. Under the guise of meeting his patient’s needs, Blauberman tries to gratify his own. He rationalizes his failures as a therapist by blaming the patient for being passive and resistant. This story highlights how difficult it is to extricate oneself from even a destructive therapeutic relationship. Dr. Blauberman’s negative impact may be short-lived, his patient’s capacity for love and creative work exceeds the therapist’s, and the patient ends therapy. (68 pp.)
August & Ordinary People
The excerpts from the novels August and Ordinary People dramatically highlight the work of two therapists. The patients in both cases are adolescents, suicidal, and coming for their first sessions. The therapists differ radically in approach and style. In the selection from August, Dawn meets a female psychoanalyst, Dr. Schinefeld, whose interventions are shaped by attention to abstinence, neutrality, and objectivity. In contrast, Judith Guest’s Dr. Berger is informal, personable, and talkative.
Asking which of these two styles indicates the better therapist is like evaluating whether jazz is better than classical music. Successful therapy depends on the elusive fit between therapist and patient. The chemist can predict how two elements will interact, there is no comparable science of human chemistry. (61 pp.)
My Love Has Dirty Fingernails
The roles of therapist and patient are not tightly scripted. In many respects, psychotherapy changes with each new relationship. Like jazz musicians, psychotherapists must be capable of improvising, gracefully. Much of the work of psychotherapy consists of exploring the unique ways in which patients respond to the complexities and ambiguities woven into the therapeutic interaction.
In “My Love Has Dirty Fingernails” the therapist pulls together the unconscious themes of the session with a transference interpreta­,tion. But the interpretation is overly theoretical and too lengthy—an attempt to “convince” the patient. The story masterfully recreates the uncertainties and power struggles, and the emotional atmosphere, of a psychotherapy in which a central question is: Who is seducing whom? (17 pp.)
The Fairy Godfathers
Patients cast their therapists into diverse and contradictory roles—parent, guide, mediator, healer, friend, confessor, provocateur, spy, voyeur, teacher, guru, advocate, conscience, moralist. Whatever role psychotherapists are assigned, or assume for themselves, their influence is felt between sessions and long after termination, patients create and hang on to multipurpose images of the therapeutic relationship. Sometimes seen as approving, sometimes seen as forbidding, the felt presence of the therapist, in reality and fantasy, shapes patients’ perceptions and may give them a tool to use in their relations with others. “The Fairy Godfathers” portrays just how pervasive therapists’ influence can become. (15 pp.)
The Girl Who Couldn’t Stop Eating
From its inception the “talking cure” has existed on the boundary between science and art. Some gifted psychotherapists, like Robert Lindner, have written “case histories” that are both scientific works of art and artistic works of science. In “The Girl Who Couldn’t Stop Eating,” Lindner challenges the misconception that analysts are, at all times, scientific—objective and emotionally detached from their patients—and demonstrates how psychotherapy can be an experience of engagement, commitment, and caring concern. On occasion, therapists have raw and primitive feelings toward their patients. Some patients, like Laura, would tax any therapist’s emotional maturity and competence and provoke agonizing self-examination. It is these patients who also strengthen Lindner’s view that therapy “is a vital art that demands more of its practitioners than the clever exercise of their brains. Into its practice also goes the heart, and there are occasions when genuine human feelings take precedence over the rituals and dogmas of the craft.” (73 pp.)
It Never Touched Me
Most forms of therapy are premised on the assumption that the acceptance and expression of the contradictory and painful feelings provoked by grief are essential to emotional health. When we choose to forget or deny the legitimate suffering in our lives, we sacrifice our capacity for pleasure as well. In this story the therapist makes an intervention and the patient responds. Her silent associations demonstrate a strangely distanced flood of painful memories, vague fears, and morbid fantasies that must more explicitly be felt in the course of therapy. (13 pp.)
