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BookREVIEW: Notes from the Margins

Notes margin imageThe Gay Analyst’s Subjctivity in the Treatment Setting

Eric Sherman

The Analytic Press, 2013
Paperback pp 158

 

Reviewer Brad McLean

Eric Sherman’s book, Notes from the Margins, offers an intimate, profoundly frank and sometimes humorous relational perspective of what it is to be a gay therapist and the unique subjectivities this identity generates.

As the world spotlight increasingly focuses on just how far we have not come, or perhaps how far we have fallen back, in the fight against homophobia, this book also offers important insights into the experience of living in a culture in which one’s identity continues to be a shamed one. He explores this from both the client’s and the gay therapist’s perspectives.

Key to the power of the book is the author’s acknowledgement of the internalized homophobia, shame and alienation that can be at the core of our histories and stories of identifying as queer and how this uniquely impacts the client-therapist dyad.

The book is neatly ‘bookended’ by two chapters. The first explores the nature of subjectivity, the history of how we look at countertransference and the concept of shame. The final chapter revisits theory in relation to sexual identity and other concepts. In between are seven detailed clinical vignettes involving gay and straight clients and the author’s experience of treating them. Separating theory from practice works well as it allows for an intimate storytelling approach to the cases making them highly engaging without theoretical distraction.

Through these vignettes Sherman courageously explores his experiences of the clients such as erotic transference, replication of unconscious S&M dynamics (not physical of course), repulsion in the face of extreme effeminacy in a male client and being enticed into playing a fantasised heterosexual family role with a straight female client. He even falls asleep in one session, a powerful metaphor of how the client interacts with the world. Sherman is not afraid to be frank about the messiness and stickiness that the work entails.

 While these experiences might sound alarming to some, it is important to note that the author is profoundly respectful of his clients and their stories – it is a book full of empathy, critical introspection, caring and kindness. These complex intersubjective experiences are reformulated into rich therapeutic tools as they play out in the conscious and unconscious world of Sherman’s therapy room.

Relationally trained therapists will appreciate the detailed explorations of potent enactments, erotic transference reactions and collusions that are detailed in the pages of this book which, utilized ethically and effectively, prove to be transformative for some of the clients – but not all.

With extraordinary honesty Sherman explains how his own longings, sense of sexual identity, shame and internalized homophobia play out in these stories and how, in the relational model, one has to ‘lean into’ these experiences to move the work forward. Such is the complexity, honesty and insight required of the relational therapist. ‘Owning’ our reactions to clients and being willing to face our own struggles is key to the work. It is not necessarily about sharing these feelings and thoughts with clients as many people often mistake. It is the process of owning them and working through them in supervision that is critical to effective and ethical work. As Sherman explains, countertransference is the arena in which transference comes alive and by using our individual sensitivities we get to know our clients, their unconscious processes, and this leads to therapeutic intimacy. He writes:

 “Since the analyst is a co-participant in enactments, the inevitability of self- disclosure draws him as a person into the relational matrix. This pull creates a powerful here-and-now experience that allows for the possibility of both participants making shifts in their internal worlds and in the inter-subjective space between them.”

He also articulates the truth that it is impossible to keep ourselves out of the therapeutic frame – that we are constantly ‘outing’ ourselves as therapists non-verbally and he talks frankly about the helpful and unhelpful things he does in the course of working with his clients.

 I was moved by many of the accounts in the book and I identified with many of the experiences. I also felt some shame myself for the profession. Sherman notes that it was not OK for gay analysts to be out in the profession until the 1990s. Psychoanalysis and psychiatry regarded homosexuality as a developmental pathology until very recently.

One feature that sets this book apart is that Sherman is a very good writer. On researching him for this review I found out that prior to becoming an analyst he was a journalist, former entertainment editor and interviewer to the stars including Oprah Winfrey. His skills show. So much of what we read in the therapeutic canon is not easy to consume but Notes From the Margins, while technically and clinically sophisticated, stands out for its well-considered structure and intimate informal conversational style.

It is also important to note that this is not a book just for gay therapists or those who see gay clients. Each and every therapist will be able to identify with how some clients evoke aspects of our personal histories, our sense of minority and being outsiders or our own repressions and self-repulsions in one way or another. As Sherman rightly points out, no matter how hard we might try as therapists, our clients are ‘outing’ us in one way or another, every day. As the psychoanalyst Christopher Bollas has written, “in order to find the patient we must look for him within ourselves.” Sherman’s unique book mounts a persuasive argument to support this view. As a gay relational psychotherapist (and former journalist), I highly recommend this book.

Brad McLean is a relational psychotherapist based in Sydney, Australia. He can be contacted at bmctherapy@gmail.com