BookREVIEW: Clinical Implications of the Psychoanalyst’s Life Experience
Steven Kuchuck (Ed)
Relational Perspectives Book Series
Reviewer Brad McLean
Thinking about the ‘blank screen’ of traditional psychoanalysis (and psychotherapy) my mind often goes to the 1939 MGM version of The Wizard of Oz. It is that penultimate point of the drama when Dorothy and her co-travellers meet the Wizard in all his fire and brimstone grandness. It is the point at which confidence swells that their longed-for wishes will be granted. Right at the point of awe and hope Dorothy’s dog Toto finds a green velvet curtain to the side of the room and, in pulling it across, reveals an ordinary silver-haired man pulling machine levers and cranking handles. The diminished, hapless man behind the curtain is working hard to create the illusion of the all-powerful Wizard that everyone expects to see. It is a disappointing moment for Dorothy as the Wizard is unmasked in all his humanness.
“You’re a very bad man,” Dorothy says to the Wizard.
“Oh no my dear, I’m a very good man…I’m just a very bad wizard.”
The scene speaks to the primary danger inherent in maintaining the artifice of the all-powerful therapist (whether forced or not) and the secondary inherent risk of having the artifice unmasked and what that brings with it. For those of us trained in the ‘two person’ approach the idea of hiding ourselves seems an impossible mission; a somewhat grandiose Wizard act that promotes hiding, self-deception and shame. Most of all, by pulling levers and cranking handles we override one of the keys to successful therapeutic work – a real, mutually engaged relationship. However it is easy to forget that not too long ago such masking was inherent in the clinical encounter and, for a diminishing few, it remains so today. Editor Steven Kuchuk’s book is an exploration of the emergence from behind the wizard’s green velvet curtain. It would see that ‘unmasking’ as a clinical inevitability today. Post modern thinking, and its emphasis on individual interpretation and reinterpretation means that no matter what we give or withhold, clients will make of us what they will, regardless of how guarded our self representations are.
As one of the book’s essayists Kenneth A. Frank explains, the reality is that despite everything we might carefully put in place to construct our professional personas, we are always ‘coming out’ in small and subtle ways that can be replete with significance for our clients. There is, he contends, ultimately no way to hide from our real selves as people and as therapists.
And why hide from the truth of the lived experience we bring to our roles as therapists? Can’t it enrich our work? Can’t our subjectivity add rather than take away? Starting with Freud (who changed his mind a few times), dealing with an analyst’s subjectivity has been fraught with challenges. For this reason, very little light has been shone on the sometimes-dark recesses of the lives of therapists and how these lives might inform their work. That is, with only a few exceptions, until now. With contributions from 18 analysts across 288 pages this intimate book invites the reader into the frank and often-vulnerable real life narratives of some of the leading relational psychoanalysts of the day. Trauma, family issues, youth, personality differences, errors of judgment and situational crises are laid out in the pages not in a confessional manner but more to reveal how these experiences inform the theory, practice and orientation of these writers’ clinical work. It is an exposition of how the therapist is a person and how her or his uniqueness makes for better clinical practice. As Kuchuck explains in the introduction: “The therapist’s subjectivity….plays a significant role in the co-construction of the clinical fit and trajectory, though it is seldom examined as carefully as other parts of the work.”
The first of two sections is an exploration of the early life narratives and influential developmental, cultural and family factors affecting contributors such as Suzie Orbach, Joyce Slochower and Eric Sherman (see my previous review of Sherman’s book in Contemporary Psychotherapy*). Slochower describes the experience of growing up a child of two strictly Freudian analysts, Orbach describes family factors that informed a drive to bring secrets out into the open and Sherman offers an insight into what it was like to be the only out gay analytic trainee at his institute in the early 1990s.
Shifting to adult life experiences, the larger second section of the book involves 18 contributions including reflections on social/professional boundary crossing, the role of fathers, loss and separation, illness and old age. The list of prominent contributors includes many leaders in the field such as Michael Eigen, Philip Ringstrom, Eric Mendelsohn and the eminent and only classic Freudian analyst to agree to contribute to the book, Martin Bergmann** who died prior to the book’s release. Bergmann had maintained a 30-hour-a-week practice up until his death at 100 and he writes poignantly in the book, about ageing as an analyst.
Reading this volume will evoke different things for different readers of course but for me it conveyed a feeling of release for the authors; an opening up to something new…to being revealed and stepping out from behind the repression of the blankness of their professional (and now historical training) screens. Kuchuck explains that the volume is not intended to promote direct self-disclosure in any way other than as ‘a valid option to be held in dialectical tension with protecting a patient’s right not to know’ and as an inevitability in the two-person frame. Of course this brings with it challenges for those in the psychotherapeutic world who wish to remain hidden and Kuchuck refers to the work of Lew Aron who has explored how those drawn to the therapy professions may struggle with conflict around intimacy and the desire to be ‘known by another’.
So where is the line that marks the point of safe self-disclosure and how do we know if we have landed on it or, more frighteningly, stepped over it? When is that subjectivity overlaid as a filter that blocks out other important colour and meaning beyond the therapist’s lived experience? What is the cost and what are the challenges we face in keeping the therapy frame while authentically ‘being in it’ simultaneously? These are questions that the professions have and continue to grapple with because the answers are largely elusive given each therapist-client dyad is unique and the individual subjectivities of the two (or more) participants in the intersubjective space created are highly specific.
I think Dorothy would be pleased with Kuchuck’s book. It opens the door and offers permission for therapists to step into the light and do so in the service of both their own development and that of their clients or patients. More importantly for Dorothy, it might mean she meets the real wizard first off (he is a good Wizard after all) and, as the story goes, she gets her wish granted anyway.
Brad McLean is a relational psychotherapist based in Sydney, Australia. He can be contacted at [email protected]
* Contemporary Psychotherapy 5(2) Winter 2013 www.contemporarypsychotherapy.org