With “The Examined Life,” British psychoanalyst Stephen Grosz has condensed 25 years of treating patients into a collection of short-story-like case studies that have the pace and intrigue of Sherlock Holmes tales. A bestseller in the U.K., the book offers a panoramic of human psychology while at the same time honing in on eccentric peculiarities. In this exclusive Q&A, Grosz describes what analysis has to teach us about parenting, intimacy and storytelling, and names the notables whose minds he’d most like to explore.
Bookish: Your book is a collection of short stories about patients, and storytelling plays role in your therapeutic approach, as well. Describe the relationship between narrative and psychoanalysis.
Stephen Grosz: The people who come to analysis are in great pain, and usually part of the pain is that they can’t articulate it well. They don’t have a way of telling it. Often, the most important stories of our lives are about some of the most difficult things that no one helped us to find the words to describe. [In analysis,] you try to hear [the patient’s] stories and work out what’s going on. All the highfalutin psychoanalytic language—which is not in my book—is, to me, a diversion from the directness of literature—hearing people’s stories, and trying to put that story as clearly and as plainly on the page as possible.
Bookish: Was it your aim, in writing “The Examined Life,” to help people?
SG: The best thing a book can do to help us feel a new thing or think a new thing. One of the reasons I love Andrew Solomon’s book, “Far From the Tree,” [is because] I have not met one person who’s read that book and not changed how they thought. I tried to write things that would change how people think. The issues I chose had a kind of urgency, because they are the things my friends and I talk about, my wife and I talk about, my children and I talk about, my patients want to know about. They are the most pressing problems. I felt I had something to say about them, or that the patients had taught me something that I wanted to show.
Bookish: Are the patients described in the book aware that you wrote about them?
SG: Not in every instance—a couple of patients have died. But, wherever possible, I gave the patients the pieces and they read them and made comments. They were all happy with them.
Bookish: Do you ever find it difficult to empathize with a patient?
SG: Forensic work was extremely difficult. I saw people who were rapists, murderers and child abusers. I did it for seven or eight years, and then I decided I would prefer to do something else. But it did help me to train and perhaps do better with the more “ordinary” patients that I see, who can nevertheless be very difficult.
Bookish: Do you ever continue your relationship with a patient after you’ve stopped treating them?
SG: The patient I write about in “Through silence” came to see me in 1989. He had been diagnosed as HIV-positive at a time when there were no treatments, and he was told that he had two years to live. I’m still in contact with him. We are very close, but the formality of our relationship is also very important to us. I feel—and I’ve said this to him, and he believes it’s true, too—that our relationship is more intimate than with any friend. It’s not a friendship. It’s just a very powerful professional relationship.
Bookish: Have you had any experience with patients who didn’t understand that professional boundary, or who had trouble maintaining it?
SG: There’s a tension at the core of analysis, which is: How to be really intimate, but not physically intimate. One of the difficult things about, say, a patient with whom the analyst shares a sexual attraction, is not so much that the analyst will behave badly, but that they’ll put themselves at a distance in order to not feel excited. You have to let yourself get really close and not be frightened of those sorts of feelings. I have confidence that I will always be Mr. Grosz; “Your session is at 10 a.m.” I’ve done this almost 30 years and that’s how it’s always been and, I presume, how it always will be.
Bookish: There’s a myth that psychoanalysts don’t bring their own feelings into sessions. But, at many points in the book, you report feeling uncomfortable, interested in or bored with a patient. How do your own emotions play into your work?
SG: We [analysts] use our feelings as facts. In [ “The Examined Life,”] there’s a chapter about a boring patient. That person actually had a really interesting life. But they found a way of removing all interest so that the atmosphere was so dry and intolerable. That was useful [to me] because that was his complaint outside of the room, too. I have to feel the thing that he is making other people [in his life] feel. It’s then the beginning of an inquiry [into] myself. I can start thinking: What is he doing to make me feel so bored?
Bookish: Many of the patients in your stories develop psychological issues as a result of the way they interact with their parents. What advice would you give to readers of your book who are parents?
SG: At the beginning of the book, I give a quote by Simone Weil [about two prisoners who communicate by tapping on the wall between them]: “The wall is the thing which separates them, but it is also their means of communication. Every separation is a link.” We are always arriving at impasses [with our parents and children]. The trick is to use that impasse to communicate, and to radically interrogate yourself: Why do I refuse to become closer to the person I’m speaking to and engaging with? I don’t think there’s a day with my son or daughter where I haven’t made mistakes. But you’re always trying to think: How can I make it better, and what is it about?
Bookish: You practice psychoanalysis in Britain, but were raised and educated in the U.S. Is there a difference between the ways American and British psychoanalysts practice?
SG: [In Britain] we have the National Health Service, and people go to their general practitioner and will be referred [to an analyst]. Within the health service, there has been for a long time psychoanalytic psychotherapy available. In London, there’s a clinic, the Institute of Psychoanalysis, where you can get psychoanalysis at a very low fee, [on] a sliding scale. And most analysts of my generation continue to see one or two patients at a very low fee—if not pro bono [in addition to their other patients]. So, there’s a lot more access [to psychoanalysis in Britain]. I think, because of insurance and health care and all the ways things have changed here [in the United States], it’s disappearing.
Bookish: There are number of alternative approaches to mental health—such as the Buddhist practices of mindfulness, meditation and yoga—that have grown in popularity in recent decades. As an analyst, do you find those approaches to be valid?
SG: Buddhists have been thinking about the mind for about 2,000 years. They probably have something to teach us. It’d be silly not to be interested in all those things.
Bookish: Are there similarities between the goals of, say, mindfulness and those of analysis?
SG: I think there are similarities: being present, being in the here and now. The boring patient [was someone] who refused to let the present matter. In another one of my stories, a woman is so caught up in the future that she’s stuck in a terrible relationship. If a patient can be one-on-one with me in the consulting room, and I can bring them to the present and show them how they’re avoiding it, that may be a way of helping them to achieve the same end [as mindfulness].
Bookish: What made you want to be a psychoanalyst?
SG: [I was always] trying to understand certain atmospheres in my family that I couldn’t get a grip on. My father had come over [from Europe just before the Holocaust and] lost most of his family. [He displayed] discomfort about certain subjects and talking about certain things. I have a story in the book, “Going back,” which really centers on him walking away from any moment of emotion. Well, I have a career where I now sit in a room with people [discussing emotions], and they don’t walk away and I don’t walk away.
On a less personal note: My brother, while at Berkeley in the 1960s, sent me a very ’60s pile of books: Freud, Dostoyevsky, Erving Goffman, R.D. Laing. [I became interested in] the idea that you could live a whole life and not know your true nature. I wanted to read everything about that split between the parts of ourselves we know and the parts of ourselves we want to know.
Bookish: Can someone be a good therapist if they have unresolved issues of their own?
SG: Short answer: no. Analysts do have problems. They have patients who are brighter, smarter and better looking, or who are making more money or doing better in the world than they are. Sometimes you help a patient to resolve a problem in their life you have been unable to resolve in your own. But, I don’t think a person with a real serious core problem can be an analyst. You have to be able to unhook yourself from your place in time.
Bookish: Who are some of the great figures in psychology you admire?
SG: Freud was important [to me]. I’ve always loved James Strachey’s writing. Winnicott is a great analyst. I love Christopher Bollas’ writing—he was a Melville scholar at Berkeley, and then became a fantastic analyst.
Bookish: What famous figures do you wish you could analyze?
SG: I would have loved to analyze Nabokov. Just to spend an hour a day with him—his mind—would have been a privilege. Obama, too—any kind of great political character. There’s a mystery [to] how someone becomes the person that they are.
Stephen Grosz is a practicing psychoanalyst—he has worked with patients for more than 25 years. Born in America, educated at the University of California, Berkeley, and at Oxford University, he teaches at the Institute of Psychoanalysis and in the Psychoanalysis Unit at University College London. He lives in London. His stories have appeared in the Financial Times Weekend Magazine and Granta. A Sunday Times bestseller, “The Examined Life” is his first book.