January non-fiction book of the month: Stephen Grosz' An Examined Life: Read his answers to your Q's.

[RachelMumsnet]

Longlisted for the Guardian First Book Award, a Sunday Times bestseller and Radio 4 Book of the Week, our January non-fiction choice is a set of short stories with a difference: The Examined Life by psychoanalyst Stephen Grosz is based on real-life sessions with his patients. Wonderfully Jargon-free, there are chapters covering a broad range of topics including why we lie, what we fear and how we change.

If you're interested to read and come back and discuss, apply for a free copy. We're also giving you the chance to post a question to Stephen Grosz. All questions must be posted to this thread before the end of January and we'll post up his answers in early February. Everyone who joins the discussion or posts a question will be entered into a draw to win a full set of Vintage books' Shelf help books. Find out more and apply for free copy of An Examined Life.

An interesting book in many ways. However, I feel, as do several other reviewers, that some of the stories are just too short and so much depth and personality analysis has been left out. Many of the difficulties discussed are extremely complex but seem to be glazed over somewhat. On the positive side, this is a book which could have been very heavy going and even morbid but has been written in a very readable and accessible way. I have not quite finished it yet but is an easy read especially as chapters are short.
My question to the author would be: are clients coming to therapists with a much wider range of problems now than in byegone years?

hi. Thanks for this giveaway-something completely new for me as its not the sort of book I normally read. Havn't quite finished it yet though. My question is: were there issues with people being too identifiable from their stories and did many people refuse you permission to feature them?

I also received a copy as part of the giveaway.

Have to agree with Ratarse - I was disappointed. The short chapters made me want significantly more detail but appreciate it would be difficult to get consent to publish lots of information.

I just wanted to know more and think that would have added to my understanding of what makes people tick.

I don't really have a question but I wanted to congratulate you Stephen on an excellent book. I've read it on maternity leave (I am a clinical psychologist), and I found it engaging, beautifully written, profound and very difficult to put down. It wasn't like a 'work' book at all.

I felt the sparse detail about the cases very useful in emphasising the process of the therapy. I'm also assuming it was to preserve confidentiality.

I spend quite a bit of time in my job consulting to non-professionals about the folk that they support. Psychodynamic ideas are often extremely helpful here, but its a huge challenge to communicate these ideas without jargon. Your use of lay language is a great achievement, and I'm sure I will be drawing on your book a lot when I'm back at work. Thank you.

I was lucky enough to get a free copy of this book.I found it interesting and easy reading but as some have said, would like to have known a bit more depth to the stories.

Reading it now and enjoying the format as easy to read a story at a time and enjoying the different problems presented.

I particularly wondered if the author had known the truth about the man with the house in France and if he could provide some suggested answers to the question, ''what are they waiting for?' for those who don't leave the building when the fire alarm goes, as that is the story which particularly resonated with me!

I have received my copy, thank you. I found that, after reading, I was left in a reflective mood, looking at my own behaviour and responses to situations.

Some of the chapters rang more true than others, especially the discussion on closure, reflecting on the nature of grief, and the suggestion that closure is not truly reached in the way often described in the five stages of grief.

As others have said I did find the brevity of each chapter sometimes leaving me unsatisfied and the resulting conclusions seeming a little too neat and trite as a result such a brief summation of months of analysis.

I was intrigued by the emphasis placed on dreams as I didn't realise this was such a key part of psychoanalysis, and I found the insight into the psychoanalysis process in general was very interesting.

My question is how Stephen feel aspects of modern life, such as the use of social media and the internet in place of real life interactions, has influenced mental health?

It's a fascinating and thought-provoking read. My question is, with the way the world has changed and the growth of blogs, social media and selfies, do you think thtis has changed the role of psychoanalysts who try to get people to open up? What do you think Freud would have thought of people sharing every last detail of their lives on internet for all to see?!

I very much enjoyed this book. I'm not sure I have any questions, except to say I was particularly moved by the chapter on how the modern obsession with "closure" and "moving on" when someone has died is misplaced and damaging. Couldn't agree more.

Hi there,

Thanks to everyone who has posted their thoughts on the book, as well as your many interesting questions. We will send your q's to Stephen and will post up his answers in the next couple of weeks.

Thank you so much for a copy of the book! It is an eye opener showing what the lives of people can actually be like. It takes some good time and talking for some people to open up. It also made me realize that the way we relate to our children is very important in helping to shape them to become confident and reliable adults.
All the subjects studied in the book invoked a lot of sympathy from me because they all have something or another not going too well in their lives. All these things almost have their roots int he past. It also showed me the importance of phychoanalysts. It is not an easy job but it is an important one especially when people suffering from things that they themselves don't understand about can be helped to lead a normal life once again.

I however felt that the author can possible add a lot more to the stories already present. This would make it much more interesting.

I enjoyed this book moderately, but not as much as I thought I was going to, so I was a little disappointed.
I found the chapters a bit too short: I would have liked more detail on each case. The author did a great job in summarising the patients' position and the case conclusion, but I would have liked to read a bit of in depth detail on why they came to feel/think that way and if andhow the author got them to change, or whatever happened to conclude the treatment.
Or maybe I have got it wrong and psychoanalysis only tells the patient why they think/feel like that. (genuine question)

One thing that really struck me is how much time is spent in psychoanalysis by each patient. Almost an hour daily/weekly for months or years. I wonder if that is indicative about the type of patient the author sees. I couldn't imagine having that much time to spend on myself, or indeed spending that much time and money on working out why I have my own feelings. Are these people really suffering that much, or ( dare I say it ) are they a bit self indulged and want to have someone listen when they talk. I'm not meaning to underestimate the suffering of anyone with mental illness here, but I am wondering about the personalities of some psychoanalysis patients.

An interesting read cover to cover but I began to grow increasingly frustrated at the summaries of each patient which began to feel somewhat supeficial. I'm not an expert but this seems to be a form of psychoanalysis strongly based in Freudian theory? Emphasis on dream subconscious etc and therefore a little dated? Doesn't more recent thinking (Carl Rogers) focus on more person centred therapy so I was interested whether Stephen Grosz uses this in his work too.

I was also amazed at the time spent - every day??!! How is this practical?

I would have loved to know more about the author's thoughts on each patient. I know it's probably not professional to be judgemental, but the man who only admitted he was gay when he was 70 and then died 2 years later... is this is 'waste' of his life, why did he finally find the strength, did those last 2 'honest' years mean more than the others. Or is this all a pointless exercise in understanding why?

Thanks for the free copy.
I was taken back to the time when I did my first degree in psychology, now nearly 50 years ago. At the time I read dozens of books for 'lay' readers, from Goffman to Laing to Gregory, as a relief from the more difficult academic works and journals. Many of them were about mental health from a non-clinical POV. This book at least shows how far we have moved in those decades, as civil rights and human rights campaigners have extended the limits of what it means to be 'normal' - or at least average.

Re the subjects of these short essays - were any of them seen as NHS patients, or is the huge amount of time spent with them only available to private patients - eg the boy with the 'broken brain'? What's your opinion of the short (and often superficial) treatment techniques eg CBT. Do they just store up problems for the future?

Thanks for all your great questions. We've had the answers back from Stephen Grosz and will post them shortly.

@thecatfromjapan

I've already read this book: it's brilliant. Fascinating, thought-provokind, warm ... just great.

I really wanted to share that!

Is he planning on publishing more?

Also, anyone on this thread who could recommend similar, please do. I'd be very interested. (Thanks in advance.)

And what is Jargo? Is it a character from the newer Star Wars? A typeface? (Do Trills and myself win pedant/proof-reading badges?)

Thank you for your kind words—I’m grateful! I am working on another book. As you know The Examined Life is a book about change and why we find it so difficult to change. My next book is about love—and some of the obstacles we encounter in ourselves; obstacles that can keep us from love.

@Loreleigh

Question for author Stephen Grosz: As a psychoanalyst, do you find the skills used in your work useful in domestic and social situations, or are there times when you consciously have to stop yourself from analysing a person or situation?

I am also interested to know how long a book dealing with such complex issues took to write?

I hope I've posted this in the right place, and that it qualifies for entry into the competition.

Thank you, Loreleigh, good question. One of the things I try to do in The Examined Life is to show a way of thinking that I hope will be useful to readers—and yes, I’ve found it useful in my life. The fact is, you can’t psychoanalyse friends and family—it just doesn’t work that way. But if a friend is always late, or repeatedly cancels at the last minute, I’d find it hard not to think that unconsciously she doesn’t want to meet-up.

The relationship I have with patients is different from the relationship I have with family and friends. Being a psychoanalyst is part of my identity, it’s who I am, and it shapes and informs my relationships with people. But I have a clear sense of the difference between ‘Mr. Grosz’ the analyst, and my life outside of the consulting room. When I’m with my children, I’m simply Dad.

Q2: A long time! It’s my first book (I’m sixty-one years old) and I thought about it over many years. I’ve spent more than 25 years—50,000 hours—with patients, and it took me time to work out what I’d learnt. I wrote, and I re-wrote, many times. I wanted The Examined Life to be heartfelt, true, honest, and this took me time.

@MrsPennyapple

I'm very interested in reading the book, I have never read anything like this though, so my question might be a load of rubbish.

Stephen: Do you ever find that you react to / view situations in your own life differently, beacuse of issues that your patients have discussed with you? Like considering viewpoints / factors you might otherwise not have thought of?

Absolutely, I learn from my patients and the work that we do. One of the things that I tried to convey in The Examined Life is how much psychoanalysis is about the work that the patient and analyst do together.

In my book, I tell a story about a Jewish woman, who I call Abby. Her father rejected and disowned her because she married a Catholic man; many years later, she discovered that her father had, in fact, been having an affair, all along, with a Catholic woman. ‘And then I got it,’ Abby said to me, ‘the bigger the front, the bigger the back.’

Psychoanalysts call this ‘splitting’. Splitting is one way we have of getting rid of self-knowledge. When Abby’s father cut her off, he was trying to cut himself off from those hateful aspects of himself that he could not bear.

I prefer Abby’s phrase ‘the bigger the front the bigger the back’—it’s more telling than the psychoanalytic term. Splitting is thinner, less dynamic; it suggests two separate, disjointed things. Abby’s saying captures the fact that front and back are a part of each other.

Ever since hearing Abby’s story, whenever I hear about a family-values politician who’s caught with his pants down, or some homosexuality-is-a-sin evangelist found in bed with a male prostitute, I think—‘the bigger the front, the bigger the back’.

So yes, my patients have changed – and do change – how I think.

@sumac

The author is very skilled at distilling his patients' experiences into short summaries and the lack of jargon (which is usually inevitable when professionals discuss mental health) is impressive.

The real life stories are interesting to read, so are the author's insights. However I found the stories a bit too smooth, with all the rough edges gone, making them curiously unemotional.

Question for the author: you make a strong case for the value of psychoanalysis. But do you feel annoyed/sad/frustrated that many who could benefit will never get to experience it due to cost, and will be offered by the NHS, a short course of cognitive behavioural therapy (CBT), or nothing at all?

You’re right, I do think psychoanalysis can make a huge difference to people’s lives. But, as you say, it requires both time and money. Part of my reason for writing The Examined Life was to try to make available some of the things I’ve learned that may be helpful to those who can’t have an analysis.

Anyone concerned about their mental health should always go to their GP. Your GP can help you to better understand your situation and, if necessary, refer you to the appropriate mental health specialist.

There are a number of different forms of therapy available on the NHS, and these will vary from place to place. I do have some frustrations with how things are; for example, I think it’s a shame that it can be difficult to find a psychoanalyst or a psychoanalytic therapist in some parts of the country. There are lots of reasons why psychoanalysis or psychoanalytic psychotherapy isn’t more widely available; analysts are partly to blame for this.

There are some places where psychoanalytic psychotherapy is available within the NHS. And there’s a clinic, the London Clinic of Psychoanalysis, where psychoanalysis is available at a low fee, on a sliding scale. In addition, many analysts see one or two patients at a low fee.

The London Clinic of Psychoanalysis offers consultations and assessments for psychotherapy and psychoanalysis. To find out more contact: Trudy Turmer, Clinic Administrator, +44 20 7563 5002, [email protected]

The British Psychoanalytic Council website also has a register of psychoanalytic practitioners. www.psychoanalytic-council.org/find-a-therapist

@Highanddry

I received the book, my first book giveaway success.

I certainly found it compelling and difficult to put down. Stephen Grosz writes really well and is a great storyteller. I got through the book very quickly.

For me the short story format was both a good and bad thing. On the good side it made the book addictive as I just wanted to read one more story. One the bad side it also made it quite unsatisfying. I would start to get to know the characters and get involved with their stories and the events and then suddenly it would be the end. Every time I got to the end of a story it felt like a bit of a wrench as I had to put down those characters, just as I felt I was getting to know them, and start a new story with someone else. I think knowing that they were based on true stories made it easier to empathise with the people. I was always left wanting to know more about what happened afterwards.

Often when I got to the end of the story I felt that although the behaviour had been explained or highlighted, somehow the answers were still out of reach and I wasn't sure what conclusions I was suppose to take away from it.

I think I was expecting something a bit more self-helpish dealing with things in black and white. Maybe the point is that there are no nice, easy firm conclusions or totally happy endings in real life and that everything is actually grey. Everyone has their own issues and it is about understanding them and working with them.

My question to the author is - there were some stories where the behaviour was quite extreme but lots of them were about issues hidden behind more "normal" behaviour. Do you think everyone has issues they are not aware of which could benefit from psychotherapy or it should be used only if they are experiencing problems?

I think all of us can benefit from thinking about our lives and the lives of those we love; part of being human is that we are self-deceiving, and that there are aspects of ourselves that we keep from ourselves. I love this quote from Michel de Montaigne’s Essays ‘There is as much difference between us and ourselves, as between us and others.’

But that doesn’t mean that everybody needs or should have psychoanalysis. Patients come to see me because they’re in pain—more often than not they’re suffering. Usually part of their pain is that they can’t articulate it—they are trapped inside a story that they cannot tell. My work is to try to listen for that story and to help the patient to tell it. Psychoanalysis is difficult, it takes time, it involves encountering painful emotions and ideas; it is not something to embark on lightly.

@snice

hi. Thanks for this giveaway-something completely new for me as its not the sort of book I normally read. Havn't quite finished it yet though. My question is: were there issues with people being too identifiable from their stories and did many people refuse you permission to feature them?

I took great care to protect my patients’ confidentiality in The Examined Life. This is something that psychoanalysts learn to do when writing up case studies; learning how to protect confidentiality while preserving the core of the patient’s story—it’s part of the training.

I changed all names and altered any identifying details. But at the same time, I wanted to write these stories in such a way that I could protect the patients’ privacy without distorting the nature of our work together. In all of the stories I made significant changes – changes to gender, for example – without in any way altering the core of the story. Where possible I showed a draft of what I’d written to the patient and invited them to make comments; all were willing to share their experiences, and many expressed the hope that their story would help others.

@SannaM

I also received this book as a prize - thank you! I am about half way through the book and what has struck me most is how easy it is to judge people on their actions and yet to realise what can be behind them can change my perspective on the person. My question to Stephen is: Does the insight into why the person does something generally change their actions going forward i.e. give them the freedom of choice going forward? E.g.Does the compulsive liar take a different path once he realises why he's doing it? I would have been/am interested in an insight into the changes brought about by the therapy revelations and what this changed in their lives.

Change is difficult for many reasons. ‘I want to change, but not if it means changing,’ a patient once said to me in complete innocence. Sometimes we feel trapped within our own lives. We want to change; but we resist it. One reason that people resist change is that all change requires loss—there can’t be change without loss. This can be hard to see, and even harder to accept.

Psychoanalysis is not about persuading a patient to change, but about asking the right questions to help the patient to discover what is holding them back from change. I try to help my patients think in a new way, so that they can act in a new way.

Thank you Stephen, I really enjoyed your book- in fact, I read it in one weekend as I found it so captivating. I'm going to go back now and read it more carefully. Your answers are very thoughtful. Thank you for coming on Mumsnet.

I realise I'm a bit late coming back to this, but thank you to Stephen for answering my question, this has been an interesting thread.

I read this book sometime ago (when it first came out) I thoroughly enjoyed reading it and was sad when I finished it (I mean I wished there was even more of it )