Lying on the Couch: A Novel

Lying on the Couch: A Novel

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by Irvin D. Yalom
     
 

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From the bestselling author of Love's Executioner and When Nietzsche Wept comes a provocative exploration of the unusual relationships three therapists form with their patients. Seymour is a therapist of the old school who blurs the boundary of sexual propriety with one of his clients. Marshal, who is haunted by his own obsessive-compulsiveSee more details below

Overview

From the bestselling author of Love's Executioner and When Nietzsche Wept comes a provocative exploration of the unusual relationships three therapists form with their patients. Seymour is a therapist of the old school who blurs the boundary of sexual propriety with one of his clients. Marshal, who is haunted by his own obsessive-compulsive behaviors, is troubled by the role money plays in his dealings with his patients. Finally, there is Ernest Lash. Driven by his sincere desire to help and his faith in psychoanalysis, he invents a radically new approach to therapy -- a totally open and honest relationship with a patient that threatens to have devastating results.

Exposing the many lies that are told on and off the psychoanalyst's couch, Lying on the Couch gives readers a tantalizing, almost illicit, glimpse at what their therapists might really be thinking during their sessions. Fascinating, engrossing and relentlessly intelligent, it ultimately moves readers with a denouement of surprising humanity and redemptive faith.

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Editorial Reviews

Los Angeles Times
If Freud or Jung has sent out to write a psychoanalytic thriller, I doubt that either one could have come up with a yarn as taught and telling as Lying on the Couch, a dazzling psychiatric whodunit by one of the leading theorists and practitioners of psychotherapy in our own times.
San Francisco Chronicle
His insight into his own profession is sharp and merciless, recalling both Oliver Sacks and Studs Terkel. This is a novel for anyone who wants to know how the mind of a psychotherapist really works.
New York Times Book Review
Raises important questions about truth-telling on both sides of the couch.
American Journal of Psychiatry
Every therapist who reads this book will identify with the struggles of its protagonist while having a marvelous time with a colorful cast of characters who come alive in the hands of a superb craftsman.
Publishers Weekly - Publisher's Weekly
A willingness to confess to his various mistakes in the course of treating patients made Dr. Yalom's 1989 nonfiction bestseller, Love's Executioner & Other Tales of Psychotherapy, endearing, but one hopes that this satire of the Bay Area psychiatric industry is not another mea culpa in disguise. The two psychiatrists at the center of Yalom's second novel (after When Nietzsche Wept) find themselves entangled in situations for which their clinical training could not have prepared them. Dr. Ernest Lash, who is, in fact, extremely earnest and given to wearing earth shoes and stained ties, decides to experiment with a new, more intimate therapeutic approach, unwittingly playing into the hands of Carol Leftman, a patient determined to ruin his professional reputation because he had encouraged her husband to leave her. Meanwhile, Ernest's former supervisor, the ambitious, self-important Dr. Marshal Streider, is fleeced by a charismatic con man masquerading as a patient. For help, Marshal turns to a lawyerthe very same Carol Leftman who's dogging Ernest. For both Marshal and Ernest, then, the absolute honesty they demand during the therapeutic hour is at odds with the professional ethic of confidentiality that binds both lawyers and shrinks. Yalom is exploring the jungles of what Ernest calls "wildcat therapy," in which therapists are unable to maintain the Olympian mantle of clinical disinterest in encounters with their patients. Whether this is good medicine or not, Yalom doesn't quite say. As absorbing as it is, the novel presents the moral or professional blunders of the analysts as the acceptable price of doing business. $50,000 ad/promo; author tour; Rights: William Morris Agency. (Aug.)
Library Journal
It's laudable when a person successful in one field tries a hand at another, but based on his sophomoric second novel (following When Nietzsche Wept, Basic, 1992), Yalom shouldn't give up his psychiatry practice to write fiction. Yalom limns the lives of a group of whining psychoanalysts as they variously cope with accusations of sexual misconduct, fall victim to con men, deal with issues of counter-transference, and come under suspicion by their colleagues for false interpretations of Freudian theory. Dr. Ernest Lash, the novel's hero, abandons his psychoanalytic training and develops a new type of therapy in which he attempts to establish an honest and authentic relationship with his patient, offering advice and support rather than limiting his discourse to interpretations of the patient's dreams and feelings. Therapy veterans and those readers who enjoyed Yalom's nonfiction (e.g., Love's Executioner & Other Tales of Psychotherapy, LJ 8/89) may start this novel, but its disjointed style and cardboard characters will fast discourage them from finishing it. Not recommended.Nancy Pearl, Washington Ctr. for the Book, Seattle
Katharine Whittemore
The therapy hour is designed to be a temple of honesty, says one of the characters in Lying on the Couch, flagging the capital-I irony of the title of Irvin Yalom's new novel. Among other things, this entertaining book is a real fib-fest. Patients dissemble, therapists don't own up and by imposing narrative neatness on psychological messes, Yalom (a Stanford psychiatrist in real life) plays into the deception, as well -- anyone who's been in therapy knows how opaque it all really is. There's nothing muddled about Lying on the Couch, however. The story streams along brightly in Yalom's second novelistic foray -- he's best known for Love's Executioner (1989), a nonfiction book that offered moving vignettes from his own practice -- even if the prose occasionally eddies in cliches.

The plot concerns San Francisco shrink Ernest Lash, Yalom's stand-in, and Lash's supervisor, Dr. Marshal Streider, plus several of their patients. One is bent on tricking Lash into a license-losing sexual transgression, another is a compulsive gambler who plays into Streider's obsession with money and status. (It's not surprising that Streider is a strider; Yalom loves significant monikers. Ernest Lash lashes himself with self-doubt, though he is very earnest. A patient who feels rage toward men is dubbed Leftman.) Lash is the iconoclastic good guy who believes in revealing himself to the patient; Streider is the old-school bad guy who thinks flaky Ernest is "therapeutically incontinent."

The forbidden candy offered by all of this, of course, is that we patients/readers get to eavesdrop on other people's sessions, and see things from the therapist's perspective -- both impossibilities in real life. There's plenty of transference and counter-transference along the way, plus nice set pieces on dream therapy and other fun tropes. Therapists are wounded when their patients progress without their help; patients resent their therapist's airs of all-knowingness. When Dr. Lash counsels Carol Leftman in one session, for example, Yalom nicely punctures the doc's pretensions: "Carol tried to nod in rapt agreement. Oh how brilliant, she thought. Shall I genuflect?"

To his credit, Yalom also serves up plenty of shrink-sensitive topics -- petty infighting within the psychiatric governing associations, the role of money in treatment, the narcissistic wound therapists feel because no one sees their work but their patients. "Nothing is worse than living the unobserved life," as Streider reflects, in a narcissistic twist on the old truism. Yalom has solved that problem; it doesn't take a genius to figure that this book is based on his own practice. As such, there's more than an air of self-serving to the whole enterprise. As the author writes, "Ernest realized he must focus not on content but on process -- that is the relationship between patient and therapist. Process is the therapist's magic amulet." Yeah, plus it moves the plot along, and makes the therapist the dispenser of cures. Which is why, in the end, Lying on the Couch is truly fiction. --Salon

Kirkus Reviews
The author of the nonfiction Love's Executioner & Other Tales of Psychotherapy (1989) and the novel When Nietzsche Wept (1992) now takes up the most vexing issue facing psychiatry: the boundaries of treatment.

Yalom begins with the story of Seymour Trotter, an unconventional therapist who has had a long sexual involvement with a female patient 40 years his junior. His testimony troubles Ernest Lash, the San Francisco practitioner serving on the ethics panel that will ultimately drive Trotter from the field, because Trotter's techniques appear to have delivered the woman from her borderline world of promiscuity and self-mutilation. Some years later, one of Ernest's patients, a timid, obsessive man, leaves his wife for a younger woman. The jilted wife, Carol, a ruthless lawyer, blames Ernest and hatches a plot to ruin him by becoming his patient and seducing him. Ernest is single, lonely, and mightily tempted, but he is also conscientious and honest, and begins to see through Carol's nearly airtight story. Carol becomes a true patient and confronts the fears that have tortured her. And sex is not the only tricky boundary that Yalom explores. In a nice twist, Ernest's analytic supervisor, Marshal Streider, an upright, formal man who feels Ernest's commitment to complete honesty is naive, enters into an investment with a con man passing as a patient. The con man reads Marshal's vulnerabilities perfectly: excessive ambition and love of money. Marshal, raging, friendless, unable to consult with another practitioner, pours out his soul to a lawyer, Ernest's patient Carol. The student teaches the master as Carol, without violating her confidences, draws therapeutic strategies from Ernest and "treats" Marshal—or, rather, forces him to treat himself.

A marvelous examination of how psychiatrists actually think, building to a vision of a community healthy and mature enough to confront its deepest and most persistent fears.

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Product Details

ISBN-13:
9780060928513
Publisher:
HarperCollins Publishers
Publication date:
07/28/1997
Series:
Harper Perennial
Pages:
384
Sales rank:
230,798
Product dimensions:
5.31(w) x 8.00(h) x 0.86(d)

What People are saying about this

David Lodge
"A witty, gripping and hugely entertaining novel from which the reader effortlessly learns a great deal about the theory and practice of psychotherapy."

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