Lying on the Couch: A Novelby Irvin D. Yalom
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/em>/em>… See more details below
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.
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
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" Marshalor, 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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