Should You Leave? A Psychiatrist Explores Intimacy and Autonomy and the Nature of Advice

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A writer who presents his vast knowledge of psychiatry with the art of a novelist, Peter D. Kramer imagines scenarios in which he addresses a series of advice- seekers. Each "session" not only reveals the various styles of giving advice - from Freudian psychoanalytic techniques to Ann Landers' application of conventional values - but probes the complexities of human relationships: How do we choose our partners? How well do we know them? How do mood states affect our assessment of them and theirs of us? When ...
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New York, NY 1997 Hard cover New ed. New in new dust jacket. Sewn binding. Cloth over boards, index. 320 p. Audience: General/trade. An intelligent and revealing exploration of ... the modern self through the prism of marriage and committment, which is surely the most crucial of relationships. Questions raised and considered about the self lead to questions of our cultural norms...is it possible we are over-valuing autonomy and assertiveness at the expense of intimacy? No easy answers given. A provocative book that make one ponder and less likely to give in to pat answere. Read more Show Less

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Should You Leave?

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Overview

A writer who presents his vast knowledge of psychiatry with the art of a novelist, Peter D. Kramer imagines scenarios in which he addresses a series of advice- seekers. Each "session" not only reveals the various styles of giving advice - from Freudian psychoanalytic techniques to Ann Landers' application of conventional values - but probes the complexities of human relationships: How do we choose our partners? How well do we know them? How do mood states affect our assessment of them and theirs of us? When should we work to improve a relationship, and when should we walk away? What does "working on a relationship" entail? Kramer's questions lead to a reconsideration of our culture's norms - and to a suggestion that we may have begun to overvalue autonomy and assertiveness at the cost of intimacy and connectedness.

"The author of Listening to Prozac now investigates the dynamics of troubled or confusing relationships...explores how people choose partners and explains how to tell if a relationship is worth working on or if it should end."

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Editorial Reviews

Christopher Lehmann-Haupt
A tour de force of analytical insight...moving and edifying.
The New York Times
Wall Street Journal
A thinking person's self-help book.
Publishers Weekly - Publisher's Weekly
Those who read Kramer's 1993 bestseller, Listening to Prozac, won't be surprised to find him occasionally flying the Prozac colors again in his latest, a self-described "odd hybrid of fiction, non-fiction and self-help." But Kramer generally limits his discussion of psychopharmaceuticals in this fascinating philosophical and psychological study of what makes relationships thrive or wither, concentrating instead on fictional case histories and an exhaustive review of 19th- and 20th-century theories of intimacy and community. When it comes to love, Kramer, a Brown University psychiatry professor who also has his own private practice, is a frank, but not unambivalent, advocate of sticking it out. He argues that couples who were compatible enough to commit to each other in the first place are probably well enough matched to succeed in the long haul as well, albeit not, in some cases at least, without some serious interpersonal spadework. In this he takes issue with the contemporary premium on autonomy, whose varying levels of boosterism he examines in everyone from Ralph Waldo Emerson, Sren Kierkegaard and Ann Landers to such analysts as Murray Bowen, Carl Rogers and Leston Havens. He also looks at some proponents of connectivity, including philosopher Stanley Cavell, analyst Carl Whitaker and 1970s feminist psychoanalyst Jean Baker Miller, who argued that "autonomy is a delusion." Even Kramer's excessive handwringing over both the inherent tackiness of relationship manuals and his profession's historic censure of advice-giving can't dilute the pleasure to be had from this thoughtful, finely nuanced work. Kramer is that rare psychoanalytic theorist who is as comfortable invoking Tillie Olsen as Freud, and his composite case histories have the verisimilitude and insight that is the hallmark of the best and truest fiction.
Library Journal
You've had enough or so you think. But should you really leave? Kramer, author of the best-selling Listening to Prozac, examines how people seek an answer to this crucial question of the heart. Along the way he offers great insights into the human condition and helps the reader to understand why we each do what we do about interpersonal relationships on the brink of a breakup. The book is concerned with more than just answering the title's basic question. It also delves into the intricate and complicated issue of psychotherapy and advice itself. Kramer contemplates the role of the therapist as well as the unspoken law against offering advice to his clients. Written with a keen ear for narrative, this nonfiction title reads more like well-written fiction: smooth as silk. -- Marty Dean Evensvold, Magnolia Public Library, Texas
Library Journal
You've had enough or so you think. But should you really leave? Kramer, author of the best-selling Listening to Prozac, examines how people seek an answer to this crucial question of the heart. Along the way he offers great insights into the human condition and helps the reader to understand why we each do what we do about interpersonal relationships on the brink of a breakup. The book is concerned with more than just answering the title's basic question. It also delves into the intricate and complicated issue of psychotherapy and advice itself. Kramer contemplates the role of the therapist as well as the unspoken law against offering advice to his clients. Written with a keen ear for narrative, this nonfiction title reads more like well-written fiction: smooth as silk. -- Marty Dean Evensvold, Magnolia Public Library, Texas
Kirkus Reviews
Not only is this a stunning and moving look at the many-layered complexities of intimacy, it is also a neat literary trick. In the wake of his hugely successful Listening to Prozac, psychiatrist Kramer was tempted to join the parade of psychotherapists who write books of advice; his would deal with the question of when to leave a troubled relationship. Instead, he has written a much bolder book that uses the tools of the advice trade while showing up their shortcomings. Addressing the reader as "you," he also recalls the style of postmodern fiction—and indeed, that is what his admittedly fictive case histories often read like, as he presents the basic facts of a case, then recasts them over and over in various theoretical and therapeutic molds, each perspective leading to a different possible outcome in terms of what advice he might offer. Drawing on the work of Harry Stack Sullivan, Jean Baker Miller, and other theorists, he examines the poles of autonomy and intimacy, betrayal and trust, identification and differentiation as they affect relationships. A Jewish man marries a Catholic woman; they agree they will not raise their children in either religion; years later the wife decides their daughter must be taught the catechism. Should he leave? A husband and wife were high school sweethearts, brought together by the unhappiness of their family lives; but her new creative and successful career is fortifying her while her husband begins to whine and then almost takes a lover. Should she leave? In the guise of trying to give advice to the people in these and other cases, Kramer simultaneously explores the near-impossibility of giving advice: People are ultimatelyunknowable, their situations too complex, the therapist blinded by his own biases. Beautifully illustrating the passion, curiosity, intellect, and sensitivity therapists bring to their work, Kramer has produced a tour de force, a book of non-advice more illuminating than any how-to could ever be.
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Product Details

  • ISBN-13: 9780684813431
  • Publisher: Scribner
  • Publication date: 9/1/1997
  • Edition number: 1
  • Pages: 320
  • Product dimensions: 6.47 (w) x 9.58 (h) x 1.07 (d)

Interviews & Essays

On Tuesday, September 9, barnesandnoble.com welcomed Peter Kramer, author of SHOULD YOU LEAVE?.


Moderator: Welcome to the barnesandnoble.com Live Events Auditorium. Peter D. Kramer, bestselling author of LISTENING TO PROZAC, is joining us online to discuss his latest book, SHOULD YOU LEAVE?Thanks for coming online tonight to discuss SHOULD YOU LEAVE?, Dr. Kramer. Welcome!

Peter Kramer: Thank you for inviting me online.



Tracey from New York City: Hello, Dr. Kramer. I read your Wall Street Journal review today. Congratulations. Why did you decide to use fictional case studies in SHOULD YOU LEAVE? Do you think that compromises the effect of your book? Were these characters based on real cases of yours?

Peter Kramer: I wanted to use the techniques of fiction, for a number of reasons. First, I think that of all our narrative forms, fiction best expresses the ambiguity and particularity of interpersonal dilemmas. Second, the use of fiction mirrors a perspective that is often useful in psychotherapy, namely the "fictive attitude," in which a patient's story is doubted and an alternative story is offered, providing an alternative perspective. Sometimes the fictive attitude is also useful in relationships, when one treats one's own viewpoint skeptically. Third, I think fiction takes certain pressures off the writing -- the therapist does not have to worry about exposing patients or exploiting them. The Wall Street Journal review faulted me for indicating only late on that certain characters are fictional; for the most part, I believe that the style of the book makes it clear that the vignettes are fiction. I will say more about this later.



Tracie from Erie, Pennsylvania: Hello, Peter Kramer. Why did you decide to concentrate on relationships after the success of LISTENING TO PROZAC?

Peter Kramer: I suppose that most writing is what psychoanalysts call overdetermined many different forces point in one direction. But I think a key motivation was my response to my patients. In part, LISTENING TO PROZAC arose from my sympathy with people who are melancholic, loyal, sentimental and under-rewarded by society. SHOULD YOU LEAVE? deals with similar people -- those who may want to stay in relationships even when the social consensus is that they should leave. Can a person be less assertive and self-reliant than self-help columns demand we all be? So this question allows me to comment on cultural issues of importance to me. Also, when a psychiatrist writes a bestseller, he is next asked to write a book of advice. I wanted to fiddle with that request -- to see if I could take it seriously and lightly at the same time. The question -- leave or stay -- is both personal and profound. It informs screwball comedies and Anna Karenina.



Sam from Los Angeles: Hello, Peter. If I have a particular problem with my relationship, what sort of advice can I hope to get in SHOULD YOU LEAVE?

Peter Kramer: SHOULD YOU LEAVE? approaches advice at a number of levels. It asks what conventional advice is and where it comes from Where do we get the values that are expressed in self-help? And where do we arrive at the practical solutions? To a large degree, I focus on psychotherapy as it has evolved in America over the past half-century. As a result, readers get a variety of perspectives to apply to a given dilemma. How would different serious thinkers approach the problem of separation or reconnection? I do give specific answers to the dilemmas exemplified in vignettes, but I may also undermine these answers, trying to make sense of how hard real choices tend to be.



Moderator: If you are just joining us, Peter Kramer is online discussing SHOULD YOU LEAVE?A PSYCHIATRIST EXPLORES INTIMACY AND AUTONOMY -- AND THE NATURE OF ADVICE. To ask Dr. Kramer a question, click on the red Submit Question button on the left of the screen and type away! Enjoy the chat.

Peter Kramer:



Bob from Atlanta: What sorts of relationships are covered in SHOULD YOU LEAVE? Is everyone married? Is everyone straight? Who is this book written for? Thank you for taking my question, Dr. Kramer.

Peter Kramer: Here is the structure of SHOULD YOU LEAVE? A mentor learns that I am considering writing a book of advice. Believing that a psychiatrist should always focus on specific dilemmas of intimacy, the mentor arranges to have an unknown person consult me. I then imagine who the person might be and how I might respond. You can see why I believe most readers will understand that the vignettes are fictional. Not all the consultees are married, but all are in long-standing relationships that it would be painful to leave. All are heterosexual -- although there is one case where, stretching the imagination, one could imagine the couple to be gay. In most of the cases, children are not involved. I am trying to get at the essence of the heterosexual relationshipWhat makes a good match? What is exploitive? When does loyalty play a role? And so on. Most of the same considerations would apply to gay couples, but I have not worked with gay couples.



Baxter from Columbus, Ohio: What do you mean by autonomy? You use it throughout SHOULD YOU LEAVE? and I'm not so sure I'm clear about what it means. Why do you think that society's focus on autonomy has affected our ability to relate?

Peter Kramer: I am trying to use words in their most ordinary senses, so I do not have a special definition for autonomy. But I mean something like knowing and following your own values, even in group or family situations where there are pressures to merge with or accede to others. The issue of autonomy (versus, say, connection) turns out to be very important in relationships -- and in the solutions advisors propose to impasses in relationships. Should you just do what is self-fulfilling (often that approach works), or should you give over to the other's perspective?



Winnie from Indiana: What about our society's obsession with advice? Where did this obsession come from? Every time I turn around, it seems like another advice talk show is on the air.

Peter Kramer: I suspect the matter is worse than you think. I find advice to be encoded in most TV sitcoms or dramas, most fiction, most film, most comic strips Don't try to reform an alcoholic; seek out livability; be flexible, make compromises; lower or maintain your expectations; assert yourself. The culture is dense with advice. Perhaps the reason has to do with a lack of intimate communities, a breakdown in more private ways of communicating values and strategies.



Jeff from Echo: Hello, Peter Kramer. Did you watch John Gray's "Mars and Venus" special on television this Sunday? Are you familiar with his work? The reason I ask is that your books seem to avoid the typical self-help format that authors like Gray use. Do you think his method of advice is useful, and why?

Peter Kramer: I did not watch the special, though I have seen John Gray and leafed through the book. I like Katha Pollitt's feminist riposte Men are from Illinois and women are from Indiana -- different, but not so different as to be unable to communicate. More exactly, I think that a culture does outline certain roles but does not always determine who inhabits them. There are relationships where the man is empathic and expressive and the woman is distancing. What interests me are the exceptions When does self-help break down?



Carter from California: Did you do any research for SHOULD YOU LEAVE? How much?

Peter Kramer: I don't know what qualifies as research. For years, I have been interested in certain psychotherapists, ones who have largely been forgotten but whose ideas seem to me to have seeped into the broader culture. I went back and read most of their work, interviewed them or their colleagues or family, traced the roots of their thought in philosophy or sociology, and tried to recall cases where their theory had influenced me. I did also review some of the statistical and experimental work on relationships. but that research was less important to me. For two chapters that deal with biological perspectives (e.g., the effect of depression on relationships) I did more conventional research. Some of the thinkers whose work I have tried to apply are Harry Stack Sullivan, Karem Horney, Leston Havens, Ivan Nagy, Hellmuth Kaiser, and Jean Baker Miller -- but I also look to Buber, Kierkegaard, Emerson, and Thoreau...while trying to keep the book light, accessible, and popular!



Moderator: If you would like to read what Dr. Kramer has already discussed, click on the Freeze Page/Unfreeze Page button, and your screen will stop reloading. Click that same button again and the chat will pick up in real time. Signed bookplate copies of SHOULD YOU LEAVE? are available for purchase by clicking on the book jacket at the top of the screen. Enjoy the chat.

Peter Kramer:



Michael from Los Angeles: Should love really take hard work to maintain? Or if you are really in love should your relationship be relatively carefree?

Peter Kramer: After the initial infatuation, love generally takes place in relationships, and relationships take work to maintain. A thinker whose work I like is the philosopher Stanley Cavell, who has written books about Hollywood "comedies of remarriage" -- like "The Philadelphia Story." Cavell says that the only true marriage is remarriage -- that it is only after one has been married for a while that one can make the informed choice to marry, the choice informed by maturity, clear vision, compromise, humor. So yes, I would say that love takes work, at least intermittently -- but the paradox is that it is not love if the relationship is characterized by mechanical effort.



Sarah from New Jersey: I recently got married and found out that my husband regularly hangs out in chat rooms and meets women on the Internet who send him intimate pictures. It really bothers me. Feels like he's cheating. He says it's all a game and no different from looking at a magazine. I disagree. I'm hurt, but should I leave? I can't help wondering if I really know him at all.

Peter Kramer: You present a sort of question that interests me On the whole, I would say that the tenor of self-help would be to advise you to leave. But I might ask, Is your husband in the grip of a minor mood disorder -- depression or obsessionality? Does he have a problem with intimacy or self-worth that reflects problems that you have with intimacy or self-worth? Is there anything that you might get out of staying and holding your own? I do not pretend to have answers to these questions, only to hint at how much more we would have to know in order to give advice that is tailored to your situation. I think a good starting point is to ask what in you corresponds to his flaws. At the same time, I think it should be said that the conventional advice is often right.



Marianne from Ohio: My husband constantly puts me down and treats me with cold detachment. Then when I start to pull away, he becomes very sweet and loving. I feel manipulated, and my self-esteem is suffering. Should I stay?

Peter Kramer: Again, I do not want to advise you but to point to key issues Are you being abused or exploited? Also, how much residual trust is there in the relationship? Does the relationship resemble others you have been in? What, if anything, do you contribute? These are issues the book addresses. But I should add that this situation may not call for advice, rather for psychotherapy, as relationships in which a person is being demeaned (if that is what is happening) are often difficult to change or to leave.



Amie from Oldwick, New Jersey: Is sticking it out in relationships an absolute for you? Do you ever think there's a time when the only choice is to leave?

Peter Kramer: In the book, I address what I call close calls, relationships that have done well but seem now to be falling short. And I do often think it makes sense to give these a chance -- sometimes it seems to me that a person may not know what it is to try. But relationships that are frankly abusive, or that have been entered into for reasons that have nothing to do with intimacy (as when a young woman leaves an abusive home life for a convenient marriage -- those often should end speedily).... And even the close call may happily end in dissolution. I hope that the book is balanced. In the vignettes, often I do advise leaving.



Judy from Geauga County, Ohio: From your research, how many couples stay together in miserable relationships for 30 years or more?

Peter Kramer: I have no research, but don't you think that married misery is quite common? Then again, so is misery in isolation.



Mark from Santa Fe, New Mexico: I like your literary allusions throughout SHOULD YOU LEAVE? You must have quite a library. Who are your literary influences?

Peter Kramer: I imagine I may be like many of the browsers at barnesandnoble.com I am a voracious reader. For some years a good deal of my reading has related to my own books-in-progress, but by choice I read fiction, from any era. While writing SHOULD YOU LEAVE?, I discovered Hermann Broch via the essays of Milan Kundera. But I also read anything by Updike, Bellow, the late Walker Percy, Wallace Stegner, Don DeLillo, Fay Weldon, Richard Ford -- you name it. Just now I am reading a novel by Edward Abbey. I also like once a year to read a Rex Stout/Nero Wolfe. And I love this question.



Moderator: SHOULD YOU LEAVE? provided a springboard for a fascinating discussion this evening, Dr. Kramer. Thank you for fielding all of our questions. Any final comments?

Peter Kramer: Thanks for having me here. I hope that I have not made the book seem denser than it is. I mean for it to have the quality of storytelling. One of my mentors (real, not fictive) often says that angels can fly because they take themselves lightly. Cheers!


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  • Anonymous

    Posted January 31, 2002

    The answer to the title's question is generally 'no'

    An excellent book examining the question most couples ask: 'Should I leave this relationship?' Kramer provides reams of insight on intimate relationships and therapy. He believes, in most cases, couples should not split up. He sights various reasons for this including the fact that many of the struggles one has in one relationship they will have in another, so the problem is rarely the relationship, it is the reader him/herself. He repeatedly brings up the concept of differentiation and explains how this process is our hope for healthy relationships and personal growth.

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