Christina Moutsou has put together a remarkable series of short stories in which she aims to eludicate the therapeutic process from a relational perspective. She tells us that the cases are fictional but of course, to write such an account, she will be drawing on her clinical experience. Fictional cases get around the issue of informed consent when using patient material and free up the author to explore intensely personal matters without worrying about revealing anyone's identity. Not only are the patients in this book fictional, so are the two therapists who give us an inner dialogue about their thoughts and feelings as the sessions unfold.
This choice of how to present the work of psychotherapy made me think about how, even when we present an actual case, we are still faced with the question of how to tell a story about the work. It reminded me of what Adam Phillips said about psychoanalysis as “a set of stories about how we can nourish ourselves to keep faith with our belief in nourishment, our desire for desire” (Phillips, 1998, pp. 3). This set of stories begins with vignettes from the lives of six teenagers, five of whom we will meet later in the book when they enter into therapy. Moutsou argues that adolescence is a pivotal time and presents traumatic events for the six protagonists that encompass parental unavailability, sexual awakening, sexual abuse, and bereavement. In an interview that has been made available on-line (see welldoing.org), she mentions that her own adolescence was “a highly emotional and turbulent period” and no doubt, her particular experience will be interleaved with the fictional accounts that enliven the first section of the book.
This idea of “interleaving” is at the heart of the relational approach with its focus on how the “emergent properties of the dyad exist in dialectical relation to the individual subjectivities of the patient and the
analyst” (Mitchell & Aron, 1999, pp. xv). Likewise, the stories that we tell each other about our patients will have echoes of our own subjective responses to the work and Moutsou's book demonstrates this beautifully. She sets the stage with a quote from Jung about an analogy between the therapy encounter and a chemical reaction, placing an emphasis on how both people are potentially transformed in the process.
In the next two sections of the book, we are then treated to seven stories from Ellie, a therapist who struggles with a painful experience of abandonment by her mother, followed by eight stories from Jake, another therapist whose relationship begins to fall apart as he continues to work with his patients. We meet five of the six teenagers again, now adults, within these accounts of therapy sessions, each of which is prefaced by a brief introduction in which Moutsou gives us her comments and questions on the main themes that each case illustrates.
The last section of the book is entitled “On losing and not being lost” and it contains an account of how Ellie and Jake meet in a professional development group. Moutsou suggests at the beginning of this final chapter that a creative connection can spring from the experience of loss and in this group, Ellie and Jake find themselves confronting each other and their feelings of loss in a way that forges a bond between them. The book raises a question in my mind about the role of loss in our motivation to do this kind of work and the wish to make reparation, which curiously brings me back to my own early interest in Melanie Klein, who said in her classic 1937 paper, “to act as good parents towards other people may…. be a way of dealing with the frustrations and sufferings of the past” (pp. 312). To what extent do we choose such work in order to try and make up for past losses?
I thought that this book could be especially helpful to young professionals who are considering whether or not to enter into a psychoanalytic training. With the intimate account through the eyes of the therapist on the experience of the work with patients, it provides a very good flavour of how it feels to be in that position. For any reader, the stories are told with dramatic tension and verve, making for an enjoyable and thought-provoking experience.