I once spoke with an author who was attempting to write about a conflict with his analyst over the question of termination at the same moment he struggled with the issue in his treatment. As he creatively explored and researched the topic, and discussed it with other analysts and friends, it became apparent that his interests as an analysand were not being served by his interests as a writer. In this case, the writing survived but the treatment did not.
Last January, at the meetings of the American Psychoanalytic Association, a novelist, a filmmaker, and a playwright offered the opportunity to consider the implications—for their art, their treatment, and the public perception of analysis—of their decisions to introduce their experiences in psychoanalysis into their creative work. Their comments on panels and in subsequent interviews offered insights into the creative process and helped clarify questions about the accuracy of representations of analysis and analysts. They also managed to provide by example, in their work and their comments, evidence that aspirations to truthfulness, in what can be heard and what can be said, constitute the core of the psychoanalytic enterprise.
Daniel Menaker, a novelist and executive editorin-chief at Random House, did not begin writing The New Yorker stories about the brilliant and outrageous psychoanalyst, Dr. Morales, which became the basis for his novel, The Treatment, until a few years into his second analysis. Before that he waited. “I was scrupulous about not writing. I did keep a journal. I have always stood outside my experience. I observe. I am a writer. I tried not to be too much the observer. But writers store things up. They are always making mental notes. Like psychoanalysts. Like magpies.”
An intentional ambiguity and openness to interpretation characterizes the novel. Menaker designed Morales to be “admirable and awful.” An example of openness lies in his sophisticated discussion of termination. The patient in the novel wants to move on with his life. He has made impressive gains and feels excited about his prospects. The analyst resists and appears to be clinging to the treatment for selfish or authoritarian reasons. And yet. The analyst articulates a not unreasonable interpretation of flight: The patient is leaving prematurely—in this case to rescue a recently widowed mother and her child and to defy a father/analyst.
Phillip S. Freeman, M.D., is a psychiatrist and a training and supervising psychoanalyst at the Boston Psychoanalytic Institute. Adaptations, a collection of ten years of his satirical monologues regarding the fate of the psychoanalyst in the modern market place, will be published in the fall.
Menaker leaves it to the reader to decide. “Psychoanalysts, like artists,” he says, “are interpreters of texts…. The patient like the writer brings on a mass of material but they only bring it halfway.” It requires an active reading. Menaker grants that the person sitting in the analyst's chair may be in a better position to see things clearly. “Who better to be on top of things?” he asks. “But, of course, we know,” he adds, “there is no top.”
Christopher Shinn, the playwright, entered analysis because he felt that writing could only take him so far in dealing with his conflicts and concerns. Once in analysis, he did not wait to write. “I began thinking of writing a play at the same moment and with the same motive as entering analysis.” His motive for beginning the analysis was a concern about the potentially character deforming aspects of celebrity. He had won an Obie for his play Where Do We Live at the age of 26. He had reason to anticipate a degree of fame within his “small world of theater.” His encounters with members of the entertainment industry convinced him of the dangers of “unbridled narcissism” that might accompany success. He needed to know that somebody would be willing to tell him the truth. He imagined a psychoanalyst might be willing to be straight with him, but, just to be sure, he began the analysis by soliciting a promise from his analyst that he “would not lie” to him. Shinn recalls associating in his initial session to having read of the misadventures in the analysis of Masud Khan by D.W. Winnicott. He recalls speculating that they ran into trouble because “they became so invested in their fame that they couldn't look at reality.”
Although he later would think of his analysis as the “most wonderful thing in my life,” Shinn found the outset of the analysis a torment. He felt alone and thought he was going crazy. He insists his hair changed color. He thought he was dying. And yet he “only wanted analysis.” He says that he “wrote the play to continue psychoanalysis in disguised form through the characters.” The play, Dying City, that has now completed successful runs in London and at Lincoln Center, was placed by Bennet Simon in the tradition of modern tragedy that offers degradation without resolution—except perhaps through an appreciation of the writer's craft.
Beyond capturing the violence of his experience beginning analysis, Shinn also evokes psychoanalysis by introducing the character of a therapist and through the fact that only two of the play's three characters appear on stage at any moment. Two of the characters, played by the same actor, are identical twins. The analysis reappeared in the parallel process of the rehearsal. There Shinn worried about the potential for the frequent and intense interactions of the two actors to spill over into action, romantic or otherwise. It did not. Parallel to the role of the analyst, Shinn depended on the “firm but loving” hand of the director to keep the dyad away from the ever tempting alternative of avoiding the work of the play.
We can speculate, given the strong feelings with which the author described struggling at the outset of his analysis coincident with writing the play, that the play serves in part as a creative solution to concerns that urgent needs and passions might be damaging to the analyst.
In Dying City, the therapist's absolving psychological perspective regarding hurtful and lying behavior by her patients—that they are communications of pain and reenactments of injury—is questioned by the brothers, who hurt and lie to her. This representation of a therapist did not pull for worries about accuracy from an audience of psychoanalysts, perhaps because the setting remained distant from an actual clinical situation and the therapist is portrayed in the role of a victim.
Menaker's character of an analyst is portrayed in the clinical situation and is depicted as confrontational and aggressive. This characterization led to protests by analysts viewing clips of the film based on the novel to the effect that analysts were never represented with the sympathy or depth that the characters of patients received. Oren Rudavsky, the director of the film, was forced to defend the film as based on the truth of his experience of analysis, a response greeted with protective applause by the audience.
Menaker reminded those who criticized the accuracy of the characterization that it was,
after all, a caricature, but it may be that a long history in the arts of representing psychoanalysts and mental health professionals in general as fools or worse makes an audience of analysts sensitive on this point. In a subsequent interview, Menaker said that all professions chafe at their fictional portrayals. He certainly does regarding stories about writers or the publishing industry, but he thinks it is also important, when receiving an unwelcome observation, to consider the element of truth that might be captured in the caricature. Like an analyst recommending that recognition of both the reality and the distortion are necessary for an analysis of the transference, Menaker emphasizes openness, complexity, and an avoidance of premature closure. Happily he attributes these aspirations, in part, to his experiences in analysis.
The question of accuracy arises again in the translation of the novel into a film. The filmmaker quotes his experiences in analysis and dedicates the film to his own psychoanalyst. In the film, the analyst character and the discussion of termination are reconfigured in light of the filmmaker's concerns. The analyst in the film is represented as an analyst-hallucination who speaks for the character's neurotic perfectionism and fears of commitment. As the patient sets off to be with the woman, he locks the hallucinated voice of analytic paralysis in a closet. At the same time, the analyst is heard spouting vestigial remnants of the original interpretations articulated in the novel.
This layering of artistic intention can lead to incoherence. Clinicians may be reminded of the incoherence that can result from the layering of reality and fantasy or from the layering of historical narratives over the course of generations. The dramatic field can become crowded with the intentions, recollections, and inventions of multiple storytellers. It is the reason that some of the best filmmakers—Francis Ford Coppola and Godard come to mind—have chosen to work from simple but entertaining novels that were unburdened by ideas that might compete with those of the filmmaker.
The novelist's story, like the experience of psychoanalysis, becomes the day residue for the next dream. Screenplay adaptations that are too faithful, too accurate, can feel constricted, like reality-bound dreams that do no apparent psychological work. The life, the meaning, even the truth of the new creation often lies in the inaccuracy of the simulation.