Cooking the Books

In 1978, Susie Orbach wrote a slim, successful book with a catchy title – so catchy you didn’t need to read the book to feel you knew what it was all about. Fat Is a Feminist Issue. The title said so much. Perhaps the title said it all. Certainly it sold a lot of copies, and went on to have a happy life of its own as a quotation and a slogan. So perhaps Orbach has similar hopes for The Impossibility of Sex. It doesn’t have the alliterative force of Fat ... but it does have the selling power of sex: a combination, moreover, of sex and mystery – for what can she mean by ‘impossible’? Impossible for whom? Impossible how? And what are we to make of the peekaboo cover, with a square cut-out of the crop-haired back view of – who? Ooh! Which of us doesn’t want to look inside to see if we, too, suffer from the impossibility of sex, whatever it is?

But The Impossibility of Sex is not about the impossibility of sex. It might have been: there is a chapter at the end called ‘The Impossibility of Sex’, which gives us the story of a lesbian couple who no longer have sex together (a phenomenon widely known as ‘lesbian bed death’, though Orbach doesn’t call it that). And Orbach says she has been intrigued for years about the ‘conundrum’ of sex in long-term relationships. She has a short section on the erotic in which she suggests that we can regard it ‘as an emergent property of the human species, a collective capacity akin to language and intelligence’. And while she believes that her observations do not amount to a new theory, they nevertheless ‘suggest some directions’. But she keeps this short, and at the end of the book, and it is not clear that readers will make it that far.

For this is a book, like the characters in it, which has problems – not least the problem of how we are meant to read it. Its central notion is to take us inside the consulting room to show us what the practice of psychoanalytic psychotherapy is like from the psychotherapist’s point of view, and allow us to discover ‘not only what happens during the analytic hour but also, uniquely, how the therapist thinks and feels about her patient’. If it is about anybody, it is about Orbach – though she is not straightforward about this. The therapist whose narrative this is may look like Orbach, sound like Orbach, and in most obvious ways be indistinguishable from Orbach, but Orbach says she is not, strictly speaking, Orbach, but someone she has invented: her ‘therapist-on-the-page’. She has to be invented, because the six case-histories that make up her book are also invented. Here are Adam, Belle, Joanna, Edgar, Jenny and Carol and Maria – all, broadly, middle-class; all, broadly, left-leaning (Edgar is a trade-union leader); some of them glamorous (Adam is a ‘celebrity chef’); some of them a trifle bohemian (Belle likes sex and drugs and rock and roll); some of them well dressed (Carol and Maria, in particular, the one with ‘peachy white skin and softly curling shoulder-length hair held with a couple of ebony-and-ivory-coloured combs’, dressed in a stylish black suit – ‘the style of an architect or a designer’; the other with ‘tiny features, short-cropped curly black hair, chocolate coloured skin’ in a casual but elegant outfit of beige boots and brown linen pants that make her look like ‘a poet, artist, publisher or writer’). However insufferable they may appear to the reader, they are admirable and likable to the therapist-on-the-page.

Orbach imagined that each of her characters would embody one of the clinical entities and diagnostic categories – borderline, narcissistic, schizoid, depressive, bulimic – which psychotherapists, psychiatrists and psychologists use among themselves. But it didn’t work out that way. They are, instead, she explains, ‘a refraction and expansion’ of her clinical work, the mulching down of more than twenty years’ experience. They are also the products of a politically correct imagination, with a suitable quota of black and white, male and female, the eating problem given to a black man in his fifties, and the relationship problem to a mixed-race lesbian couple who want a child. ‘There are inevitable hints of experiences I have had in the consulting room,’ she confesses; but there is no one recognisable as Orbach’s most famous client, Princess Diana. Nor, in spite of the mix-and-match approach, is there anyone whose problems are worth examining from a self-help point of view – which is where you are likely to find this book in a bookshop.

We are not meant to think like that, however. Nor are we meant to think too hard about the efficacy (or otherwise) of the so-called talking cure. Orbach writes with such enthiusiasm for her profession that one wonders if her client list is falling off. ‘I have seen individual and family lives transform,’ she declares at the start of this book:

I have witnessed and been inspired by people’s capacity to change their lives, to resituate themselves within themselves so that their creative, intellectual and emotional capacities can develop. From the sidelines I have participated in the victories, the psychological struggles, the achievements and the strength they have found to activate a life that has personal purpose and value. Their struggles have forced them to confront the deeper questions about human nature, about the integrity of human beings, about the meaning of human connection, about what makes us laugh, cry, love, grieve, hate, hurt, embrace, heal.

Put out of your mind, too, the popular view of the therapist as a ‘silent, implacable listener unaffected by the most shocking revelations’. For your shrink is not like that. She (she is always a she) is a ‘guest’ in other people’s pain, ‘bobbing’ in and out of the emotional turmoil that is at the heart of the human condition. She is less a surgeon winkling out the canker in your mind than an aesthete appreciating the wondrousness of your soul: ‘Just as a beautiful sculpture describes in concrete form a set of feelings and ideas, or a poem inscribes and communicates a mood which demands that form of expression, so a therapy is the process of a deep intersubjective, interpersonal encounter’. One of the deepest one could hope to have, in which ‘there can be tenderness, belligerence, anguish, despair, depression, love, hope, longing, disappointment, anger, passion and grace’: quite heavenly at one end of the spectrum (‘a profound sense of well-being permeated my spirit ... I had been given Edgar’s precious soul to carry for months’), somewhat hellish at the other (when bearing witness ‘to the perverse, the sadistic, the barbarous and the unimaginable’). Orbach’s therapist doesn’t cut you short when your 50 minutes is up and charge you a fortune for it. Indeed, she doesn’t mention money at all. The privilege is hers: to know that one has had an intimate hand in this development is a source of ‘tremendous satisfaction’.

Accordingly, there is barely a page of this book when she is not in extremis in one way or another. Orbach’s therapist weeps and hurts; she feels bruised and battered, sullied and chilled. She is overwhelmed by mood and atmosphere. And she experiences counter-transference on an extraordinary level. When overweight Edgar is in her room, she feels herself expanding and growing fat. Even Edgar detects it. ‘When I come in and you greet me,’ he says, ‘I don’t really notice your size, but when you get up at the end of the session you’re small, a bit too small really.’ With Adam, the ladies’ man, she goes into a kind of sexual overdrive. His smell is in her nose when he leaves her room. At night she is ‘full’ of him, and she wakes in the morning uncertain whose bed she is in or who is in hers. Taking her morning shower, she luxuriates in the sensual flow of the water over her body: ‘all at once the image of an enormous shower-head in a Claridge’s bathroom I had glimpsed years before melded into an image of Adam and me making love ... I saw and felt that I wanted to love him.’

The smaller point here is that Orbach dares to be embarrassing. There are not many psychotherapists, one imagines, who will open their books, as Orbach does, with the confession, ‘I felt twitches in my vagina, pleasurable contractions’ – or who come on so strong. ‘I am aware,’ she writes, ‘that I may create an unease among professional colleagues who, while familiar with the kinds of feelings and scenarios I am writing about ... would be happier if such discussions were confined to the learned journals.’ But openness is all and they shouldn’t be so uptight; the more embarrassing, perhaps, the better. Certainly, she gives embarrassment a good work-out in the section on Adam, where she has him declare himself unboundedly:

I have to make love to you ... I need you more than I need therapy. It’s killing me coming here session after session dreaming about you, thinking about you, smelling you – your sweet body smell and your perfume ... I imagine caressing you. My hands between your silky legs, my body aching, desperate to be with you. I know you feel it. I know you want me. I know you’re just holding yourself back because you’re my doctor. I know you are.

The larger point, as Orbach explains, is that it is through scrutinising the ways in which she is affected and stirred up by her patients that she is able to fulfil her professional responsibilities. By what authority does she proceed? Why, by the authority of her feelings. What else could she have to go on? Only by paying attention to her feelings of corpulence, for example, can she sort out the reasons for Edgar’s difficulties with food. Only by paying attention to her aroused senses can she start to help Adam: although part of her envisioned professional reproof for the thoughts she was having, another part of her knew that she had to go on with this exploration and receive the feelings she was having as part of the treatment.

This is the least one might expect of one’s therapist, especially if one is paying her (as one will be). The problem is that she has made it up. So what are we to make of her results? What writer would present a set of case-histories that didn’t prove her argument? What are we to make of her evidence when she has cooked the books? How spontaneous is this spontaneity meant to be, when it is recollected in tranquillity? What value is the reader to place on her analysis of the dreams that Adam presents her with, for instance, given that she has invented their details?

We know the reason for this. Orbach cannot simply retail things her clients have told her. She has been in trouble about that before:

Having written a regular column in a national newspaper and in a national women’s magazine, as well as several books, and because at times I have attracted extremely unwelcome media interest in my practice, I know the extreme care that is required when using vignettes. Readers frequently write to tell me that they are the person in an article or on a page in one of my books. Sometimes individuals in my practice have assumed that I am writing about them even though this is something I would never consider.

So she has to make them up. She also has to make things up, she says, because in real life, the stories she has heard are so strange and unlikely that if one were to read them in a novel one might regard them as either ‘too fanciful or too horrific’. Besides, the mere business of transcribing analytic stories, she believes, traduces them: changing the details in order to disguise the individual distorts the individual and makes what one has learnt and wishes to illustrate less convincing.

As proof of her success, Orbach cites the reactions she got when she gave a paper about one of her characters to fellow clinicians at a conference at the Freud Museum. ‘Participants inquired why “I” had followed one route and not another, suggested significances “I” had not seen in her symptoms and talked as though she were a real person, the therapist a real therapist and the case a real case.’ One might wonder how else her fellow clinicians were supposed to react, given that this was a psychoanalytic conference, not a literary one. What sense would it have made for her colleagues to discuss her characters as though they were only people in a book? But the reaction of her fellow clinicians only confirmed for Orbach what she had come to believe herself: that her characters were as good as (if not better than) real people. They behaved, as she saw it, like real people. She could not control them as she put them on the page. They simply did as they wished, acting ‘according to their own logic’ and presenting her with as startling or as unexpected behaviour and information as the people who actually visit her consulting room.

We are asked to believe (wholeheartedly) that there is no substantial difference between the freedom of a real person and the freedom of a created, fictional person; that, by extension, there is no substantial difference between real therapy and writing about therapy; and that Orbach is giving us the whole truth when she explains that getting close to her patients-on-the-page has been ‘as challenging, exciting, galling and beguiling as it is in therapy’. This takes us well beyond the habitual question of whether or not we are convinced by a story that we know either to be true (analytic literature) or to be made up (fiction). As John Bayley once remarked, writing about Iris Murdoch,

it is bound to be a tautology to talk about ‘freedom’ in a novel, in which only the author is free to do as he likes. Pushkin, and Tolstoy following him, liked to emphasise that their characters ‘took charge’, and that they were surprised by what they did, and by what happened to them. Once again there is a kind of truth in that, but it won’t really do. It is a cliché which novelists invent or repeat. What matters is whether the world created is both convincing and wholly sui generis, and here of course Pushkin and Tolstoy pass with top marks. So does Iris in her own way.

Orbach does not. The therapist-on-the-page may find Adam’s protestations of love authentic and exciting, but not many readers will thrill to the truth of such declarations as: ‘You don’t believe I’m for real because I told you about all those other girls. But this is different. You know it. You can feel it. I know you can. We’d both be missing something we’ve never had before if we said no to it. This is big. Something that comes round once.’ The therapist-on-the-page is no better. I’m surprised Edgar didn’t sack her after she ended a session: ‘I’m loath to suggest a specific homework without quite knowing what you’ve been pondering, but perhaps thinking about the time in your life when you first started to eat when you weren’t hungry might be useful.’

You might feel differently, however, if this were real life and your own therapist had said it to you at the end of a 50-minute session for which you were paying and of which you had high hopes. It might not do, as Bayley says, in fiction; but it would suffice in real life. And though Orbach is not a good short story writer, she might well be a good therapist. One of the successes of the book is that it makes psychotherapy seem a helpful and intriguing thing to be involved with: the psychotherapist enables ‘the conditions for discovery, understanding and connection to occur’; psychotherapy aims ‘not to unwrap and rewrap an individual’s life ... but rather to open up ways of thinking’. But can it be right to invent one’s proof?