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Lying on the Couch, Irvin D Yalom, Basic Books/HarperCollins, 1996, 369 pp
Irvin D Yalom is an emeritus professor of psychiatry at Stanford University who also writes fiction. Three years ago I read and found stimulating his most recent novel, The Spinoza Problem, so when one of my reading groups chose this one, I looked forward to it.
Lying on the Couch was his third novel and I think he was still working out how to switch over from writing technical works to writing fiction. It wasn't bad; in fact it is a thought provoking look at the inner workings of professional psychotherapy, but it had some rough patches.
Two therapists come into conflict. Marshal is the entrenched older mentor to Ernest Lash. The former believes in the efficacy of psychotherapy with all its guidelines and procedures, but has deep issues himself about success and money. He mentors the younger Ernest Lash, formerly trained as a psycho-pharmacist (meaning one who prescribes drugs rather than counseling) but who has now become a "talk-therapy" proponent. The two clash over methodology and how open a therapist should be with his patients.
Threaded through their professional relationship are other characters and story lines. Marshall falls prey to a patient who is in fact a supremely successful con man and is almost ruined. Lash is the victim of a predatory female patient bent on seducing him in revenge for Lash having broken up her marriage to another of his patients.
The whole novel nearly collapses under the psychological and criminal thriller element the author layers on to what is also a treatise on the state of psychiatry in the late 1990s. The sexual aspects are a bit cringe-worthy, the criminal elements are somewhat improbable, and despite the propulsion of a rather trashy plot, I felt queasy much of the time.
Really, the novel is enough to put the reader off from ever submitting to any sort of therapy. If therapists are actually working out their own obsessions and mental problems as they try to help others, how can anyone fully trust them?
We had a profound reading group discussion. I decided that there are always people with a fervent desire to help others, whether they be therapists, ministers, teachers, family or friends. Once the political and economic interests of organized institutions get involved with helping others, the subject of help gets murky and sometimes outright destructive.
Often I feel I have gained more insight into my own troubles and relationships by reading great fiction, more than I ever got in the countless hours of therapy I have had. I can't say that therapy didn't help me sometimes but for now I am sticking with fiction.
I don't think that was Yalom's intention, but his novel cemented my decision to leave therapy alone in the future.
(Lying on the Couch is available in paperback by order from Once Upon A Time Bookstore.)