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Fictional therapists: the overlap between therapy and fiction

At first glance, there might not appear to be much of an overlap between the preoccupations of therapy and fiction. After all, the first focuses on facts while, by definition, fiction is pure invention. At least, that’s what I thought when I was making the transition from clinical psychologist to novelist. Now I know better.

Some therapists would dispute my assumption that facts matter in therapy, or at least that they should be prioritised over the emotional truth. But it’s this emotional truth that attracts many readers to fiction. What is a story but a lie that points the way to a deeper truth? What is therapy but the route to a better story about ourselves?

Like therapy, fiction is concerned with change. It’s concerned with what disturbs us. It’s concerned with uncovering secrets and confronting hidden fears.

The connection between the two types of enterprise might be strongest in fiction that takes therapy as its subject and/or a therapist as character. Readers often appreciate characters who have a vibrant inner life, who are thoughtful, perceptive and well-intentioned, although with idiosyncratic blind spots and flaws. Readers also enjoy stories about facing daunting challenges and overcoming adversity, with plots that twist and turn between beginning and end. Doesn’t this remind you of therapists and therapy?

Over the past three years, I’ve built a collection of over thirty novels, published between 1992 and 2017, featuring fictional therapists. Like real-life therapists, they are a diverse group, not only in therapeutic orientation but in their credibility on page. Some swap brands and professional titles as often as they change their clothes, and blurring the boundaries of time, setting, relationship and confidentiality is all too common. Perhaps that’s because fictional therapists rarely receive their own therapy or clinical supervision.

On the other hand, fictional therapists can articulate some of the ways in which therapy differs from a conversation with a sympathetic friend. For example, Jamal Khan, the London psychoanalyst in Hanif Kureshi’s Something to Tell You, recalls discovering that (p265):

listening to another person was almost the hardest thing you could attempt … the truth wasn’t hidden behind a locked door in a dungeon called ‘the unconscious’, but … it was right there, in front of the patient and analyst … Listening is not only a kind of love, it is love. But, sitting with my first analysands, trying to bear the anxiety of hearing someone unknown, whose dreams and ramblings I could not comprehend … I’d want to flee the room, wondering who was more afraid, analysand or analyst.

Mira is another psychoanalytically-orientated psychotherapist in North London whom we meet in Sylvia Brownrigg’s The Delivery Room. Working with a woman, Kate, following a stillbirth, she must (p82):

find a way to give Kate a place within herself to hold the child that she had lost.

Others would tell her to move on, to put it behind her; to go on holiday, or buy a dog, or take up gardening, anything to move her attention from the loss at hand. Some might urge her to try to get pregnant again, thinking that if she had another child she would be all right. Mira knew her role in the cacophony would be to give the woman space and quiet and to let her know, gently, that it would never be all right again.

Well-handled therapy narratives can also stimulate discussion about the limitations and paradoxes of therapy, such as whether the therapist benefits as much as the client and whether therapy is reserved for those who need it least. Novelists can also raise questions about what therapy is for: is it an instrument of liberation or of social control? The function of fiction to entertain is not lost on the creators of fictional therapists, some of whom make playful use of the stereotypes to humorous effect, as in the opening of John Katzenbach’s The Analyst (p9):

In the year he fully expected to die, he spent the majority of his fifty-third birthday as he did most other days, listening to people complain about their mothers. Thoughtless mothers, cruel mothers, sexually provocative mothers. Dead mothers who remained alive in their children’s minds. Living mothers, whom their children wanted to kill.

In this series of posts on fictional therapists, I’ll introduce you to the manipulative and the manipulated, the excavator of buried truths, the insightful therapist and those who miss the point. I’ll show you wounded healers, therapists in training, therapists confronting war and trauma, historical therapists both real and imagined. While the majority of fictional therapists with whom I’m acquainted work individually with individuals, we’ll also meet a few who work with couples or as part of teams. We’ll also look at psychiatrists in the role of therapist and the benefits or otherwise of their dual role.

I’m hoping I can engage your interest, not only in reading the posts (and possibly then going on to read the novels in which they appear) but in helping me extend my list … I’d also be interested in what you might like to know about therapists in fiction. I might not have the answers to your questions, but I’d certainly do my best.

'What is a story but a lie that points the way to a deeper truth? What is therapy but the route to a better story about ourselves?'

Authors Bio


After a twenty-five year career as a clinical psychologist, and extensive personal therapy, Anne Goodwin now explores issues of mental health and well-being in fiction. Her debut novel, Sugar and Snails, about a woman who has kept her past identity a secret for thirty years, was shortlisted for the 2016 Polari First Book Prize. Her second novel, Underneath, about a man who keeps a woman captive in his cellar, is scheduled for publication in May 2017. Catch up on her website annethology or on Twitter.

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