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Jessica Gross interviews Psychoanalyst Stephen Grosz

In twenty-five years as a psychoanalyst, Stephen Grosz has spent more than 50,000 hours listening to his patients’ stories. His first book, The Examined Life, published last year, presents a selection of these in beautiful and incisive prose. (As Michiko Kakutani put it in an enthusiastic review, the book reads “like a combination of Chekhov and Oliver Sacks.”) The portrayals of his patients’ struggles and changes, thanks to the talking cure, accrue over the book into a powerful case for the psychoanalytic process. Jessica Gross spoke to Grosz, who lives in London, by phone last year.

Jessica Gross: It took a few decades for you to decide to write a book. Can you tell me about that process?

Stephen Grosz: I’ve written technical papers for analytic journals, and I always liked analytical presentations, but I didn’t like the format of our scientific journals. Talking is more convincing than any outcome study, and I wanted to find a way to get that on the page. Another thing is, I am sixty, I got married at fifty, my daughter is ten and my son is seven. With parenting, you are very aware of death and loss. My mom died at sixty-four and my father had heart attacks. There was something about that that was very motivating. I wanted to do two things: write something my kids could read when they were eighteen or so, and give them a picture of a kind of disposition toward the world. That is maybe the thing that I find hard explaining to people who haven’t been in analysis. I hoped that the book would leave them a picture of my way of thinking about things.

JG: A friend was recently asking me about analysis, and was clearly very interested in it, but also afraid. I explained what it is like, at least in my case. She said, “Well, I don’t mean to be offensive, but I find that analysis is very indulgent.” That is something I have heard frequently. How do you respond to that?

SG: I do hear that a lot in consultation. Most of the people who come and see me are in pain, and are suffering. Sometimes people have anesthetized the pain, so they may not feel it directly—overworking, drinking alcohol, masturbating, prostitution, pornography, over-exercising, overeating—

JG: Any kind of addiction.

SG: Yes, to be numbed in some sense. They come because that numbness is starting to break down and sometimes, as you can imagine, they want me to make it work again. They are numbed so they are not fully present with themselves or their children or husband or girlfriend. It is not too hard to see pretty quickly that if they are able to take it apart a bit, to slow down, they will be able to work better too, to be more productive and successful. That is hardly an indulgence. 

Also, psychotherapy is not very fun. I am not very nice. I will say terrible things, as my analyst did once to me, which is very useful but can be quite tough. The atmosphere of acceptance makes that possible: some people really thrive because they feel deeply accepted, sometimes for the first time in their lives, in a way they can really think and talk about and draw the distinction. They can feel loved. To have that is not an indulgence. Plus, patients will say, the money I used to spend on shopping, or traveling, or dining out, as an anti-depressant, has paid for my psychoanalysis. I don’t need to do that anymore. So what did you say to your friend?

JG: Well, the first thing I said was defensive.

SG: It is hard not to be, because the person is covertly saying you are self-indulgent, spending all that money on yourself.

JG: Yes, but I don’t think it’s just about the money—I think it is also about very explicitly choosing to participate in an activity that is entirely focused on you, even though so much of what we do is, but presented in other guises. With analysis it is so explicitly focused on you. But after a minute I thought and said, I feel that the intensity of the introspection has allowed me to be more empathetic. It is really hard to see outside of yourself when you are not really aware of yourself.

SG: I totally agree. I think it is almost priceless.

JG: Your book features many of your patients’ stories. They’re all anonymous, but did you ask permission? And what were people’s reactions?

SG: I’ve taken every possible precaution to protect my patients’ confidentiality, another reason why it took so long to write. That I meant I had to change all the names and particulars to preserve anonymity. These things are complicated because no one comes into analysis to be written about, they come into analysis to get their problems solved. On the other hand, it is an illusion for patients to think it is 100% private.

People’s reactions were different. Everyone who is in the book has been positive about it, because they were asked, unless they were no longer alive. A patient who is currently seeing me, who isn’t in the book, said, “I presume my story just isn’t finished yet.” Which was kind of interesting. I have had people come for consultations since the book was published, and one said at the end, “This has been a very interesting consultation, but you weren’t as good as you are in your book.” Which I thought was fair. [Laughs.]

JG: Analysts, I believe, don’t tend to take notes during sessions. Did the quotations in the book come from post-session notes?

SG: I do sit with a notebook after sessions and write things up. They are the closest to what I remember, and I can’t think of a single instance where a patient read the book and said, “That’s not what I said.” Sometimes they will say, “Oh, wow, I completely forgot that dream or that exchange but that is exactly right, I did say that.” That is also interesting. Sometimes we forget that part of analysis is “I don’t remember.” It reminds me of Virginia Woolf explaining why most biographies aren’t very good—people remember the facts, but they don’t remember the experience of what it was like to be them at fourteen or fifteen or sixteen or twenty. Looking back, they can tell you the events that happened to them, but they don’t remember how they felt. What an analyst is trying to do is help you remember what it was like to be you at that time. Sometimes, it is very moving when you both remember it together—“Oh, yes, I was very trapped or hopeless, up against a wall, I didn’t feel like I could get out”—and that’s not how they feel now, and they had forgotten that experience.

Jessica Gross: What makes a person seek out analysis?

Stephen Grosz: There are as many reasons as there are people. Part of the work of the analyst doing the consultation is to make contact with just that—to try and find together a bit of why that person is coming, to put it into words, so the person can feel that they are heard. I’ve had people who have never been alone with their mom or their dad, and just to be alone with a person in a room with the telephone shut off, no television, just a person there, for an hour, to listen to them, can be astonishing. They were yearning for that.

JG: What makes a person able to do analysis?

SG: I think that is really a good question. Some people can’t. Take an alcoholic with a serious addiction: they already have a cure that is more powerful than my words. In the first meeting, I try to get my patient to bring their internal experience to mind, to just say what they are feeling, be brave, have the courage to talk about it if they can. I try to help people say what they are thinking and feeling, and some people are better at that than others. I’ve had a lot of people act out, and sometimes you have to help them find the words for what they are doing.

JG: Can you tell me how you decided to become a psychoanalyst?

SG: Towards the end of the book, I describe going back to Eastern Europe with my father, who had come to the States after the occupation by the Fascists. My father was a person of action, and he didn’t ever talk about his history. If you wanted to talk to him about it, he would sort of wander off. That’s one thing about my patients, they never wander off. [Laughs.] They stay and talk to me.

I think I was always curious about people, through literature. When I was 16, I was at Berkeley, and at that time politics and psychoanalysis were very mixed together. Left-wing ideas had a lot to do with hidden desires. When I went to Oxford and studied philosophy, I was interested in those ideas too. I think I found I liked being with people and listening to their stories and talking with them, and I have for a very, very long time. As soon as I started to work with patients, I was completely gripped by it.

JG: You’ve mentioned that you didn’t want to put the word psychoanalysis on the cover of the book, and it is not really in vogue to think about or talk about. Why do you think that is?

SG: On my book tour in New York, I met young people and felt a slightly manic undertone, as though everyone I spoke with was drafting their CV as we were speaking. It was like they weren’t talking, but telling me the whole road ahead and where they were and what they had done. It felt—how can I put it—almost like a counter-depressant to the real, lived life.

I think we live in a very difficult world right now, in terms of economics and careers and our personal lives, and there is a huge amount of real anxiety. When I was growing up, with very little work it seemed I could have a house, a swimming pool, a couple of cars, my wife wouldn’t necessarily have to work. You didn’t think you had to do that much to earn a living. Well, no one thinks like that now, and everything is different. So, in the middle of all this, analysis is another expense, oh my God, it feels huge. I think analysis is a very powerful force, but for a lot of people I think it feels like another big thing to undertake.

JG: But I think it is more than that. I’ve run into many intelligent, educated people who don’t just say, “Oh, psychoanalysis is well and good, but not for me”—they say, “Psychoanalysis has been discredited.”

SG: Yes, and I think analysts are to blame, too. Analysts for a long time behaved as know-it-alls and didn’t engage in the kinds of discussions that we are having right now. I did think, when I went to my analyst, that he knew everything. I thought, Oh my God, this guy has x-ray eyes. I didn’t have to say anything and he would know my subconscious based on how I crossed my legs. But of course, that is ridiculous. Actually, analysis is a form of not knowing. It is two people not knowing together and slowly building up a picture.

Some of my friends and colleagues do empirical defenses of psychoanalysis. I think all those things are good and important, but I’m not sure that empirical views will paint the best picture. The way people experience something like analysis is more about being. But that is why we have stories. That is what literature does: we go into people’s minds and thoughts and memories. There are lots of better ways of portraying that than statistics. Some of that may be what I am trying to do—tell stories.

JG: What do you find most difficult about this profession?

SG: I make it pretty clear in the book that you fail a lot, you don’t understand things. It can be difficult, working with someone, before you have figured that out. But after all this time, I feel rather lucky, to be honest—I feel privileged by the stories people tell me. It is a wonderful and remarkable thing. I feel personally encouraged by my patients’ courage.

JG: You mention in the book that you feel envious, at times, when you help patients through conflicts that you struggle with. I was wondering if you could talk a little about that.

SG: I thought it was important just to be honest. Envy is a word that we don’t use socially, outside of the consultation room, but there is tons of it around. It is pretty ordinary that parents envy their children. Their children have more time than them, more potential, life can change. I started seeing a child of a patient of mine who is starting at Oxford in the autumn. He is fabulous, brilliant and funny, and I did sort of wish I were starting university again, that I were his age now. But of course, it is an illusion. I sometimes envy patients—they are brighter, more attractive, earn more money. Teachers envy bright students, coaches envy good athletes; it does happen. The key is unhooking ourselves from that. It is not that we don’t do it, but that we exist in the reality of our place and time, and accept that.

Jessica Gross is a writer based in New York City. She contributes to The New York Times Magazine, The Los Angeles Review of Books, The Paris Review Daily, and elsewhere.