• Rather than reading books on psychology, fiction can help us understand our experience

  • Fiction and free association helps us to connect with our feelings, says Dr Christina Moutsou

  • If you are struggling to make sense of how you feel, find a therapist here 


My patients often ask me if they could read a book to help themselves further. The question usually takes the form: ‘Could you recommend a book I could read specifically on my symptom or on this problem I am dealing with?’ I rarely recommend psychotherapy or psychology books, as I feel they may, in fact, make the problem worse through creating further anxiety or theorising what needs to be understood in terms of the person’s specific experience. What I often suggest though is a novel or a short story or a memoir. All these genres are more likely to give a glimpse of direct experience that can move or even transform.

In a recent talk about the power or reading to transform our lives, Michael Rosen talks movingly about reading a poem which helped him connect with his feelings about his son’s death. He says:

"There is an incredible poem (by Raymond Carver) where he gets locked out of his own study and he looks back into his study and thinks about himself. And he doesn’t say he is thinking about death, he doesn’t say that, but as a reader you can take it as a way of thinking about a person or yourself who is not there. And I got utterly overwhelmed by it. I remember thinking that’s exactly how I feel about Eddie and that’s exactly how I feel about myself."

Though I work within the psychoanalytic tradition, I rarely see people more than twice a week. Traditional psychoanalysis can be at a frequency of five times a week and, if this is the case, the patient will also be lying down on the couch. For the wider public, this image of psychoanalysis is often represented as excessive, indulgent or dated. Yet, there is something valuable and hugely unrecognised in our society about the value of free association, which I think both literature and psychoanalysis harbour. What is much trendier nowadays, is meditation practices where the impetus is to empty and quieten our mind. Yet, our minds are not meant to be empty or even quiet. An example of this is when we sleep. Sooner or later, if we are lucky to get enough deep, uninterrupted sleep, we will start dreaming. Dreams are elaborate and vivid, but often incoherent stories. I think a similar process takes place when one has enough space to free associate either through engaging deeply in reading or in the process of therapy. Free association helps us connect creatively with our feelings through the building of stories.

Let’s imagine a young man in his late twenties named Nicholas, who goes to therapy once a week to help with his depression. Nicholas is a university lecturer and he has a tendency to intellectualise and disconnect from his feelings. Through the therapy, he begins to understand that his depression is linked with the sudden death of his father when he was a teenager, which he was not able to grieve at the time. 

Though Nicholas understands this, on a cognitive level, he cannot access his feelings of grief. Instead he talks about his depression and he reports to the therapist that the form it takes, which for him is feeling flat, empty and robotic, has not shifted at all. When the therapist prompts and asks Nicholas how he is feeling in the here and now he either says he feels nothing or he grows silent. Let’s imagine Nicholas has started lying down on the couch and has increased the frequency of therapy to twice a week. Here is what happens:

He stopped in his tracks. He turned on his side facing the wall. The next thing I heard was like a wail from a wounded dog left on the side of the road to die after being knocked over.

‘Nicholas?’ 

The sound continued intermittently. He then asked me for the box of tissues which I passed on to him. He wiped his nose, turned on his back again.

‘I just remembered that my father used to prepare sandwiches for me to take to school with me. He was a food inspector and also, a fit man who wanted to live for as long as possible. Not very lucky there.’

I could hear the bitterness in his voice, thick like a double espresso swallowed down at once with no sugar.

‘I guess it was only right he wanted to live long as he chose to bring me to the world, he wanted a child, a son.’

He seemed for once to want to talk a lot, to get it out of his system and I held my breath. 

‘So, he would insist that I needed to have a sandwich at school at about midday to keep my blood sugar even. He would just not get it that I wanted to fit in or at least not to stand out. Nobody else took sandwiches or any other food to school. Some kids would buy from the canteen, but my father had said it was shocking how bad the quality of the food the canteen sold was. Especially as it was catering for children. The thing is, I would throw all his sandwiches away before I got back home from school. The day he died, I had got back from school and he was not there. A couple of days later, I discovered a decomposing sandwich in my bag. It’s like I knew he wasn’t going to be at home that afternoon when I returned from school and I forgot to chuck the sandwich out.’ His voice cracked again. (Extract from No Words in Fictional Clinical Narratives in Relational Psychoanalysis: Stories from Adolescence to the Consulting Room, Moutsou, 2018).

In the above extract, Nicholas connects with his feelings through free association and reverie. Connecting with one’s feelings can seem frightening, and it is indeed a painful process. Yet, it is the only chance we have to utilise them creatively in living a full life.

No Words will be read out during the event on psychoanalysis and fiction on 28 June, where I will be in conversation with Val Parks – more information here


Further reading

Meet the therapist: Christina Moutsou

Welldoing.org's recommended books

The powerful benefits of reading fiction

Why books about mental health are so important