Susie Orbach's In Therapy: A Client's View
Last Friday evening I went to listen to Susie Orbach talk about her latest book, ‘In Therapy’, joined on the couch by author Jill Dawson, as part of the Spring instalment of the Cambridge Literary Festival. ‘In Therapy’ is the book of the hugely successful Radio 4 programme of the same name, in which we are given a glimpse into the process of therapy.
I was nervous going into it not having either listened to the radio programme or read the book, though I was an admirer of Susie Orbach through her thought-provoking articles in The Guardian. I was relieved that I was not the only one not to have ‘done my homework’ - one brave soul admitted as much during the Q&A. I arrived early, bought a copy of the book, and started to read it while waiting in line. It drew me in immediately, and I didn’t want to put it away when we were called in to sit down. As with any good story – and therapy is greatly concerned with stories – I wanted to know what happened next. Or rather, in this case, I wanted to know who said what, next, and why.
One of the first things that Susie talked about was how the radio show was put together and recorded. She gave a very minimal brief to the director – for example, the type of client and the type of issue they were struggling with - and the director worked with actors to fill in the back story. When asked about the ‘reality’ and the authenticity of the recorded sessions, Susie made it clear that they felt authentic to her, and that she wasn’t simply ‘playing a part’. Her responses were of the moment and unscripted – she had no idea, beyond the summary she had given to the director, what her ‘clients’ would bring.
Through her discussion with Jill Dawson and afterwards, when the floor was opened up to questions, Susie brought out a number of the key aspects of the process of therapy, in a way that was very accessible to ‘lay’ audience members, but did not shy away from the grey areas, the complexity, the nitty gritty, or the more intangible elements of the experience which do not lend themselves so easily to words. As Susie has written about before, the therapist and client create their own unique relational language together, but therapy is also about what can only be shown, rather than said, and about the space in between the saying. Susie talked about the fact that the BBC had allowed silence to exist, unaltered, in the recordings. To my mind that was a decision that was both respectful of the process, and courageous, particularly given that silence engenders discomfort in so many people. It certainly did in me, for the first few months of therapy, until I was able to get to the bottom of what the silence meant for me, and why.
The conversation ranged over topics such as the importance of paying attention to the interaction between therapist and client, the emotions experienced by the client, and also by the therapist in response to the client. Susie talked about the importance of allowing oneself, as a therapist, to be ‘in’ the client’s experience and affected by it, in order to gain insight; while at the same time standing outside the client’s experience in order to be able to hold the space for the client, and not be overwhelmed. A number of questioners were curious about how it’s possible to do that, and about whether Susie found it difficult to do. It was interesting to hear her respond that it was like using a muscle. By which I understood her to mean that it is by exercising the muscle – practising therapy – that it becomes stronger and its abilities and motions become more familiar and ingrained, and are achieved more easily. Throughout the event, it was both fascinating and moving to experience Susie’s honesty in conversation, and her obvious curiosity and passion for her work.
As a therapy client, it was strangely terrifying sitting in an audience which in all likelihood, contained a large number of therapists! But as a therapy client, it was also immensely encouraging to hear a therapist talk openly not just about the process of therapy, but how they see it, and their own experience of being in that room. Many clients – myself included - would love to know more about what goes in their therapist’s head, and while we recognise that therapists are people, and all people are different, we hope there is some common thread in therapists’ experience, that can give us some comfort and knowledge about the questions we puzzle over. For example, it was good to hear that Susie sometimes thinks about clients outside the therapy room – because many clients want to matter enough, to be interesting enough, and to be cared about enough, not to be forgotten when our time is up. It was also fascinating to hear Susie talk about how being a therapist is a way of continuing to be reflective about oneself. I know that I’m very conscious of how much I receive from my therapist, and how limited are the ways in which I can ‘give something back’. Knowing that I am part of a process which helps my therapist to think about herself, feels a little like that ‘giving back’.
There were some moments that really stood out for me, partly due to resonances with my own experience. One therapist in the audience asked how Susie deals with times of ‘not knowing’ in session. As well as the responses any individual might have to that sort of situation - “oh ****”, “what’s going on” – she also talked about the possibility of being open with the client about not knowing. It reminded me of the times my own therapist has ‘admitted’ to not knowing, and how powerful that has been. Realising that I won’t always be understood, and that that’s okay, has been a big learning point for me in therapy. Sometimes, seeing how committed my therapist is to helping me, and seeing how much she really wants and tries to understand, feels just as connecting, and just as intimate, as those moments when she seems to see right to the heart of me.
Another audience member asked Susie what she would consider to be a ‘good outcome’ of therapy. Her response made me think that we should dispense with the misnomer of the ‘talking cure’- because it is change, not cure that the process is concerned with. Susie talked about a good outcome being one in which there is an increase in one’s appreciation and understanding of complexity, an acquisition of a greater emotional range and a vocabulary to describe that range. A good outcome is acquiring the ability to make use of the questioning and ‘therapeutic’ ways of thinking about oneself and the world, years and decades after sessions have ended. And – what resonated most strongly for me – it is the ability to be in the world, engaged with it, while holding a boundary that facilitates neither intruding, nor being intruded upon. What struck me about all of those aspects of a ‘good outcome’ is that they are not one-time, defined, achievements, they are daily practices, involving continual growth. They start during the therapy process, and continue beyond it – and like the ‘therapist’s muscle’, they grow stronger and more ingrained with practice. That is a huge comfort for me, as I think about my therapist’s retirement in the not-too-distant future, and my fear of not ‘completing’ the process and not ‘achieving’ everything I need to, by the time we finish together.
Listening to Susie speak gave me an intellectual impression of her own practice of therapy. But there was one moment during the evening, which more than anything else, conveyed to me a sense of what it might be like to be in a session with her. Someone rather hesitatingly asked a question which drew an audience response unlike the appreciative intake of breath or friendly laughter that had greeted other questions. It felt as though the audience’s reaction contained a shot of surprise, a measure of incredulity, and a dose of judgement. In the couple of seconds before Susie answered, I felt the audience’s reaction as shaming, and I felt pained for the questioner, wondering how they were reacting. Was it a case of me projecting my own judgement of the question onto the audience, and then feeling ashamed for that judgement? Perhaps.
Sometimes, when I feel great shame and inadequacy in session, I notice that my therapist’s tone of voice changes. I don’t know if she does it deliberately, or is even aware of it. Her voice becomes softer, gentler, and its quality changes in a very subtle way. And it felt, to me, as though this is what happened when Susie responded to that question, and it felt as though the room fell into a greater quiet as well. It felt to me as though her response gave the question the gentle dignity, seriousness, and compassion that the questioner deserved, and by the end of her response it felt as though that hesitant question – perhaps from someone who was uncertain about therapy - had been one of the most important, most illuminating questions of the evening. This whole exchange took no more than a couple of minutes, and I fully acknowledge that what I heard, felt, and interpreted, could have little or no correspondence to what the questioner, or Susie herself, experienced. But in that moment I felt I’d encountered Susie as a practising therapist, and not just as a therapist talking about her practice. I felt what I imagine her radio audience felt, as they listened – but being ‘in the room’ as it were, had an immediacy and impact all of its own.
I’m very much looking forward to finishing ‘In Therapy’, and just wish I could have mustered up some interesting and appreciative words to say to Susie, when she was signing my copy of it! I’m also grateful to the organisers of the Cambridge Literary Festival for a fantastic session, and for bringing therapeutic story-telling into the frame of the event.