The Doctor Is All Ears : CONFIDING: A Psychotherapist and Her Patients Search for Stories to Live by, <i> By Susan Baur (HarperCollins: $23; 304 pp.)</i>
I was walking my dog a few evenings ago when, across the street, an overweight blond woman with about an inch of dark roots began yelling at a shirtless, scraggle-bearded man: “Stop lying to me!” She dropped her purse on the sidewalk, sobbing. The man said something I couldn’t understand, then grabbed her shoulders. “Let go!” The woman continued to scream at him, completely hysterical, until the man threw both hands theatrically into the air, then turned and walked away.
“I’m laughing now,” he said as he went by me. “Ha-Ha-Ha.”
Dark-roots Woman faced the small group of people who stood staring at the scene--mostly Russian kids and their protective grandparents. “I can’t believe none of you helped me.” Her voice was filled with terrible anguish. “You people.”
And that was the moment when I began to understand “Confiding,” Susan Baur’s brilliant and passionate examination of how the stories we tell about ourselves shape our lives. Baur, a therapist who works with severely mentally ill people, believes that stories “not only state that this and that happened to me, but also that I’m a certain kind of person. I am one who characteristically copes or suffers or goes to sleep. Taken together, the anecdotes about my daily doings that I share with friends or simply tell myself give me an identity as well as an itinerary.”
Dark-roots Woman is a shining example of Baur’s ideas. One could actually see her entering the story she would likely tell to others, a story of being alone and vulnerable in a hostile world. People had watched her get brutalized and had done nothing. She had been betrayed her. Yet, in reality, or my reality anyway, the whole episode was over in a few seconds, and the man, while certainly an aggressive jerk, didn’t seem in those moments to be dangerous. In addition, with the exception of myself, the entire group of people who, in her eyes, had coldly refused to help, were children and elderly Russian immigrants who had limited English.
The stories we tell, Baur says, are structured around our sense of self and the world. It is one of the jobs of therapy to open our stories, to deepen and enrich them, and in the process, open our world as well.
Baur’s thoughts are interesting, but hardly new. The qualities that make “Confiding” so effective come largely from her unconventional approach to therapy and from the beauty of the writing itself. Chapters alternate between case-studies of people she has seen in therapy and explorations of various types of mental illness. Baur manages to keep one foot in clinical description, an elbow in philosophy, an ear in fiction and an eye toward spirituality, while consistently coming through with plain old good stories. Her case studies, instead of reducing people to a diagnosis in a goldfish bowl, are full of vivid, urgent life.
There’s Mr. Bartlett, a 50-year old man whose uncontrollable delusions are like a humid jungle growing over his entire existence. At the end of an exquisitely written chapter, full of humor and empathy, Baur says of her sessions with him: “We both understand that Mr. Bartlett’s mind does not work as it is supposed to, and also that Mr. Barlett has walked too far with Bobby Two-Ton Eagle and the others to leave them now. To admit that all the people he has ever loved are delusional . . . is to label his entire past insane and his entire future hopeless. Both of us are willing to let the heartbreak take its time in coming.”
In the only section dealing with a non-client, we meet senior therapist Ned Bennett, Baur’s supervisor at the Rhode Island clinic where she did graduate work. Dying slowly of diabetes, Ned was loved almost to the point of worship by everyone who knew him. He was brave, loyal and kind, and he had the gift of making people feel that they and they alone shared a special understanding with him. As Ned’s health worsened, he began to confide in Baur--his abusive childhood, terrible prognosis, pain and fear. Their relationship became even closer.
One morning when Ned was gravely ill, Baur accidentally discovered that much of what he’d been telling her were huge lies. When she confronted him, Ned attacked, making a cruel, throw-away comment so unlike the bighearted person he appeared to be, that just reading it gives an almost physical sensation of shock and loss. The following chapter, “On Lying and Believing,” is among the best in the book.
Whether Baur is exploring manic-depression, schizophrenia, pathological lying or family dynamics, she is unfailingly generous to the clients in all their quirks and contradictions (of course identities are changed). In a chapter titled, “The Tyrannical Nature of Explanations,” she contends that most of us draw ironclad conclusions about life and then edit out any information that conflicts with our belief system. This is damaging in particular to the mentally ill, Baur continues, because doctors will ignore whatever doesn’t seem pertinent to their diagnosis. This almost guarantees that no important, personal connections will be forged between doctor and client, and even more significantly, no one will really grow.
Instead, as a therapist, Baur advocates something she calls, “dangerous listening.” “When a therapist agrees to do the slow and careful work needed to modify the plot of a life, then such a clinician must sink into that life. . . . Dangerous listening wholeheartedly accepts the emotions expressed . . . but declines to be drowned in what appears to the client to be the unalterable facts of the matter, be they ‘facts’ about the CIA, . . . or about how life must be lived with an alcoholic spouse. In other words, dangerous listening involves both client and therapist. . . . Both are shaken and changed . . . and for the schizophrenics or manics telling their stories, this dangerous listening finally provides an opportunity to maintain their inherent differences and find common ground with members of the dominant culture.”
“Confiding” is a difficult book. It demands not only concentration but also a willingness to examine one’s own ideas about mental illness, emotional pain, and stories. Perhaps if the world were full of dangerous listeners, Dark-roots Woman would stand a better chance of finding someone truly to hear her, someone who would experience her story without squashing it with their own systems and symbols. Someone who would help to change the plot of her life.