Summary: Susie Orbach's new collection of fictional case histories addresses three themes. The first, and least developed, is the relationship of the clinical case history to literature, its dubious resemblance to the detective story, and the resentments such potential breaches of trust provoke in patients and colleagues alike. Where the former fear even the most disguised disclosures of their confidences, the latter worry about the public's discovery of their own emotional engagement with their analysis. This brings us to Orbach's central theme, the importance of the analyst's counter- transference in the therapeutic relationship. The unconscious feelings which the patient's responses stimulate in the analyst are the subject of these six narratives, responses varying from the emptiness experienced in highly erotic sessions with a compulsive casanova to the vertigo provoked by a patient's sudden transformation into a knife-wielding self-mutilator. In each story the analyst's ability to go with the emotions produced in the therapy and yet monitor her own responses enables crucial interpretations to be made. Here, despite Orbach's disclaimers, the aha! of detective fiction does seem to be operating, and everyone gets better, even the patient who never discovers the actual solution to an inexplicable--and terribly traumatic-- robbery.
My one reservation about this very interesting attempt to explain the psychodynamics of the counter-transference is its titular--but only briefly discussed, final theme--the 'impossibility of sex' between female therapists and their heterosexual women patients, and logically, between women in general. The book's brief afterword on this theme is hugely provocative and highly frustrating. Need the mother-daughter bond ban inter-female desire? Is celibacy the necessary fate of all lesbian love stories? Is it a girl thing? Or is it simply Orbach's own sympathetic, but disengaged, counter-transference which prohibits eroticism between her and all but her most homosexual women patients? And what happens then?--Mandy Merck