Table Of ContentSTORIES OF THE INTIMATE RELATIONSHIP BETWEEN THERAPIST AND PATIENT
THE IMPOSSIBILITY OF SEX
Susie Orbach is a psychotherapist and writer. With Luise
Eichenbaum she co-founded The Women's Therapy Centre in
London in 1976 and in 1981 The Women's Therapy Centre Institute
in New York. She lectures extensively in Europe and North
America, is a visiting Professor at the London School of Economics,
and has a practice seeing individuals and couples and consulting
to organizations. She is a frequent contributor to newspapers and
magazines, as well as to radio and television programmes.
Her other books include Fat is a Feminist Issue (1978), Fat is a
Feminist Issue II (1982), Hunger Strike (1986), What's Really Going on
Here (1993), Towards Emotional Literacy (1999), and On Eating (2002).
With Luise Eichenbaum she has written Understanding Women: A
Feminist Psychoanalytic Account (1982), What do Women Want (1983)
and Between Women (1988).
Susie Orbach lives in London with her partner and two children.
THE IMPOSSIBILITY OF SEX
Susie Orbach
K A R N AC
LONDON NEW YORK
First published in 1999 by Allen Lane The Penguin Press
Published by Penguin Books 2000
Reprinted in 2005 by
H. Karnac (Books) Ltd,
118 Finchley Road, London NW3 5HT
© 1999 by Susie Orbach
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise,
without the prior written permission of the publisher.
British Library Cataloguing in Publication Data
A CLP. for this book is available from the British Library
ISBN: 978 1 85575 333 4
www.karnacbooks.com
Printed in Great Britain by Biddies Ltd, www.biddIes.coMk
For Sara Baerwald, Caroline Pick and Gillian Slovo
Contents
A Room with a View i
The Vampire Casanova 7
Belle 34
Footsteps in the Dark 63
Fat is a . . . Issue 94
Two Parts Innocent:
Two Parts Wise 116
The Impossibility of Sex
And So 184
Reflections and Questions 190
Thanks 2.09
End Notes 211
In this book I have struggled with certain words without a satisfactory
conclusion. I am unhappy about all the words used to describe the
person who visits the therapist's consulting room. Is she or he a patient?
Well, sometimes yes. Certain individuals like that word because it
captures for them the sense that there is something wrong, an emotional
illness. Is she or he a client? Again, sometimes yes. Certain individuals
like that word because it connotes a kind of consultative process. Is
she or he an analysand? Certain individuals like this word because it
conveys something about the process of a therapy and it has a sym
metry: analyst-analysand.
I myself find that all these words capture something about the
therapy and the therapy process but are considerably less than perfect.
In what follows I have chosen to use the words interchangeably, as
well as the words psychotherapist, therapist and analyst.
In the text, in the musings in italics, I have usually referred to the
primary carer in the person's early life as mother. I realize that
this is not always the case. There are fathers who have primary
responsibihty for their children from birth and there are relatives and
nannies who fulfil this role. Rarely in my clinical experience of seeing
adults has this role been an enterprise between two people in the way
that it is becoming for some couples with children today. We have
yet to see the effects of joint child-rearing on adult psychologies so I
have retained the notion of the mother or mother substitute, a notion
which will have to be expanded as the generations now raising children
make new arrangements between them.
I have also chosen for simplicity's sake to use the word 'she'
throughout for the personal pronoun rather than 'she or he'.
A Room with a View
Every working day people come into my consulting room to talk. And
although depression, anguish, disappointment, dread, fear or anxiety
may have propelled them into therapy in the first place, the conver
sation soon opens up into a confidential exchange in which desire,
hope and longing also fill the room.
Therapy is at its core an intimate relationship which explores some
of the most profound questions wc have to encounter as human beings.
The issues of how one can trust, how disappointment tears the psyche,
how love and hate are related, what sexuality means to the individual,
how betrayal closes us off to other people and how we can dare to open
ourselves again are all dramatized within the therapeutic relationship.
Therapy addresses these crucial issues in two ways. Firstly, as one
might expect, it examines how particular themes unfold in a patient's
life. Secondly, it explores how the issues of trust, betrayal, disappoint
ment, love, hate, sexuality and so on occur in and shape the relationship
between therapist and patient. The relationship in the consulting room
becomes witness to, a stage for, as well as a participant in, a unique
form of human drama.
Over twenty-odd years I have listened to and engaged with women
and men, couples and groups of people, sufficiently troubled about
themselves to want to understand themselves anew. Successful women
and men, highly educated, articulate and in demanding jobs, as well
as students and the unemployed, young and old, people from different
ethnic, national, religious and class backgrounds have entered my
consulting room to talk about what they yearn for amidst lives which
feel stopped or thwarted.
Listening to, talking to and engaging with people as a psycho
therapist, I have seen individual and family lives transform. I have
i
The Impossibility of Sex
witnessed and been inspired by people's capacity to change their
lives, to re-situate themselves within themselves so that their creative,
intellectual and emotional capacities can develop. From the sidelines
I have participated in the victories, the psychological struggles, the
achievements and the strength they have found to activate a life that
has personal purpose and value. Their struggles have forced them to
confront the deeper questions about human nature, about the integrity
of human beings, about the meaning of human connection, about
what makes us laugh, cry, love, grieve, hate, hurt, embrace, heal.
The psychotherapist has a particular view from her room. Drawn
into the world of her patients, trained to surrender to the drama that
patients create, as well as to extract herself sufficiently to see what
repetitively hurtful patterns are enacted, the therapist bobs in and out
of the emotional turmoil that is at the heart of the human condition.
The therapist is offered a special kind of opportunity to enter into
the emotional experiences of another. She does so as a guest, touched
and moved by the pain that besets her patients, but unlike them she
is not trapped by these emotions.
The interest and fascination that people have in psychotherapy and
psychoanalysis have encouraged me to try to write something about the
experience of psychotherapy from the psychotherapist's perspective. It
is common for clinicians to write books and academic papers about
psychological theory, psychological development and about the techni
cal issues in the therapy relationship and I have done so myself.1 But
here I am trying to do something very different. By trying to give a
flavour of what the practice of psychoanalytic psychotherapy is like
from the psychotherapist's point of view, I want to convey particular
aspects of doing psychotherapy: the challenges it poses, the intellectual
and ethical problems a therapist encounters, the feel of the relationship
developed between therapist and patient.
The popular view of the therapist, generated from novels and
movies, is of a silent, implacable listener unaffected by the most
shocking revelations. We are accustomed to thinking of the therapist's
neutrality, of her imperviousness and of her attentiveness, but we may
not be aware of how this equanimity comes about. In the stories that
follow I try to show the kinds of psychological states that a therapist
experiences during the process of a therapy and to demonstrate that
it is through scrutinizing the ways in which she is affected and stirred
z
A Room with a View
up by her patients that she is enabled to fulfil her professional respons
ibilities.
I decided to do this by creating a set of stories between imagined
patients and a fictionalized therapist, told from the perspective of the
therapist. I hoped both to convey a sense of the therapist's journey
with particular sets of issues that might come up and also to explain
the kind of thinking and theory therapists employ to understand
what is occurring in the patient's inner world and in the consulting
room.
The stories that I have heard in the consulting room over the years
are so extraordinary, so unpredictable and often so unlikely that if
one were to read them in a novel one might regard them as either too
fanciful or too horrific. The stories I have invented, by contrast, are
much less startling and rather more ordinary. I sensed that if I gave
them the kind of complexity and drama that is any of our real lives,
they would strike the reader as unbelievable and might be dismissed.
What 1 have tried to do none the less is to convey a sense of the risks
of the consulting room, the excitement and the emotional truths told
and discovered there. My fictional characters find themselves in life
and within the therapy in situations that have an emotional approxima
tion to the dilemmas of my actual patients.
Because each patient-on-the-page evokes differing responses from
the therapist, each story has a different feeling and shape to it. Some
patients evoke a need to theorize their experiences in order to make
sense of them while others do not. So some stories contain more
theoretical musings or tangential thoughts than others to elucidate
the story from the point of view of the therapist. These thoughts are
there not to illustrate psychological theory but to illustrate how certain
issues provoke my therapist-on-the-page into the thought process of
a psychotherapist as she works. They are printed in italics to allow
them to be easily distinguished.
In popular lore the psychotherapist is a detective fashioning from
the patient's material a plausible narrative which, when tracked down,
reveals the byways of the psychic journey. But while the detective
form which Freud was such a master at employing is one way of
telling about a therapy, it is not the method that I can use. Therapy
today is not so much the putting together of details to produce the
cathartic aha! as it is an exploration of the development of the therapy
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