Writer’s Digest Article

How Fiction and Psychotherapy Compliment Each Other

I am a psychotherapist who writes fiction. Or maybe a fiction writer who practices psychotherapy.

The chronological order of when I applied myself to each discipline is clear, but what has become clearer now is how the two professions require a similar skill set that has made them complementary to one another.

I hadn’t always known this. I had been involved with storytelling in some form since college, writing for the school newspaper, reading and analyzing scripts for a movie production company, writing my own stories, and graduating with an MA in literature and creative writing. After teaching college freshman English courses for many years, and now with two children, I decided to make a career switch and apply to a master’s in clinical social work program.

Had I abandoned my love for writing and literature for a more dependable career path? On the surface of it, I thought I had. I had traded Tolstoy, Beckett, and Wolff for Freud, Beck, and Linehan. And yet I found the same zeal for them as I had for the other. I found that the skills involved in reading and writing fiction were also needed in understanding and aiding human behavior. The tools for doing so were different, but in many ways also very similar.

For one, the practice of psychotherapy requires deep listening and observing.  Often what’s not said is as important as what is said directly. Body language, facial expressions, tone of voice, automatic self-talk, and mood all play a role in understanding a person. Why does she say one thing, but her face and affect say another?  What is he trying to tell me when he drops a hint of something important right when he walks out the door?  What is she actually saying to herself that creates the mood she’s describing after she left that party?  The answers to these questions help me and the client begin the process of self-discovery that can lead to positive change and/or healing.  Watching a person begin to make connections about oneself and have what I call, “Ah-ha!” moments, is as exciting to be a part of as watching a character come alive on the page.

When developing a character, I ask:  How do I, as a writer, express in words who this character is and what this character is feeling?  I can write descriptive passages and I can also show the reader by creating mannerisms, character-driven dialogue, and internal thoughts.  If all goes well, the reader will begin to know the character by more than what is said directly, but also by a growing knowledge of how that character thinks and behaves.  The passage below is from my short story, “Joint Custody,” in which a single mother departs for the airport after her young daughter has left to stay with her father for the summer.  When a taxi arrives, her elderly neighbor, Mr. Bastible, encounters her on the street:

And just as Mr. Bastible took his hands off his cart automatically, his body moving to help her, Ann lifted the suitcase and heaved it into the cavernous trunk. One-two-three. Just like that. The women today, he thought, once again surprised, expecting nothing and doing everything on their own while this jerk cabbie sits in the front seat, picking his nose. “You’ll miss the fireworks display this Fourth,” he wanted to say, when the whole building, it seemed, climbed the stairs to the rooftop to watch it, a mass of humanity gathered together and the familiar warmth he felt when he saw her face, Emily’s, with maybe one or two of her friends, and Ann staring at the evening sky for that burst of color and spectacle when they all mouthed, “Aw!” in unison and glanced at each other to see if they’d caught that special one.

“See you later,” he said, barely looking at her and pushing his cart away with a heaving step.

“Goodbye!” she said to his back, feeling a little disappointed that he had turned away so soon.

Mr. Bastible’s “heaving step” reveals his loneliness and secret fatherly connection to Ann and her daughter in the anonymity of apartment living. Ann is completely unaware of this connection. The italicized words are his internal thoughts.  Ann’s need for support, despite her independence, is also felt when she finds Mr. Bastible has walked away so soon as she enters the taxi. A simple gesture by a character can communicate, at this point, more than a thousand words.

 And then, of course, there is empathy: the ability to put yourself into someone else’s shoes to understand what she or he feels.  There is a lot of discussion about empathy these days.  The media and online algorithms pull us into more and more distinct enclaves of thought and feeling.  And yet fiction still has the power to pull us into a different world unlike any other form of communication.  When I write or read a character, I leave my own life and enter one that is distinct from mine. 

 This is not unlike my work as a therapist.  The most effective psychotherapy takes place when there is an empathic connection between therapist and client.  Sitting with a client, I leave myself, reserve judgement, and sit with that client where he or she is now.  Writing and reading prepared me for this.  When I’m developing characters, their thoughts and feelings become their own and it’s as if they begin to write themselves. I, as the writer, am along for the ride. As readers, we may personally find Emma Bovary frivolous and selfish, but as we enter her life in the book, we become empathic to her spirit and passion as she feels trapped in her quiet country life. 

 People ask me if I ever write about my clients.  In a word:  Never.  To begin with, that would be a breach of the special pact between therapist and client: complete confidentiality.  Secondly, I don’t need to.  The richness of the human life makes for plenty of material for character development.  The human story is endlessly fascinating. Fiction and psychotherapy share compatible windows.