Book clinic: which fiction best depicts therapy and therapists?

The counsellor and author Bijal Shah recommends novels from the psychiatrist’s chair and beyond

Q: I’m studying to become a therapist. What are the best depictions of therapists and therapy in fiction?
Georgia Smith, 43, North Carolina, US

A: Bijal Shah, a counsellor, ‘book therapist’, author and poet, writes:
Fiction offers thoughtful insight into the conscientious work of therapists. Using the full breadth and depth of the creative licence, client cases are examined in blistering detail. The book that jumps to mind is Irvin D Yalom’s When Nietzsche Wept. A perennial literary guide for both therapists and therapists-in-training, it marries philosophy and psychoanalysis. Modern psychoanalysis founder, Joseph Breuer, attempts to treat the influential philosopher, Nietzsche, who is on the brink of suicide. Breuer, himself, is recovering from a broken heart. They form a therapeutic alliance, each attempting to heal the other’s depression. Yalom’s other notable novels with protagonist therapists, also of interest, include Love’s Executioner & Other Tales of Psychotherapy and The Schopenhauer Cure.

For something a little closer to home, try Pat Conroy’s The Prince of Tides, about New York psychiatrist Susan Lowenstein’s attempt to untangle the dysfunctional family secrets of her suicidal patient, Savannah. Lowenstein persuades Savannah’s twin brother into therapy hoping he might offer much-needed insight. She soon discovers the twins’ deeply disturbing past, realising the significant task ahead of her, only to fall for her brother – her own turbulent past is not so different. Eloquently written, it’s harrowing and testing for any therapist.

And if that falls short of a page-turner, the recently published psychological thriller, Alex Michaelides’s The Silent Patient brings to life every psychotherapist’s nightmare, a seemingly innocent patient potentially on trial for murder.

While different in plot, structure and writing, what these books have in common is the importance of a successful, intimate client-patient relationship. In this respect, it’s worth considering one nonfiction that reads like fiction, Lori Gottlieb’s Maybe You Should Talk to Someone. This reaffirms our faith in therapy through client stories and her own parallel therapy with her father-like psychotherapist, bringing healing and hope.

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Bijal Shah

The GuardianTramp

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