Top 10 books about psychotherapy

Its tantalising mix of self-exposure and self-discovery is as intriguing in fiction as it is in fact. A therapist-novelist recommends the best of both

The mystery of what goes on behind the closed door of the consulting room has long intrigued those outside. Unsurprisingly, a world where secrets, problems, emotions, and taboos are shared with a complete stranger is one that provokes enduring fascination.

It was Sigmund Freud’s work and his theory of the unconscious that revolutionised the field, and he maintains that we are all unreliable narrators caught in the grip of a more complex web of desires and motivations. His case studies, now justifiably shrouded with controversy, read like gripping detective stories. We are drawn to them, and the multitude of other books that followed, to unravel the mystery, and perhaps in so doing discover more about ourselves.

In my novel, A Good Enough Mother, I have attempted to combine a compelling narrative with authentic insights into the psychotherapy process. My therapist-protagonist Ruth Hartland is floored when she’s referred a new client who looks shockingly like her missing 17-year-old son. While an expert on others’ emotions, her own grief is an achilles heel, blinding her to the dangerous consequences of blurring professional and personal boundaries.

Here are 10 favourite books that have informed my work and writing:

1. Playing and Reality by Donald Winnicott
Winnicott’s innovative work as a paediatrician and psychoanalyst, and his ability to write from both the heart and head, had a profound and lasting impact on both fields. Along with wonderful insights into the origins of creativity in children, and how it might be nurtured in adulthood, he also coined the phrase, “the good enough mother”. The term refers to a mother who is not, as commonly misunderstood, one who is adequate or mediocre, but one who manages a difficult task: both caring for her child, and stepping back and allowing them to experience enough natural frustrations to lay the foundations for a proficient coping mechanism in later life. It still proves an aspirational concept for parenting and living life.

2. Ordinary People by Judith Guest
This novel is startlingly good on domestic breakdown in the aftermath of tragedy, and in particular, the way a child absorbs shame and blame on behalf of the family. Jared comes to therapy because he “wants more control” but paradoxically, over time, it’s the place where he can lose control and, after a poignant lightbulb moment, is finally able to connect with his grief.

3. Understanding Trauma – A Psychoanalytic Approach, edited by Caroline Garland An excellent book on the work of the Tavistock trauma clinic and its approach to working with difficult life events. The case studies show how primary (childhood) trauma can affect a person’s ability to cope with secondary trauma in the aftermath of tragedy in adulthood. It left me full of admiration for the painstaking work of the clinic, and also for those people irrevocably changed by events we might read about in the headlines without registering how much they have to do to rebuild their lives.

… Stephen Grosz.
‘The bigger the front, the bigger the back’ … Stephen Grosz. Photograph: Graeme Robertson/The Guardian

4. The Examined Life by Stephen Grosz
This deserved bestseller by psychotherapist Grosz is the beautifully written distillation of more than 50,000 hours of work with clients. The case studies read like exquisite short stories that perfectly encapsulate the weighty depths of longing, grief, denial and loss that find their way into the consulting room. I particularly like his observations on boredom, and the concept of splitting – his excellent phrase, “the bigger the front, the bigger the back” perfectly describing the hypocrisy of public figures in the light of their personal misdemeanours.

5. The Unconscious at Work, edited by Anton Obholzer and Vega Roberts
The relationship here is not between therapist and client – but with the workplace. This is a brilliant application of psychoanalytic concepts, especially the theories of Wilfred Bion, to the world of work. Written in a practical and accessible way, it offers valuable insights into leadership, “primary task”, team dynamics and the system of the workplace, inviting readers to find new ways of understanding organisational stress and the dysfunctional ways we can behave in the office.

6. Regeneration by Pat Barker
Set during the first world war, the role of the conflicted real-life protagonist Dr Rivers is to help shell-shocked soldiers recover enough mental fitness to return to the frontline. While Rivers, in his work with characters such as Siegfried Sassoon and Wilfred Owen, uses his pioneering treatment to contain the feelings associated with trauma, so he changes his own views about the war. An illustration of how the therapist might learn from the client and be transformed by the process.

7. Couch Fiction by Philippa Perry and Junko Graat
A recent discovery for me and one I’d recommend to all therapists in training. This graphic novel takes us on a journey with psychotherapist Patricia and her client James. It functions at two levels – the pictures showing their surface interaction, while the notes underneath give a more detailed breakdown about what else is going on. Tricky psychoanalytic concepts such as transference and countertransference, projection and splitting are made wonderfully accessible. It’s funny, too.

8. Aphrodite’s Hat by Salley Vickers
In this collection of short stories Vickers, a prolific novelist and former psychotherapist, explores love in different guises. In the story Troubles she examines the love a client has for his therapist. It’s good on the dynamics of the therapeutic relationship, in particular the false sense of intimacy it creates. At one point, the therapist muses about how much she knows about her clients, but how little about her husband. “I sat all day silently or overtly making enquiries, it was restful not to have to bother at home.”

9. In Therapy by Susie Orbach
Orbach was the founder of the Women’s Therapy Centre and has written popular and hugely influential books over the years, including Fat Is a Feminist Issue. This, her latest, uses five case studies to explore the process of therapy. As well as capturing the dialogue between therapist and client, Orbach enlightens the reader about what she thinks is really going on in the process. The associated dramatisation made for a gripping listen on BBC Radio 4.

10. Mad, Bad and Sad by Lisa Appignanesi
A historical overview of the treatment of women’s mental and psychological health from 1800 to the present day. Appignanesi offers a fascinating insight into the relativity of diagnosis and how treatment approaches have altered over time. It’s particularly good on the shift of attitude around abuse, from disbelief and denial to the acceptance of a different reality that embraces the true complexities of trauma. It left me wondering how our current mental health services will be viewed by future generations.

• A Good Enough Mother by Bev Thomas is published by Faber & Faber. To order a copy, go to Free UK p&p on orders over £15.


Bev Thomas

The GuardianTramp

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