Book Review: In Therapy, The Unfolding Story by Susie Orbach

I suppose I should start a review of a therapeutic book by confirming that I’m no expert, and that these really are just my thoughts about the book. I’ll also probably start with the things I didn’t like, because there are less of them than things I did. In Susie Orbach’s In Therapy, The Unfolding Story, to follow up to In Therapy (2016) there was an awful lot to learn, and I have pages and pages with highlighted text, so I suppose most of my issues with the book are cosmetic.

Room for Improvement

My first thought is: why on earth did they not spend money on a proper editor? Goodness, even on Fiverr this book would only have cost a couple hundred pounds to edit, and I simply can’t take a badly edited book seriously.

The other thing was – apologies for the spoiler alert – but I found myself… disappointed?.. when I found out at the end that the scenes were all paid actors for a radio show (or TV show, someone has since told me?) but either way, I felt duped. It doesn’t make sense an that’s probably an issue I should take up with my counselling supervisor. But there you have it. I guess, in comparison to ‘On Learning from the Patient’ by Patrick Casement, where he has used carefully considered real client experiences, I just felt that it was less authentic. But I understand the ethical dilemma and I truly get that this is a ‘me’ issue.

Things I liked

I loved the style of the book. So many therapy books are so dull, and so heavy, that reading them is a chore. This book was a light read, easy and digestible. It showed real insight into working with clients, and the chapter sizes were perfect for keeping attention. There wasn’t a huge amount of theory, which I found interesting – I never know how much theory to throw at clients, or whether the theory is just for me as the therapist and this book highlighted that for me.

It also really struck me how much she talks, and how much she interrupts the client. One of the things I’ve found frustrating in my own training is the number of therapists who are simply ‘listeners’. There’s nothing wrong with listening, but if I’m paying a pound a minute, I don’t want to feel like I’m sitting having coffee with a friend who has never experiences what I’m going through. I want to be challenged, and in her sessions, Susie Orbach does that in spades. I think that’s made me feel much more comfortable in speaking to my clients.

Things I learned from Susie Orbach, In Therapy, The Unfolding Story

To be honest I can’t really write down everything I learned, because I’d be practically re-writing the book, but here are a few key things that stood out for me.

Clients can be ‘full of words’ and yet ‘devoid of the ones they need to express the underlying confusions.’
As I write this I have seven client hours to my name, and I can already confirm this. People have no problem talking, but they often don’t have the emotional vocabulary to actually express what they’re feeling. Sometimes our job is simply to put words to the emotions; to name them.
“The work of therapy is simply to open up these three levels: feelings, words and ideas.”
That’s self-explanatory and feels like a huge relief to me. We don’t have to have the answers. Often when clients are helped to name what’s going on for them, they’re able to come to their own conclusions. That makes so much sense to me now.
In one of the stories with Harriet, Orbach comments “The words aren’t conveying the emotional dejection Harriet is transmitting, so I try to give her some.” I found this valuable, because not only does it confirm the idea of giving the client emotional vocabulary, but clarifies for me that this isn’t the same as ‘putting words in their mouth’. The client still has autonomy to say ‘no, that’s not really it’ or ‘yes, that is it exactly.’
“When you are drenched in shame, it stops other kinds of thinking and feeling. You are in a closed loop where it is hard to release the sorrow.” This made me think of a client, and I think I need to explore the concept of shame further, because this could be relevant to an awful lot of people.
Still on Harriet, this concept of shame and being stuck in it is interesting. “If we probe, we may be able to enable a wider spectrum of feelings… (which) once experienced may move the individual who is ‘stuck’. I think this is much of the idea behind Somatic Therapy – allowing the client to move beyond that ‘stuck’ feeling that is keeping them trapped in a loop, often doomed to keep enacting the same behaviours, or what Jung calls the ‘unconscious’ that needs to be made conscious in order for it to no longer direct our lives.

Quotes to remember from Susie Orbach, In Therapy, The Unfolding Story

Therapy takes the time to listen closely. To find entry points so that contradictory thoughts and feelings can surface and be acknowledged, so angers can be heard, disappointments felt, anxieties unpicked. In that hearing, a person or a couple can know themselves, their motivations, their feelings, their understands of self, more deeply. (p.9)
“Therapy’s aim is to understand, to provide context, to indicate ways of thinking, feeling and being that invite the individual to know more of her-or himself, to extend their experience, to intervene in stumbling blocks or hurtful practices, to live more richly.” (p.9)
“As we probe, we may be able to enable a wider spectrum of feelings, such as disappointment, sadness, hurt, loneliness, fragility. Such feelings, once experienced, may move the individual who is ‘stuck’. (p.91)
“If therapy is just about letting off steam, then it isn’t therapy. It doesn’t provoke change, it just keeps things in stasis.” (p.128)