Open Book

New and Noteworthy

The latest offerings spanning the therapeutic spectrum

Jim Naughton
Magazine Issue
September/October 2002
New and Noteworthy

Schopenhauer’s Porcupines: Intimacy and Its Dilemmas

By Deborah Anna Luepnitz

Basic Books. 249 pp. ISBN 0-465-04286-4

Therapy books based on case studies present problems of confidentiality. Writers frequently solve this problem by changing details or creating composites. But a composite, however faithful to the reality of actual cases, is basically the author’s creation. The result is that the author is, at least to some degree, making up the evidence to support his theories. And there’s no way for the reader to know how complete the fabrication is.

Deborah Anna Luepnitz tackles the problem by getting her clients’ permission to write about them. The result, in this instance, is a book of five case studies that are entirely true to life, right down to the meandering and sometimes inconclusive nature of clinical encounters. She uses her case studies not as a pretext for strutting her therapeutic stuff, but as opportunities to examine issues of desire and intimacy in all their rich and maddening complexity.

Luepnitz’s primary influences, the British psychiatrist Donald Winnicott and the French psychiatrist Jacques Lacan, could hardly be more dissimilar in approach or conviction, yet she attempts no tortured synthesis of their thought. Rather, she regards the sunny Winnicott as the comic face of psychotherapy, the gloomy Lacan as its tragic face, and remains open to the wisdom of each. This sophisticated eclecticism, and the lively clarity of Luepnitz’s prose, makes this a stimulating book.

The book’s title refers to a parable told by the sour 19th-century philosopher Arthur Schopenhauer. On a cold day, a group of porcupines attempts to huddle together for warmth only to lance one another with their quills. They withdraw, but still chilly, they come together once again, only to hurt each other and withdraw a second time. Schopenhauer felt this dynamic characterized all intimate relationships. Luepnitz, a psychoanalyst, doesn’t entirely disagree. “Psychotherapy cannot make us whole,” she writes, “but it does allow us to transform suffering into speech and, ultimately, to learn to live with desire. [I]t can help turn egregious neurotic misery into the porcupine dilemmas of everyday life.”


Candor Connection, and Enterprise in Adolescent Therapy

By Janet Sasson Edgette

W. W. Norton. 232 pp. ISBN 0-393-70356-8

Janet Sasson Edgette should have been fictitious adolescent Holden Caulfield’s therapist. On the evidence of her new book, she is one of those rare adults who understands adolescents’ obsession with all things “phony.” She writes with chatty authority about what the experience of therapy feels like for teens, mapping the many shoals on which adolescent therapy can founder.

Edgette is savvy about teens’ reluctance to participate in therapy. She recognizes that they don’t trust the therapist and that they find the entire process hopelessly contrived, potentially pointless, yet vaguely threatening. She knows too that therapists frequently make this bad situation worse by trying too hard to make teen clients like them, or taking on too much of the responsibility for making therapy work.

“Maybe the most important part of our job as therapists to unhappy teenagers is to reinstate a measure of faith in their pleasure at letting a kind adult really get to know them, and allowing themselves to be told what they need to hear,” she writes. Some of the essential steps toward that goal include being mindful of the teen client’s need to save face, and instinctive radar for therapeutic artifice.

The book has no theoretical pretensions and consists primarily of tips and case commentary. Still, a kind of philosophy of treatment does emerge–one based on mutual respect, subtle but definite boundaries, and creative responses to the challenges inherent in doing therapy with teens. For clinicians who feel deficient in this last respect, the chapter on “Troubleshooting Individual Session Impasses” will be especially helpful.


How Can I Get Through to You?: Reconnecting Men and Women

By Terrence Real

Scribner. 299 pp. ISBN 0-684-86877-6

Patriarchy is bad. People who oppose patriarchy are morally admirable. Had there been some way for readers to communicate their agreement on these points to Terence Real in advance, he might have felt free to write a better, shorter book. As it is, it’s still a pretty good one. The reader just has to work to separate the clinical insights–which male readers may find particularly painful and profound–from the ideology–which seems dated and simplistic. It’s as though patriarchy is the one suspect that Officer Real has in custody, and he’s going to pin as many unsolved crimes on it as possible.

Real’s premise is that men are initially less willing and less able to benefit from couples therapy than are women. He doesn’t spend much time establishing this fact. The reader is expected to trust his testimony, rather than weigh an assembled body of evidence. But if Real is right–and he must be in some cases–then any approach to couples work that’s based on the notion of therapeutic “neutrality” is destined to fail, because the man can’t participate as an equal partner. Men in couples therapy need remedial emotional education, Real says, and their wives and therapists are the teachers best suited for this job.

The book could easily have deteriorated into a stereotypical exercise in male-bashing, but fortunately, Real has a keen appreciation for how men are warped by prevailing standards of masculinity. His understanding of how failure to achieve impossible cultural standards imbues men with shame and a face-saving grandiosity is especially astute, as is the insight that many men are unhappy in their marriages because their wives are so unhappy with them.

Real’s understanding of women, deeply influenced by Carol Gilligan’s In a Different Voice, is fine as far as it goes. Women do put up with a lot from emotionally stunted men. This, however, isn’t all that they do, except in this book, where they express agency primarily by participating in therapy. And it’s therapy of a very therapist-driven sort. Despite his respect and sympathy for his female clients, Real tells readers little about their coping strategies or self-insights. The women he presents have been thwarted in their attempts to change one man, and so have turned to another man, albeit it an enlightened therapist, to help them.


Beyond Technique in Solution-Focused Therapy: Working with Emotions and the Therapeutic Relationship By Eve Lipchik Guilford. 230 pp. ISBN: 1-57230-764-1

As one of the originators of Solution-Focused Therapy (SFT), Eve Lipchik is familiar with the frequent criticism that SFT is formulaic and mechanistic. While she does not agree with the critics, she acknowledges that the method’s minimalism can be so seductive that practitioners can lose sight of the client in their devotion to the craft. As a corrective, in this book she proposes “elevating emotions to an equal position with cognition and behavior in SFT” and tries to demonstrate how to do it. This may seem like a “radical step” to therapists who were taught to “stay away from the feelings,” Lipchik says, but she reminds us that therapy is not simply a matter of asking the right questions, no matter how compelling those questions might be.

The book is divided into two sections, “Theory and Practice” and “Applications.” The former is more thought-provoking, the latter more manual-like. Clinicians who use SFT will appreciate Lipchik’s respect for the method. She is a reformer, not a debunker. Critics of this method will be gratified to see one of its pioneers wrestling so dexterously with its limitations.

One reviewer’s cavil: It is time for admirers of Humberto Maturana, the Chilean biologist and systems theorist, to acknowledge that however brilliant he may have been, and however decisive his influence on their own thinking, he was not the first person to recognize that humans do not experience reality in an unmediated form. It is an understanding as ancient as ritual.