The last book I picked to read in 2021 was rather unique, far from the fields I’m working in or from the other books I have been reading over the year. The Examined Life is written by psychoanalyst Stephen Grosz based on the life of the patients he encountered during his practice. As I read through the chapters, I can’t help but think of similar occasion that happened when I was growing up, and probably shaped me into who I am today. Reflecting on each chapter, I found that some of the message struck directly to my heart and made me more conscious of my feelings and emotion.

Below are some passages in the book that I found most relevant, but it is far from substitute to reading the book itself.

The author Karen Blixen said, ‘All sorrows can be borne if you put them into a story or tell a story about them.’ But what if a person can’t tell a story about his sorrows? What if his story tells him? Experience has taught me that our childhoods leave in us stories like this – stories we never found a way to voice, because no one helped us to find the words. When we cannot find a way of telling our story, our story tells us – we dream these stories, we develop symptoms, or we find ourselves acting in ways we don’t understand.

Nowadays, we lavish praise on our children. Praise, self-confidence and academic performance, it is commonly believed, rise and fall together. But current research suggests otherwise – over the past decade, a number of studies on self-esteem have come to the conclusion that praising a child as ‘clever’ may not help her at school. In fact, it might cause her to under-perform. Often a child will react to praise by quitting – why make a new drawing if you have already made ‘the best’? Or a child may simply repeat the same work – why draw something new, or in a new way, if the old way always gets applause?

In a now famous 1998 study of children aged ten and eleven, psychologists Carol Dweck and Claudia Mueller asked 128 children to solve a series of mathematical problems. After completing the first set of simple exercises, the researchers gave each child just one sentence of praise. Some were praised for their intellect – ‘You did really well, you’re so clever’; others for their hard work – ‘You did really well, you must have tried really hard.’ Then the researchers had the children try a more challenging set of problems. The results were dramatic. The students who were praised for their effort showed a greater willingness to work out new approaches. They also showed more resilience and tended to attribute their failures to insufficient effort, not to a lack of intelligence. The children who had been praised for their cleverness worried more about failure, tended to choose tasks that confirmed what they already knew, and displayed less tenacity when the problems got harder. Ultimately, the thrill created by being told ‘You’re so clever’ gave way to an increase in anxiety and a drop in self-esteem, motivation and performance. When asked by the researchers to write to children in another school, recounting their experience, some of the ‘clever’ children lied, inflating their scores. In short, all it took to knock these youngsters’ confidence, to make them so unhappy that they lied, was one sentence of praise.

Being present builds a child’s confidence because it lets the child know that she is worth thinking about. Without this, a child might come to believe that her activity is just a means to gain praise, rather than an end in itself. How can we expect a child to be attentive, if we’ve not been attentive to her? Being present, whether with children, with friends, or even with oneself, is always hard work. But isn’t this attentiveness – the feeling that someone is trying to think about us – something we want more than praise?

In 1946, while working in a leprosy sanatorium, the physician Paul Brand discovered that the deformities of leprosy were not an intrinsic part of the disease, but rather a consequence of the progressive devastation of infection and injury, which occurred because the patient was unable to feel pain. In 1972, he wrote: ‘If I had one gift which I could give to people with leprosy, it would be the gift of pain.’ Matt suffered from a kind of psychological leprosy; unable to feel his emotional pain, he was forever in danger of permanently, maybe fatally, damaging himself. After Matt left my office and before writing up my notes, I did what I sometimes do after a knotty, affecting consultation. I walked round the corner to buy a takeaway coffee and then returned to my consulting room to zone out by reading who knows what on the Internet. The truth of the matter is this: there is a bit of Matt in each of us. At one time or another, we all try to silence painful emotions. But when we succeed in feeling nothing we lose the only means we have of knowing what hurts us, and why.

‘Love can’t change what’s wrong with me,’ Michael said, ‘because love feels threatening. It’s the thing that made me break down before my wedding. Being loved is the problem, because love is a demand – when you’re loved, someone wants more of you.’

Over the years, I’ve seen several male patients become obsessed with prostitutes. The pick-up, put-down nature of the experience – the avoidance of dependence and emotional intimacy – makes the sex feel safer. And of course prostitution is a monetary transaction, and this inspires fantasy. But for Joshua, Alison meant something else. ‘Listen to the words you’re using,’ I told him. ‘ “Launch her into the world”, “love you for what you’ve done for her.” You sound a little like a mother talking about a baby.’ Joshua took another sip of water. ‘So I’m doing all of this because I wish I was a mother too? I envy my wife?’ I didn’t answer. It might be true that he envied his wife, her relationship to their son; this would explain something of the nature of his relationship to Alison, particularly Joshua’s mothering and the absence of sex. And yet it also seemed possible that he was acting out of envy for his son. In trying to seduce Alison from prostitution he might be endeavouring to steal a woman away from men – as he felt his son had stolen his wife from him. ‘Have you gone to prostitutes before?’ I asked. ‘No, never,’ he said. He told me that he and Emma had been together for eight years and he’d never been unfaithful to her, until this. ‘Did I tell you she calls the baby by the nickname she used to call me?’ ‘You’re telling me that you’ve always been faithful to Emma, but something’s changed. I think you’re betraying your wife because you feel betrayed.’

‘And then I got it,’ Abby says, ‘the bigger the front, the bigger the back.’ Psychoanalysts call this ‘splitting’– an unconscious strategy that aims to keep us ignorant of feelings in ourselves that we’re unable to tolerate. Typically, we want to see ourselves as good, and put those aspects of ourselves that we find shameful into another person or group. Splitting is one way we have of getting rid of self-knowledge. When Abby’s father cut her off, he was trying to cut himself off from those hateful aspects of himself that he could not bear. In the short term, this gives us some relief – ‘I’m not bad, you are.’ But in denying and projecting a part of ourselves into another, we come to regard these negative aspects as outside of our control. At its extreme, splitting renders the world an unsettling, even dangerous place – rather than recognise his devils as his own, Abby’s father meets them, as if for the first time, in his daughter.

‘I’m awkward. Some people like that, some don’t. I always seem to say the unsaid thing, the thing everyone’s thinking but no one wants to say.’ I tried not to show it, but I think he sensed how I heard this – that he could say the unsaid thing about others, but not himself. Did he make it awkward for others so that he didn’t feel awkward?

Most, if not all, of us have had irrational fantasies at one time or another. And yet we rarely acknowledge them – even to spouses or close friends. We find them difficult, even impossible, to talk about. We don’t know what they signify or say about us. Are they a sign that we’re breaking down? Momentarily mad? There are various psychological theories about why paranoid fantasies are a part of normal mental life. One theory is that paranoia allows us to rid ourselves of certain aggressive feelings. Anger is unconsciously projected: ‘I don’t want to hurt him, he wants to hurt me.’ Another theory holds that paranoia allows us to deny our own unwanted sexual feelings: ‘I don’t love him, I hate him and he hates me.’ Both of these descriptions may well apply, but neither seems quite sufficient. Anyone can become paranoid – that is, develop an irrational fantasy of being betrayed, mocked, exploited or harmed – but we are more likely to become paranoid if we are insecure, disconnected, alone. Above all, paranoid fantasies are a response to the feeling that we are being treated with indifference. In other words, paranoid fantasies are disturbing, but they are a defence. They protect us from a more disastrous emotional state – namely, the feeling that no one is concerned about us, that no one cares. The thought ‘so-and-so has betrayed me’ protects us from the more painful thought ‘no one thinks about me’. And this is one reason why soldiers commonly suffer paranoia.

It seemed to me that Amira’s mother’s desire to protect her daughter from other people’s envy was rooted in her own feelings of envy. Amira was at first surprised by this idea. But as she thought about it, it became clear that her mother was probably missing an earlier time. Amira’s mother had once told her that one of the happiest times in her life was during her first year of marriage, when she and Amira’s father had lived in France. ‘It can’t be easy for her,’ Amira admitted. ‘I’m looking forward to a marriage and children, and she’s a widow, looking back.’ Later, Amira wondered if she had been insensitive, or had perhaps unwittingly tried to make her mother jealous. We often envy our children their treasures – growing physical and mental strength, liveliness, joy, material comforts. But above all else, we envy our children their potential. Robert B., a fifty-five-year-old civil servant, once described to me a dream he’d had: ‘I’m on a mountain. My dead grandparents are at the very top, above the clouds. They’re resting in a small wooden hut, waiting for my parents who are just below the summit. I’m further down the mountain from my parents. My children are at the foot of the mountain and have just left our base camp. I hide behind a rock and my children pass me. When I step back on to the path and see them high above me, I feel euphoric.’ Among other things, Robert’s dream depicts his view of life’s expedition from birth to death, from cradle (base camp) to grave (a small wooden hut). It also represents his unconscious wish to step out of time, to reverse places with his children, so that he might have an even longer future stretching out before him than they do. For the most part, the envy I’m describing is unconscious: furtive, resistant to investigation or corroboration. We glimpse it in our dreams, but also in our slips and blunders. A mother I know, raised in poverty, was thrilled to buy her daughter a wool suit at Prada but, within hours, had accidentally put the skirt in the washing machine, ruining it. Envy often comes disguised in a correction – a father deflates his enthusiastic child with words like ‘cheeky’ or ‘precocious’ a mother complains that her child is ungrateful: ‘You don’t know how lucky you are,’ ‘I never had a such-and-such like this.’ When we envy our children we deceive ourselves – we think too little of them and too well of ourselves. You don’t have to be a parent to feel this particular envy. A sports coach can envy his athlete, a teacher can envy his student, and – it would be unfair not to include this – a psychoanalyst can envy his patient. Sometimes our patients are younger, brighter and financially more successful than we are. And it is not all that unusual that a psychoanalyst can help a patient solve a problem that the psychoanalyst himself has been struggling with unsuccessfully in his own life. Any ‘parent’ can get snagged by this particular form of envy.

Most of us have come down with a case of lovesickness at one time or another, suffering its fever to a greater or lesser degree. In severe cases, lovesickness can lead to delusional behaviours (stalking, for example) or sexual obsession. When we are lovesick, we feel that our emotional boundaries, the walls between us and the object of our desire, have fallen away. We feel a weighty physical longing, an ache. We believe that we are in love. Many psychoanalysts think that lovesickness is a form of regression, that in longing for intense closeness, we are like infants craving our mother’s embrace. This is why we are most at risk when we are struggling with loss or despair, or when we are lonely and isolated – it is not uncommon to fall in love during the first term of university, for example. But are these feelings really love?

Scrooge doesn’t want to think about the death of his mother, the death of his sister, or the loss of his fiancée – he cannot bear the thought that love ends. Dickens tells us that, before bed, Scrooge eats alone and reads his banker’s book – his ledger of deposits, withdrawals and interest paid. I take this to mean that Scrooge spends his evenings comforting himself; as he reads his deposit book, he thinks to himself, ‘You see? No losses, only gains.’ Ultimately, Scrooge changes because the ghosts unpick his delusion that you can live a life without loss. They undo his delusion by haunting Scrooge with the losses he has already experienced, the losses now being endured around him, and the inevitable loss of his own life and possessions. Dickens’ story teaches another lesson: Scrooge can’t redo his past, nor can he be certain of the future. Waking on Christmas morning, thinking in a new way, he can change his present – change can only take place in the here and now. This is important because trying to change the past can leave us feeling helpless, depressed.

Research has shown that, when a fire alarm rings, people do not act immediately. They talk to each other, and they try to work out what is going on. They stand around. This should be obvious to anyone who has ever taken part in a fire drill. Instead of leaving a building, we wait. We wait for more clues – the smell of smoke, or advice from someone we trust. But there is also evidence that, even with more information, many of us still won’t make a move. In 1985, fifty-six people were killed when fire broke out in the stands of the Valley Parade football stadium in Bradford. Close examination of television footage later showed that fans did not react immediately and continued to watch both the fire and the game, failing to move towards the exits. And research has shown, again and again, that when we do move, we follow old habits. We don’t trust emergency exits. We almost always try to exit a room through the same door we entered. Forensic reconstruction after a famous restaurant fire in the Beverly Hills Supper Club in Kentucky confirmed that many of the victims sought to pay before leaving, and so died in a queue. After twenty-five years as a psychoanalyst, I can’t say that this surprises me. We resist change. Committing ourselves to a small change, even one that is unmistakably in our best interest, is often more frightening than ignoring a dangerous situation. We are vehemently faithful to our own view of the world, our story. We want to know what new story we’re stepping into before we exit the old one. We don’t want an exit if we don’t know exactly where it is going to take us, even – or perhaps especially – in an emergency.

I read ‘Bartleby, the Scrivener’ as a portrayal of the continuous struggle at the core of our inner world. In each of us there is a lawyer and a Bartleby. We all have a cheering voice that says ‘let us start now, right away’ and an opposing, negative voice that responds, ‘I would prefer not to.’ When we are in the grip of negativity, we lose our appetite for human connection. We become Bartleby and turn those close to us into lawyers. Unconsciously, we drag others into pleading our case to us.

‘Success has ruined many a man’, Benjamin Franklin once said. This is true enough, but what Franklin didn’t mention is that we often work the ruin upon ourselves.

there are many men and women who work hard to attain a goal, achieve success, and then suddenly, cataclysmically, fall apart. What are the unconscious forces that cause us to sabotage ourselves – sometimes in even the tiniest of ways – when we’ve achieved a success? To begin with, we may be undone if we don’t foresee that winning is also losing. Three years ago, I had a patient named Adam R., a teacher, who became extremely agitated and then dangerously depressed after being appointed headmaster of a well-known school – a job he had always wanted, but one that would require him to move to another town. At our first meeting, he told me about his past – he had felt a similar anguish after the purchase of his first flat and then again after his wedding. ‘I want to be headmaster,’ he said, ‘but I never imagined how I would feel about moving. My whole life is here.’ Like many of us, Adam was utterly surprised by the loss that winning can entail. But through our work together, Adam and I came to realise that it wasn’t just the move that depressed him. Unconsciously, he believed that each of his achievements took something away from his father. ‘I feel bad becoming headmaster just as my dad is retiring,’ Adam told me. I pointed out that the one thing had nothing at all to do with the other. ‘I can see that,’ he replied, ‘but it feels aggressive. For the first time, I’ll be earning more than my dad.’ In Daniel’s case, his first instinct, like mine, was to suspect that the loss of his wallet signified some similar drive to undo his own success. And he too worried about how his success would affect others. ‘It made me queasy when my office manager said, “We’re going to have a lot of fun and we’re going to make a lot of money.” I felt a bit of a fraud. Am I really better than the nine other architects on the shortlist? I don’t think so, and they won’t think so either,’ he told me.

There are various ways to circumvent depressed, anxious feelings. It’s not uncommon, for example, to exploit sexual fantasies, or to use hypochondriacal worries. Elizabeth employed her disasters to calm herself – they were her tranquilliser. It’s also not uncommon to use some large-scale calamity, or someone else’s personal disaster – the newspapers are full of both – to distract oneself from one’s own destructive impulses, and I soon noticed this tendency in Elizabeth.

In 1956, the psychoanalyst Donald Winnicott, in an essay on unconscious guilt, pointed out in passing that a melancholic patient may irrationally confess to starting some major disaster, one to which he has no connection whatsoever. ‘The illness’, he writes, ‘is an attempt to do the impossible. The patient absurdly claims responsibility for general disaster, but in so doing avoids reaching his or her personal destructiveness.’ In other words, sometimes we might try to assume responsibility for a major disaster in order to avoid responsibility for our own destructive behaviour.

Boredom can be a useful tool for a psychoanalyst. It can be a sign that the patient is avoiding a particular subject; that he or she is unable to talk directly about something intimate or embarrassing. Or it can mean that patient and psychoanalyst are stuck; the patient is returning again and again to some desire or grievance that the psychoanalyst is failing to tackle. A boring person might be feeling envious, and might kill a conversation – disrupting it or paralysing it – because he cannot bear to hear a helpful or compelling idea coming from someone else. Or the boring patient may be playing possum – just as there are beasts in the jungle that survive by playing dead, some people, when frightened, simply shut down. It’s also true that psychoanalyst and patient will sometimes unconsciously collude to desiccate the atmosphere between them because they fear things becoming too emotionally disturbed, or too exciting. (Some years ago, I found that my sessions with an attractive young female patient were getting more and more lifeless. If I had to guess, I’d say that we were unconsciously avoiding any sort of charge between us.)

During a session a few days later, he spent a very long time describing a relatively minor incident from his childhood. And it hit me that Graham was silencing me. He understood that I would consider dreams and memories important, that I would not interrupt him, and so he took his time, staying in those stories as long as possible. Graham’s being boring was aggressive – it was a way of controlling, and excluding, others: a way of being seen, but not seeing. It also served another purpose. Especially in the context of his psychoanalysis, it protected him from having to live in the present, from having to acknowledge what was happening in the room. When I spoke to him about what was happening in his life, his response was to look back, avoiding how he felt or what he thought now. ‘I was never there,’ says Hamm in Beckett’s Endgame, ‘Absent always. It all happened without me.’ Graham’s long detours into the past were a haven from the present. Over and over, without knowing it, he was refusing to let the present matter.

Psychoanalysts are fond of pointing out that the past is alive in the present. But the future is alive in the present too. The future is not some place we’re going to, but an idea in our mind now. It is something we’re creating, that in turn creates us. The future is a fantasy that shapes our present.

they suffer more because they’re stuck on the idea of closure. They suffer more because they both expect to make progress, to move through certain stages of grief. And when they don’t, they feel that they are doing something wrong, or, more precisely, that there is something wrong with them. They suffer twice – first from grief and then from a tyranny of shoulds: ‘I should have pulled myself out of this,’ ‘I shouldn’t be so angry,’ ‘I should have moved on by now,’ and so forth. There is little room here for emotional exploration or understanding. This way of being leads to self-loathing, despair, depression.

My experience is that closure is an extraordinarily compelling fantasy of mourning. It is the fiction that we can love, lose, suffer and then do something to permanently end our sorrow. We want to believe we can reach closure because grief can surprise and disorder us – even years after our loss.