Book Review: Consuming Psychotherapy

CONSUMING PSYCHOTHERAPY by Ann France. Free Association Books, London, 1988.

Ann France, a lecturer and writer in modern literature, wrote Consuming Therapy as a personal account of her own experience of therapy which lasted eight years. She reflects on the relationship she had with her three therapists, and their strengths and weaknesses in dealing with the various issues that arose during her therapy. She has a good knowledge of the psychotherapeutic literature and uses it to explore themes such as beginning therapy, transference, friendship versus professionalism, interpretation, play, silence, holding, absence and loss, and separation.

The style of her book therefore contains a mixture of subjective experience where she describes her relationship with each therapist, and a great deal of useful criticism of not just the

psychoanalytic way of working that she experienced, but the whole procedure of psychotherapy including the theory which informs the practice.

France describes the process of therapy as an encounter between two people in which one of them risks a great deal, exposes their vulnerabilities, in the hope of gaining greater growth and integrity. For this reason she suggests the titles of consultant and consultee, as it implies a more appropriate reflection of what she feels the relationship should be. Her own therapy progressed from initially very positive gains to a period of deep depression which she sees as a result of the negative transference that occurred with her second therapist who was ultimately unable to maintain a 'holding' relationship. Her third therapist, unconventionally, worked with the second therapist concurrently for eighteen months to enable France to move away from what had now become a stagnant and destructive experience. As a result of this, France discusses the problem of dependency in psychotherapy, particularly where there is more than one session a week.

The importance of experiencing genuine caring and interest is a theme that constantly recurred. She is particularly critical of the 'blank screen' approach which she refutes as even being possible. Neither caring nor interest can, she believes, be conveyed by an impassive professional. Therapy takes place as a result of the 'cooperative venture between two equals' in which both individuals participate and exchange both negative and positive feelings. In particular she questions the idea and validity of breaking down her defence mechanisms. She concludes that for her psychotherapy was not just a 'talking cure' but an opening up of the life inside and around her.

From the point of view of a therapist reading this book, France's account of psychotherapy is original because it is written from the consumer's view point. It is both highly readable, though academic in style. It examines all the main issues that are fundamental to most psychotherapeutic approaches, and questions many of the underlying assumptions of some and the validity of others. It is difficult to imagine any therapist reading this and not being challenged to look at or even modify their work. Highly recommended to both therapist and consumer.

Bernice Sorenson