‘The Examined Life’ Gathers Decades of Wisdom in One Book

This will be one of the easiest reviews I will ever write. The Examined Life is a joy from start to finish. I can’t think of a reader who wouldn’t benefit from the insights Stephen Grosz presents here, in his first book.

Grosz has been a psychoanalyst for many years. Upon reaching his 60th birthday, he realized that he might not be around for his child’s emergence into early adulthood, and he wanted to be sure that he had a book of insights to pass on to her. So he contacted some of his patients and asked if he could gather their stories into one volume. Not a single patient objected; each hoped that others might benefit from his or her story.

Grosz divided the book into sections on various life stages, such as beginnings, changes, and death. Each section contains surprising insights.

For example, in the “beginnings” section, Grosz recalls a patient who shocked him. This patient had been in therapy for several weeks when he stopped showing up. His girlfriend sent Grosz a note that said he had killed himself and, obviously, would not be coming to therapy anymore. Months elapsed. Suddenly, the supposedly dead man materialized; he had forged the note from his girlfriend. He had felt a compulsive need to astonish and unsettle Grosz.

After several consultations, Grosz and the patient discovered that the patient had been badly traumatized in the years of his infancy. His young parents had been overwhelmed; they had used physical violence to try to calm their baby. The baby “stored” memories of that startling violence for years and though, as an adult, the patient could not consciously recall having been abused, he enacted his own story by abusing others. Grosz says, “When we cannot tell our own stories, our stories tell us.” If we have repressed something traumatic, we may end up enacting the trauma without understanding what we are doing.

Other stories are equally remarkable. One patient is an autistic child who insists on spitting at his therapist at the beginning of each session. Grosz, and the child, cannot unearth the reason for this obsessive anger. Finally, Grosz realizes that the anger is meant to mask a deeper feeling: intense sadness. The child is sad that he will never be like his siblings, or like other “normal” children. He will always suffer from disabilities. Once Grosz and the child are able to discuss and mourn this reality, the treatment progresses. The child grows up and becomes a mailroom worker in a company, and fondly, annually recalls the help Grosz once gave to him.

Still another patient, in Grosz’s section on death, discovers that he has HIV. As his body fails him, he begins to fall into silence in each of his sessions. The silences have their own individual qualities; some are anxious, some are restful, some are sad. Knowing that he can be quiet, and still be present in Grosz’s mind, the patient begins to relax and to articulate his wishes for his own death. He wants suicide; he does not want to be powerless before his surrender.

As it happens, the man lives through the development of pioneering drugs and now, 20 years on, he is reasonably healthy. Grosz’s larger point seems to be that we humans communicate with one another via silence, just as we communicate via words. We know some things about one another, even when we cannot articulate all of our perceptions, feelings, and thoughts.

A fourth patient has a less inspiring story. In his early 20s he, too, has HIV, and he is sent to Grosz by his doctor, so that Grosz might find a way to persuade him to take his medicine. Grosz fails at his task. He cannot find words to get the patient to practice self-care. Instead, the patient skips off to a tropical country for vacation and dies, at 26, of dysentery. Memories of this unfortunate chapter haunt Grosz years later, when he cannot persuade his own young son to take medicine for a different ailment. Suddenly, he finds the right tactic: empathy. If he had been able to communicate to the 20-something a bit about his own fears and irrational attitudes toward medicine, he might have helped that patient.

Grosz concludes the story by acknowledging that, sometimes, he finds himself longing to speak to patients many years after the therapy has been terminated.

It’s thrilling to read — and re-read — this book. It’s the sort of thing that makes you, briefly, aware that the things you’re living for are probably sort of inconsequential. We worry about money, and status, and how we are perceived by strangers, but the thing that really matters is our close relationships. We all have a pronounced need to have intimate connections to others — to understand, and to be understood.

I wish I could say I think this book will change my life in serious ways. It probably won’t. Books about therapy tend to be like slices of pizza, at least for me; they’re quite delightful on the way down, and then I forget about them.

Still, for a while, this book gave me a great deal to think about. It also renewed my belief in the efficacy of good therapy.

May we all seek help from a counselor as wise and as patient as Grosz.