Short stories as case studies – How People Change

(The caption reads: Change is the essence of life)

I’ve been enjoying reading the short stories in Bill Tucker’s “How People Change”. Tucker, a psychiatry professor in New York, uses short stories by authors from Anton Chekhov to Jean Rhys as the basis of psychological case study discussions. Yesterday when I was reading some of the stories I was listening to Jacqueline du Pre playing Elgar’s cello concerto, which provided quite an intense accompaniment to the human dramas in the stories.

I was discussing the link between literature and psychology with a colleague and he was saying that it’s pretty obvious. Before we had psychology we had stories to give meaning to the crises of life. I think often this link between psychology and stories gets lost, and problems become reified in individuals. So-and-so has a problem with depression or anxiety rather than being part of a broader story, which has multiple plot-lines and narrative possibilities.

Here are some extracts from the first few stories. I love the vivid immediacy that these authors create:

“When he gets home Grisha begins to tell mamma, the walls, and the bed where he has been, and what he has seen. He talks not so much with his tongue as with his face and his hands. He shows how the sun shines, how the horses run, how the terrible stove looks on, and how the cook drinks …
In the evening he cannot get to sleep. The soldiers with the brooms, the big cats, the horses, the bit of glass, the tray of oranges, the bright buttons, all gathered together, weigh on his brain. He tosses from side to side, babbles, and, at last, unable to endure his excitement, begins crying.” (Grisha, Anton Chekhov)

“And then, because of the strange anxiety at her heart, she stole upstairs to her son’s room. Noiselessly she went along the upper corridor. Was there a faint noise? What was it?
She stood, with arrested muscles, outside his door, listening. There was a strange, heavy, and yet not loud noise. Her heart stood still. It was a soundless noise, yet rushing and powerful. Something huge, in violent, hushed motion. What was it? What in God’s name was it? She ought to know. She felt that she knew the noise. She knew what it was.” (The Rocking Horse Winner, D.H. Lawrence)

“Do you really eat oysters, youngster? That’s interesting! How do you eat them?”
I remember that a strong hand dragged me into the lighted restaurant. A minute later there was a crowd around me, watching me with curiosity and amusement. I sat at a table and ate something slimy, salt with a flavour of dampness and mouldiness. I ate greedily without chewing, without looking and trying to discover what I was eating. I fancied that if I opened my eyes I should see glittering eyes, claws, and sharp teeth.” (Oysters, Anton Chekhov)

“One evening I went into the back drawing room in which the priest had died. It was a dark rainy evening and there was no sound in the house. Through one of the broken panes I heard the rain impinge upon the earth, the fine incessant needles of water playing in the sodden beds. Some distant lamp or lighted window gleamed below me. I was thankful that I could see so little. All my senses seemed to desire to veil themselves and, feeling that I was about to slip from them, I pressed the palms of my hands together until they trembled, murmuring, ‘O love! O love!’ many times.” (Araby, James Joyce)

“Floor’s not bad,” said the new voice. Did one always begin with the floor? And then, “Were you at the Neaves’ on Tuesday?” And again Leila explained. Perhaps it was a little strange that her partners were not more interested. For it was thrilling. Her first ball! She was only at the beginning of everything. It seemed to her that she had never known what the night was like before. Up till now it had been dark, silent, beautiful very often — oh yes — but mournful somehow. Solemn. And now it would never be like that again — it had opened dazzling bright.” (Her First Ball, Katherine Mansfield)

Discussion
Tucker uses five questions to structure the discussion of each story. These questions are basically: 1) who is the patient? 2) what is the presenting problem and its history? 3) What happens (the treatment summary) 4) what’s the prognosis (for maintaining the change or responding to a similar crisis in future)? 5) what would be the relationship to the physician / psychologist / psychiatrist (what would help or hinder basically).

Erik Erikson’s eight psychosocial stages are also used as a basic unit of analysis, and as a way of ordering the stories. I tried to guess what developmental crises the characters in the stories above were facing. Grisha is autonomy vs shame and doubt; The Rocking Horse Winner is initiative vs guilt and industry vs inferiority (while the mom is experiencing a crisis of intimacy vs isolation); Oysters: industry vs inferiority; Araby: ego identity vs role confusion; Her First Ball: ego identity vs role confusion.

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