By MARGIE THOMPSON
Forget the rather Freudian stereotype of the slowly nodding head and the gravely pressed fingers that typifies a kind of psychotherapeutic detachment.
Susie Orbach - best known probably to women as the author of Fat Is A Feminist Issue - is warm, friendly and patently caring. Her publicity photos characterise her as svelte and bubbly.
Her professional record testifies to a level of engagement that is the opposite of neutral. In fact, with the Orbach brand of psychotherapy, words such as intimacy and involvement are what spring to mind.
Which is partly why she will visit New Zealand next week, as a guest speaker at the New Zealand Association of Psychotherapists' annual conference in Tauranga.
(Psychotherapy is definded as the treatment of mental disorder by psychological means.)
She and her partner, psychotherapist and writer Joseph Schwartz, have been invited partly to share their views on the controversial nature of the relationship between therapist and patient - and also because Orbach remains a respected theorist on eating disorders and women's relationship with their bodies.
In keeping with her tendency towards involvement, whether that be in the consulting room or on a wider stage, she is well known as a tenacious participant in social policy debates, especially since the election of Tony Blair's Labour Government in Britain.
Orbach is a visiting professor at the London School of Economics, works as a consultant for the World Bank, and with other psychotherapists, educators and economists is part of an activist group called Antidote, whose mission is to "bring an analytical understanding to the public sphere."
It's a matter, she says, of understanding such issues as what produces violence in society and in individuals. And how people behave when they are abandoned, or what kind of social initiatives could make a difference in people's lives.
This approach fits well with the New Zealand association's code of ethics, which also recognises the impact on clients of their social environments.
"Psychotherapists view themselves as having a responsibility that extends beyond the consulting room relationship," says spokeswoman Sarah Calvert.
The association has a social concerns committee and extends its activities into political lobbying.
But the issue with which Orbach is currently making waves around the world is explored with extraordinary personal frankness in her latest book, the inaptly named The Impossibility of Sex.
(Her visit here matches the promotional campaign for this and another just-released book, Towards Emotional Literacy, a selection of the columns she has written over the past 10 years for the Guardian newspaper).
The Impossibility of Sex opens the door not only on the drama of the consulting room, but also to the process inside the therapist's own heart and head.
Therapy, Orbach maintains, is a "fabulous human endeavour" comprising a dynamic between two people who together explore some of the most profound questions we have to encounter as human beings.
To be useful, the therapist must be fully conscious of the effect her patient is having on her; it is only this kind of intimate involvement that will result in a positive outcome for both parties.
What Orbach is talking about, however, should never be confused with the intimacy of friend, lover or family member. It is an intimacy that is simply a means to an end.
The therapist, she says, is offered a special kind of opportunity to enter into the emotional experiences of another.
"She does so as a guest, touched and moved by the pain that besets her patients, but unlike them she is not trapped by these emotions."
From her London home - which itself sounds like a centre of active engagement, with her second phone line ringing constantly, Schwartz leaving for the day and taking the dry-cleaning with him, and Orbach herself frequently but charmingly apologising for the interruptions - she says that these issues have not been publicly talked about at all, although they have been hotly debated inside the profession since its beginnings more than 80 years ago.
"So-called therapeutic neutrality is not about being a blank screen, but about being very curious about what's going on in the room and in yourself. It can teach you such a lot ...
"But what you find with some psychoanalysts is that when feelings are aroused, these feelings are seen to be something that 'the patient has done to me.'
"I don't like this idea. No one can do things to you unless you've got the receptors in you," she says, applying a tenet of therapy to the therapists.
Self-knowledge and understanding have got easier as she has grown older.
Orbach says age - she is in her 50s but has been a therapist for "so long that people expect a little old lady to come hobbling in" - has brought complexity and depth to her thinking, and an important ability to tolerate ambiguity.
The Impossibility of Sex is an odd, genre-crossing book.
Its six case studies are conglomerates, extrapolations, blendings of people Orbach has seen over the years, or read about. None is based on actual individuals.
Therefore, the therapist/narrator can not truly be Orbach either.
"No," she says, "I didn't have the experience of Adam or Joanna or Edgar, but they do represent things I know about, and the reactions of the therapist in the book would have been mine."
The book thus becomes startlingly personal, certainly a demystification of the therapeutic process, but also - bravely - of Orbach herself, and of her most private thoughts.
* Susie Orbach's book The Impossibility of Sex is reviewed in the Life section on J9.
A svelte and bubbly kind of therapist...
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