People are fascinated by psychology and what makes humans tick. However, for the most part, what happens behind closed doors in a psychologist’s office remains a bit of a mystery. All that is generally known about therapy is that patients are asked to share their wishes, fears, fantasies and vulnerabilities in hopes of finding out what is overwhelming them. But who exactly are these people to whom we confide our innermost thoughts and secrets?
Psychologists and psychiatrists have long been used by crime and thriller writers to provide a protagonist’s backstory, advance theories about a crime, or give us insight into the mind of an unstable character. . Yet, recently, therapists themselves have become the center of attention in this genre. Specifically, the novels ask who this person really is? Are they trustworthy? Could the doctor be lying to protect someone or maybe even himself? What interests do they really have in mind?
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It’s no surprise to me that therapists take center stage in thrillers given that most people know little about therapy and the people who practice it. In truth, therapists contribute to the mystery because we generally only provide the most basic personal information to our patients and share nothing of our family life or personal history. What little a patient knows becomes the basic fodder for fantasy and guesswork. This certainly lays the groundwork for using therapists as a source of serious intrigue.
Often, the initial desire to become a therapist can indeed come from difficult experiences in childhood. However, we are usually required during the training process to enter therapy ourselves so as not to contaminate the therapeutic exchange with our own issues. But the lack of personal sharing by the therapist can leave the patient fantasizing that he is seeing only “the tip of the iceberg”.
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Speculation about a therapist’s motives can also be fueled by very real experiences patients have had or heard of regarding unethical therapists who violate the intimacy of the client-therapist bond, or worse again, engage in sexual boundary violations with their patients. Combined with the perception of a power differential in the clinical relationship, the fear of emotional manipulation can seem very real.
Subsequent novels spotlight incompetent therapists at best and immoral characters from his nightmares at worst.
“Blood Sugar” by Sascha Rothchild is an intensely unsettling yet terrifyingly immersive and fast-paced debut thriller.
Ruby Simon, 30, is a therapist who lives and practices in Miami. She loves her sister Ellie, adores her cat, has close friends and was in love with her diabetic husband until he recently died in his sleep. Now Ruby is charged with her murder. As a therapist, she knows she is not a psychopath. After all, psychopaths are generally not empathetic and do not form close, loving relationships. But that doesn’t impress the detective in charge who thinks she’s actually guilty of four murders. In reality, she’s only really responsible for three. And there were good reasons for each. So if Ruby isn’t a serial killer or a psychopath, what is she?
“The Patient’s Secret” by Loreth Anne White is a powerful, tautly written, twist-filled tale inspired by a real-life Canadian crime.
Lily Bradley is a psychotherapist, wife and loving mother in an affluent seaside community. One morning, her husband, Tom, a psychology professor, finds a dead woman while on his morning jog. Even though he is the one calling the police, he quickly becomes the prime suspect. It seems that the deceased woman, Arwen Harper, a sensual and free-spirited local waitress with her own secrets, attracted not only Tom but other men in the neighborhood. Was his death an accident, a brutal murder, or part of a serial crime? Not only is Lily’s seemingly perfect life thrown into question, but the neighbors begin to mistrust each other. Even the detective in charge, Rue Duval, has secrets she must keep. As all of their secrets begin to unfold, it’s important to remember that ordinary people can do terrible things if pushed to the brink.
The Silent Patient by Alex Michaelides is a smart, slow-paced story of love, loss, and revenge.
Alicia Berenson, famous painter, is married to the handsome fashion photographer Gabriel. One evening after returning to their fabulous London home, Alicia shoots her husband five times in the face and never says a word again. Her total refusal to speak brings Alicia to a secure psychiatric unit in north London, where Theo Farber, a dedicated psychotherapist, hopes to reach her. While Theo is determined to uncover the secrets behind Alicia’s crime, it seems Theo himself has some jaw-dropping secrets.
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Book Smart is a monthly column by Nancy Harris, of Scituate, a practicing psychologist and former professor of psychology at Harvard Medical School.