Thursday, February 23, 2012

Psychotherapy and Writing Fiction

Image: Ambro /
In real life, I have a real job that is miles away from writing. I’m a psychologist. A neuropsychologist, actually. And while my practice tends to focus on assessment and diagnosis of neuropsychological difficulties such as learning disabilities, Autism, developmental disabilities, acquired brain injury, etc. I’m also trained in cognitive behavioral therapy. It’s not really my forte, but I do it on occasion.

I was reading a novel in the paranormal romance genre when a thought struck me. Now, maybe I’m biased because of my job, but as I read through it seemed to me that the female protagonist had an awful lot of inner dialogue going on that consisted of negative thoughts. This got me thinking about cognitive therapy and the human experience in general.

In cognitive therapy the theory is (according to Aaron Beck and others) a person’s emotions and behaviors are largely determined by the way he/she structures the world. That is, thoughts or “cognitions” (verbal or image-based events in the stream of consciousness) are based on attitudes and assumptions developed from previous experiences. The goal of therapy with people who are feeling depressed or anxious or otherwise experiencing difficulties is to identify, reality-test, and correct distorted conceptualizations and beliefs that underlie these cognitions.

People in general have underlying thoughts that may or may not be in conscious awareness based on their past experiences. Trauma like divorce, a death in the family, an accident, or anything that is subjectively upsetting can have long lasting effects, causing us to interact with the world in a way that is affected by these events. For example, children whose parents divorce and subsequently lose access to one parent often feel that they are not important enough to be loved. A death or an accident can cause subconscious thoughts about lack of control in an individual’s life. Something as common as bullying at school can cause children to grow up with the recurring thought that nobody truly likes them.

Now, how does this work into writing? Well, it's a universal human experience to have these underlying thoughts. Everyone suffers some kind of trauma in their life that shapes the way they engage the world and other people. In the paranormal book I mentioned above (and as I think is frequently the case in this genre), the female protagonist was experiencing feelings that she was unworthy to have someone like the male lead love her. She was too damaged, too unattractive, too unimportant for someone as incredible as him to take an interest in. The majority of the tension in this book was created by him doing things to prove the contrary (reality-testing if you will) until I, as the reader, was practically screaming at this girl to open her bloody eyes and see the truth. The climax comes when they have a hot and heavy intimate session where she is forced to change her distorted belief (at least for the moment).

This seems to frequently be the case across genres. The protagonist is struggling against thoughts of inadequacy based on past experience, yet forced to confront these distorted beliefs and overcome them when faced with extreme events. Think J.R.R. Tolkien’s Frodo (or Bilbo for that matter) – how can anyone as unimportant as him carry out such a huge task? This makes for great tension. It also is a natural way to develop character growth. What a cool thing to consciously incorporate into writing fiction.

I recently ran across another blog post on Writer Unboxed related to therapy, albeit a very different concept from what I outlined above. It’s very worth checking out.

Looking forward to hearing comments on this post and get the perspective of people with different backgrounds than mine!


  1. I think it is fascinating when an author is aware of the psychology behind what they are doing and uses it to manipulate the reader. I also love when a writer is trying to work through something and unconsciously deals with it through their writing. Not that I would ever do such a thing. I'm speaking for my friends, of course.

  2. Stewart - I know you would never do such a thing and it's just coincidence that you like to write brooding hedonists. Just like it's coincidence that I tend to write characters that are awkward, social misfits. Wait, did I just describe the two main characters from our novel "The Breach"? I think I did.

  3. Great post. I've always thought of writers as having a bit of the psychologist in them, because good writing deals so much with character development. A believable story has to have characters who make sense to the reader, and this I think comes from understanding the motivating factors in characters' lives. Of course, as writers we don't always have to be as accurate with our assessments as you do as a psychologist.

  4. Thanks Joe! It really is all about developing character, no matter what background you're coming from.