You’ll get more out of The Skeleton Cupboard, Tanyan Byron’s account of her training as a clinical psychologist, if you read the epilogue first.
It tells you that the patients described in the book are fictional, to preserve confidentiality, but indicates that the stories were representative of real situations.
This is a common device in clinical memoires, from Irvin Yalom’s existential tales of psychotherapy to Philippa Perry’s couch fiction, but I’m never quite sure what to make of these clinical quasi-biographies.
They are usually realistic, insightful and wonderful to read, Byron’s book is no exception, but the smudged line between truth and necessary fiction is sometimes hard to navigate.
In Byron’s case, her book is perhaps the most deliberately autobiographical in the genre, where she intends to reflect the role of the psychologist’s own psychology in working with distressed, impaired, and sometimes difficult individuals.
This is part of what clinical psychologists aim to do – understand how your own reactions are colouring your approach to the patient – but when the patients are literary collages of real people, it is perhaps the process rather than the content of those reflections that are the most informative.
From this perspective, The Skeleton Cupboard is best understood as an illustrated history of ‘how my thinking evolved as a clinician’ rather than a journal of patients past, although we assume the non-clinical parts are factual: the hard-boiled supervisor, the misjudged snogging of a psychiatrist, the friends through good times and bad.
Byron is Britain’s best ambassador for clinical psychology and a very good writer to boot and I’m sure The Skeleton Cupboard will prompt many to take up the profession or inspire them during their training. It’s also a good account of how thinking and practice evolves through first contact with patients.
It has some artistic license, maybe even melodrama in places, but it has some points of emotional truth that are hard to deny.
Link to more details of The Skeleton Cupboard.