A Good Enough Mother

I’m delighted today to share a fascinating new book with you by author Bev Thomas that hits bookstores today. What happens when an experienced therapist starts breaking all her own rules? This is the fascinating question at the core of A GOOD ENOUGH MOTHER (Pamela Dorman Books / Viking; On Sale: April 30, 2019) – a powerful debut novel about motherhood, grief, and obsession set inside the secret world of therapist and patient.

Ruth Hartland is an experienced therapist at the top of her game. The director of a renowned psychiatric unit for trauma victims, she is wise, intelligent, successful, and respected by her peers. But her calm professional demeanor belies a personal life full of secrets and sadness.

The mother of grown twins, she is haunted by the fact that her son Tom, a beautiful but fragile boy who could never seem to fit in, disappeared eighteen months ago. So, when Dan—a volatile new patient bearing an eerie resemblance to Tom—wanders into her waiting room, it’s not long before her judgment becomes clouded, boundaries are crossed, and disaster ensues.

Bev’s debut novel is a powerful page-turner about motherhood, grief, obsession, and the importance of letting go.

A clinical psychologist herself, author Bev Thomas has in-depth knowledge of therapy and mental health and takes readers inside Ruth’s head with rich detail and realism. Who among us hasn’t wondered what goes on in the private thoughts and life of a therapist? What is it like to be a sounding board for someone else’s troubles—and how do you deal with your own demons in the meantime?

A deeply compelling narrator, Ruth is poised on the outside but troubled within, incapable of moving on, fixated on how she failed her son and whether he can be found. With her family in pieces and her marriage crumbling, Ruth finds this new patient Dan is both a balm and a landmine—he is clearly unstable and manipulative, but he is also the shadow son she might actually be able to save. As Ruth twists herself into knots about her duties as a mother and a therapist, she becomes frantic and reckless, events spiral out of control, and her once calm and orderly life is violently disrupted.

A GOOD ENOUGH MOTHER will have readers on the edge of their seats, but it is also a brilliant, beautiful story of parenting, of how love consumes us and how difficult it is to heal from tragedy, even when we must.

Here’s a conversation with Bev.

The protagonist of A GOOD ENOUGH MOTHER is Ruth Hartland, an experienced therapist who specializes in helping trauma victims. You were also a clinical psychologist for many years and have an in-depth understanding of this world. What made you want to explore the patient-therapist relationship in fiction and how did your real-life experiences inform the novel?

Bev:

In my work, I had always been very interested in grief and loss – powerful emotions that not only underpin the human condition, but frequently find their way into the therapy room. But I was initially reluctant to explore the therapeutic world in fiction, as I didn’t want the focus to be on a patient. It was only when I flipped the concept and made the protagonist a flawed therapist instead, that the story began to emerge. What if a brilliant therapist is blindsided by feelings of grief about her own missing son? What if one of her new patients reminds her of him? And so the story began. 

All the detail around the case work is fictionalized, but the world is real. The workings of a National Health Service [NHS] department, the therapy work, and the understanding and treatment of psychological difficulties are very much drawn from my experience of working as a clinical psychologist in the public sector.

How do you feel about the way therapy is typically depicted in popular culture, including books, movies, and television shows? And why do you think people are so consistently fascinated with this subject?

Bev:

I find that in popular culture, therapy is often used as a plot device rather than something to be explored in its own right. There are many different types of therapy, but since my training was in the psychoanalytic model, it was this area that I wanted to explore in greater depth in fiction. It places emphasis on the transference, the relationship between therapist and patient, and the importance of boundaries, and these are the elements that get played out in Ruth’s story. 

Therapy is about enabling a person to make sense of their own life story. I think the general fascination with therapy in the media is partly because it’s such a private world: just two people talking in a room. There’s both an intimacy and secrecy to that relationship. In my book, people come to therapy feeling desperate, and hope their lives will change for the better. By opening a window into this world, the reader becomes a fly on the wall, and by seeing it all through Ruth’s point of view, the reader is simultaneously party to, and full of, her anxieties and struggles. People are endlessly fascinated and intrigued about other people’s lives, but I believe it’s more than just curiosity. I think people want to ‘listen in’ to learn about what makes people tick, in order perhaps to apply that learning and wisdom to their own lives.

There is clearly an appetite for this subject matter. Among recent works of nonfiction, there is the brilliant An Examined Life by the psychotherapist Stephen Grosz, where he writes beautiful case study vignettes. They read like perfect short stories that teach us about life, love, emotions and relationships. On television, the series In Treatment with Gabriel Byrne was an excellent portrayal of the complexities of psychoanalytic psychotherapy.

A GOOD ENOUGH MOTHER is also, as the title suggests, about the responsibilities and challenges of motherhood. Why did you choose to ground the novel in Ruth’s role as a mother and in her relationships with her children—and were there particular themes or issues you hoped to explore?

Bev: 

In my clinical work, I became particularly interested in attachment theory, and how this can affect the relationship between a mother and child. The title is taken from the writings of Donald Winnicott, a British pediatrician and psychoanalyst. It refers to the necessary progressive detachment of a mother to her child, so that the child is able to develop appropriate independence. The aim is for something less than perfect, not all encompassing, enabling a child to learn to thrive. In the book, the irony for Ruth is that, despite her best intentions, it is her own difficulties in separating from her son that contribute to his problems. 

Attachment and mothering are key themes in the book, reflected in the relationship between Ruth and her mother, Ruth and her son Tom, and also what we come to learn about the relationship between Dan and his mother. We also see how patterns can unintentionally be repeated through the generations. And in making Ruth the mother of twins, I wanted to help the reader to see differences in the way she parents her two children. Carolyn, as the overtly less ‘needy’ child, gets much less attention and focus, which clearly affects their relationship.

I think the book highlights a general tendency towards ‘over parenting’ and perhaps taps into the maternal anxiety of our generation. We are bombarded with messages that encourage perfection, success, and the emotional happiness of our children. And while we of course need to offer love and support to our kids, we also need to know when to stand back and let them find their own way, however painful that might be. 

Because of your background, you already had firsthand knowledge of psychological therapy and psychoanalytic theory before beginning this book. But you did do some additional research while writing. Can you talk a little bit abot what that process looked like, and what you learned more about?

Bev:

I did further research into the psychology of trauma. It was something I had encountered in my clinical work, but I was able to deepen this understanding through research, particularly into the psychoanalytic understanding and treatment of trauma. I came to appreciate the difficult and enormously valuable work done by therapists who treat the survivors of awful tragedies and traumas. We might read those stories on the front page of the paper, or see them on the evening news, but we don’t always think about how those people go on to live their lives after experiencing such terrible events. While Ruth is a flawed character, I hope readers will gain an insight into the psychoanalytic model of therapy and the extraordinary work done by skilled therapists in this field.

I also did further research into missing persons. I was appalled by the statistics of young people and adults that go missing every year.  My research focused on the lives of families and loved ones who are left in an awful limbo, a state that has been described as an ‘ambiguous loss’—a particularly painful psychological experience that is punctuated by hope, uncertainty, and a lack of closure.

From the first introduction of Dan—Ruth’s new patient who bears a striking resemblance to her missing son—it is clear that he is damaged and manipulative. Yet Ruth is drawn to him all the same, and the reader must wait with bated breath to see just how bad things get. How did you go about building suspense, and were you inspired by any other novels or films?

Bev:

I probably spent an inordinate amount of time on the opening chapter! It really needed to set up the book, revealing simultaneously both the risk and the inevitability of Ruth’s choice to continue seeing this patient. The reader needs to know it’s unwise, but also to understand the pull. In the book, the two parallel stories of Dan and Tom are interwoven. In each strand, there are important questions to which the reader wants answers, and it is the slow and steady revelations that build suspense, continuing until the narratives collide and come to a climax at the same time.

Unsurprisingly, I’m drawn to books and film that explore psychological and emotional complexities. One film that gets a mention in the book is Ordinary People, which is an extraordinary film about the aftermath of grief and loss in a family. I am endlessly fascinated about why people do the things they do.  The books and films I enjoy the most are often about ordinary people’s lives. The dynamics of family life are steeped in conflict and tension and encapsulate huge drama.

One of the fundamentals for me in writing this book was to ensure the characters make ‘psychological sense’.  I wanted the reader to really believe in them as characters; back stories, motivations, emotions and subsequent behaviors had to be believable and true. 

In many ways, Ruth represents the archetype of the “wounded healer.” Can you expand on that idea a little further, and what it means in the world of this book?  

Bev:

The “wounded healer” was a term originally created by the famous psychoanalyst Carl Jung. It refers to the idea that analysts are compelled to treat patients because they themselves are ‘wounded.’  

Many people in the caring professions come to the work because they are interested in it, but also perhaps because they have also had difficult personal experiences.  Therapists, just like all people, deal with the complexities of emotional and family life, and this can often add, rather than detract, from ability to do a good job.

As is highlighted in the book, however, a problem arises if work becomes a way of trying to heal a personal problem. For Ruth, helping and fixing was something that was rooted in her complicated childhood. She was the child of an alcoholic, and after her father left her family, she was the sole caretaker of a mother who was volatile and inconsistent. Undoubtedly, this life experience played a part in her decision to train as a therapist – and probably contributed to her being an extremely good one.

Yet, it is her more recent, current grief for her missing son that is her undoing. She is ‘wounded’ by this trauma, so at the very time she needs to be pulling back, she sinks in deeper, and Dan becomes a focus of her feelings of grief and despair. 

Therapists are not immune from the tragedies of life, and support and supervision are essential to ensure that their work is not compromised by their personal lives. In the book, Ruth has a supervisor, but she is not honest with him, hiding crucial information because she knows exactly what he would say if he knew the truth. She fails to practice what she preaches. 

Without giving too much away, A GOOD ENOUGH MOTHER culminates in a terrible act of violence. But the book doesn’t end there, and instead shows the characters working through the aftermath—confusion, grief, penance, acceptance. Why was it important to you to examine the effects of trauma and to grapple with the toll that this violence takes on the characters?

Bev: 

There is a multilayered aspect to the book, as I wanted to create mirroring between the emotional experiences of the characters. We see how Ruth’s childhood feeling of suffocation and lack of individuation at the hands of her mother is mirrored in her relationship with her son. We also see how her unresolved trauma regarding the disappearance of Tom draws her inexorably to Dan, as she’s compelled to try to find a way to ‘fix’ him, in a way she has failed to do with Tom. Dan was looking for a mother; she was looking for a son. It was a perfect storm. Interweaving these stories was fundamental to the plot, but I also wanted to make sure the emotional fallout following the tragedy was similarly multilayered. It couldn’t be a clearcut line of blame and responsibility that would fall at the door of one person – life very rarely works that way. It felt important to show the subsequent emotional unravelling in all its complexity.

What do you hope readers take away from A GOOD ENOUGH MOTHER?

Author Bev Thomas

Bev:

First and foremost, it’s a book of fiction, and so I hope they enjoy it and find the narrative thought-provoking. But I also hope they learn something new about the model of therapy, and the fact that you don’t need to be in a therapy room to find the concepts useful. I hope people will take away the value of acknowledging and experiencing our feelings. While Ruth thinks she is in control of her world, she is in denial about the strength of her deep feelings of grief and loss. But these feelings seep out. While there’s no instant ‘cure’ for such feelings, talking and connecting with them is essential. Ruth’s state of denial involves the suppression of feeling and that is what causes problems. 

I’ve worked in the NHS for many years, and currently work with staff teams in mental health services. On a daily basis I work in a system that is stretched and under-resourced. Mental health problems are increasing and services to support people are decreasing. It was my aim to highlight this pressure in the book. In one chapter, when Ruth works with a traumatized staff team, we see firsthand the tragic impact of the unavailability of in-patient beds for a desperately unwell patient. Services for mental health patients are shockingly underfunded and as a patient group, they are often disenfranchised and without voice and power to demand better services. One in four people will be affected by a mental health problem in their lives regardless of culture and social class, so this is an issue we should all be paying attention to. In particular, the book highlights adolescent mental health issues and so I hope it will draw attention to our responsibility for the youngest and most vulnerable in our society.

Now for those who aren’t familiar with the author, here’s a bit of background on her.

Bev Thomas was a clinical psychologist in the NHS for many years. She currently works as an organizational consultant in mental health and other services.

She lives in London with her family.

Thanks so much for stopping by today. So, what are your thoughts about a therapist that starts breaking all her own rules? Do you think there are certain times and circumstances that allow that?