Lucy Ashe on The Model Patient

In this episode, I’m joined by author Lucy Ashe to talk about her latest novel, The Model Patient, looking at her own experiences with therapy helped shaped the story and how her research into women’s lives in the 1960s made her feel a sense of urgency.

Of course, no episode of Best Book Forward is complete without book recommendations. Here are the books that have shaped Lucy. You’ll find links to buy below:

Books by Lucy:

The Model Patient

Clara & Olivia

The Sleeping Beauties

Lucy’s Book Choices:

Northern Lights by Philip Pullman

Ballet Shoes by Noel Streatfeild

Fingersmith by Sarah Waters

The Bell Jar by Sylvia Plath

All About Love by Bell Hooks

Other Books Mentioned

The Handmaid's Tale by Margaret Atwood

Why We Dream by Alice Robb

Woman's Lore by Sarah Clegg

I’ll be back next week with another author conversation, and I’d love for you to join me for that too.

In the meantime, if you’ve enjoyed this episode, please subscribe, rate, and review Best Book Forward, and don’t forget to tell your friends. It really helps new listeners discover the show.

See you tomorrow, and happy listening.

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https://best-book-forward.captivate.fm/listen

To stay in touch with Best Book Forward news please follow me on Instagram @bestbookforward or visit my website: https://bestbookforward.org/

Welcome back to Best Book Forward.

I'm your host, Helen, and this is the podcast where I chat to authors about the books that have shaped their lives.

You can think of it as a little like a bookish version of Desert Island Discs.

Before we get started, I just want to share a quick reminder that subscribing to your favorite podcasts really helps shows like this one to grow.

It's completely free.

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Right, let's crack on.

So today I'm joined by Lucy Ash, here to talk about her brilliant new novel, the Model Patient.

Expected to lead.

Struggling with terrible nightmares, she begins therapy sessions with Dr. Daly.

But what starts as help soon becomes something far more unsettling.

The Model Patient is a gripping story about identity control and the cost of playing a role you never chose.

Lucy joins me today to chat about her writing experience of the Model Patient, including how her own experiences of therapy helped to shape the story.

And of course, later in the show, we'll also dive into the five books that have shaped her life.

So I think we should get straight into it and give Lucy a warm welcome to the show.

Lucy, welcome, and thank you so much for joining me today.

I am so excited to be here.

I'm so excited to have you here.

We're here to chat about your brilliant novel, the Model Patient, which is out now.

As you can see, I've been busy with my tabs on it, so really looking forward to diving in.

We are going to keep this conversation completely spoiler free to protect the story for anyone who hasn't read it yet.

But would you like to start off by giving listeners an idea of what they can expect when they pick it up?

Yes.

So the.

Excuse me.

The Model Patient is a psychological thriller.

And she is in this marriage that she was very excited about, but it's actually become very difficult for her because of all the things that she's given up.

She's given up her career.

Now her husband wants them to start trying for a baby and she is just not ready to do that.

She's also having these terrible nightmares so she goes to see a psychotherapist, which in the.

In the 60s was actually not the most common thing to do.

So she keeps it really secret.

She's.

She already has a lot of complex feelings about it.

But her relationship with this therapist very quickly intensifies.

She.

Because of the transference where she's projecting her past relationships, past traumas onto the therapist, she becomes pretty obsessed with him.

And this obsession deepens and deepens and deepens.

He takes her deeper into those delusions until she starts to lose her grip on reality and the novel.

Obviously, we're keeping it spoiler free, but there's.

Throughout, there's this very unsettling question of is she being manipulated or is she being cared for?

And yeah, it's a real kind of slow burn.

Simmer to the climactic ending.

It really is.

Actually.

It's a really good way of sort of describing it.

And you say it's a slow burn, sort of simmer.

And I know when you say that to some people, they're like, oh, I like things that are really sort of fast paced.

With this one, though, when you say slow burn, it is, but it feels like you're traveling at the speed and experiencing it.

With Evelyn, like, I felt like I was with her through the journey completely, although it took a while for me to sort of understand what happened in her past.

But it's brilliant and it's so compelling.

Like, I found it really hard to put down and actually really intense as well.

I found when I was reading it, I was like, I felt really uncomfortable in places because it wasn't, as you say, it wasn't a typical thing to do to go for therapy.

And her sessions are quite difficult at some points, which we will talk about in a minute.

So should we go back to the beginning then, and find out where did the inspiration.

Where did the idea for this all come from?

What was your original spark?

Yeah, the original spark was, I guess it was actually very, very personal because I had started going to therapy for the first time in my life because I was moving countries, I was leaving behind a job that I loved.

And these really big changes in my life were making me feel really unsettled.

So I thought I was going to therapy to deal with those things.

But what happened next I could not possibly have imagined because what I realized I was doing was psychodynamic therapy, which is kind of a form of psychoanalysis.

I didn't really know what that meant.

I didn't know what to expect from it.

But I had this very Intense kind of transference reaction to the therapist, where I was projecting a lot of my past relationships from my.

I used to be a ballet dancer, so, like my ballet world, relationships with men from the past.

And it was really intense.

And I would say it was kind of re.

Traumatizing.

Made worse by the fact that I didn't feel very sort of safe or contained in this therapy relationship.

I didn't really understand what the dynamics of our relationship was.

And the more I tried to ask my therapist, I like, why is this therapy?

How is this therapy?

Like, what.

What is the method behind what we're doing?

The, you know, the less he would tell me.

My questions were interpreted as a symptom of my kind of neuroses.

So I found that so bewildering, troubling that.

And also, I guess I was becoming pretty obsessed with the therapy and the therapist because of the way he's sort of very sort of silent and withholding.

It makes you really want to know what they're thinking.

I remember really thinking, like, am I doing therapy?

Right?

What is he thinking?

And he obviously would never tell me.

So I turned to books, as one does when one is confused about something.

And I was doing more and more reading and research into psychotherapy, the history of psychoanalysis, that sort of thing.

And the idea for a novel started to emerge.

I thought this.

This really interesting, vulnerable, delicate relationship between a patient and therapist is unlike anything in real life.

And yet it's supposed to reflect real life.

And the complication of that was really fascinating for me.

So I came up with the idea for the model patient, this very complex relationship between a patient and therapist.

But I did want to make sure that I wasn't just writing a book about my own therapy, because no one wants to be that pretty boring.

I started doing a lot of research about that.

I wanted to create a more of a historical setting, partly to distance it from myself, but partly because I felt that this would intensify some of the tensions for Evelyn Westbrook, the main character, because of the world that she's living in.

So really, the novel started to emerge alongside the first year of this therapy, this very intense, painful, retraumatizing year.

So I was sort of do.

I was living the book in so many ways in.

In that year of both doing the therapy, writing the book, researching it was.

It was both joyful and tormenting at the same time.

That's so interesting.

And you know that you've used your experience.

I mean, I've had therapy through my life, but it's always been sort of CBT or.

And I feel like it's a safe place.

So when I read Evelyn's story and I said to you before we came on, I just wouldn't cope well there.

I'm such a people pleaser.

I would be like, what's my answer?

And as you say, am I doing it right?

But I think that's really interesting.

My gosh, when you finish the book, you must have needed therapy almost again to sort of recover from writing it and being through it.

But it's interesting the sort of echoes of you and Evelyn that you've put in there.

Let's start with Evelyn, then talk about her.

So she is a really complex character.

Character.

She's so interesting to read.

Where did she come from in this sort of.

When you were doing your therapy, at what point does she sort of come into your mind?

And does she come in sort of developed or does she sort of progress as you were going through therapy or as you wrote the book?

Yeah, that's such an interesting question because I guess I. I mean, the first.

The first chapters of a novel for me are the hardest to write because you're really getting to know your character and developing that voice.

So they take the longest.

They take the most real thinking about.

So I suppose her character was quite formed in my mind quite early on in the writing.

But in terms of coming up with who she was, what kind of tensions that she's bringing to her therapy, her relationship with her husband, her best friend Diana, the.

That that did emerge quite gradually.

And, you know, I wouldn't want to say that Evelyn is a reflection of me and what I was talking in my therapy, because she's not.

She has completely different issues and dynamic with her therapist compared to what I had with mine.

But I did want to reflect this kind of.

And she is also a model.

So she's been under the gaze, the male gaze, for so much of her life.

And that's the way she.

She understands herself.

So that was a really important thing for me going in.

It's like she.

She sees herself through this lens of, am I attractive?

Am I making other people like me?

Am I going to get the next modeling job.

She's lived her childhood and teenage years and early twenties always searching for the next modeling job, which is quite a high pressure thing to do.

And it's imprinted itself on her personality.

So I had that with me as a driving force.

And that all gets repeated sort of compulsively in the therapy sessions.

And I wanted to show the way that when you do bring that sort of need to know if you're getting things right and you know, are you being likable?

If you are bringing all of that with you to therapy, it will play itself out, particularly if the therapist isn't giving you any val or feedback or reassurance.

And in some ways that's probably better as a form of therapy to actually be put in that place of discomfort and be forced to work through, like, why is it that I always need to know, like what someone else is thinking and am I getting things right?

Why am I so why am I valuing myself so much based on other people's opinions?

But it's a really difficult thing to do.

And it's especially in the intimacy of the therapy where relationship, it's very jarring, it's very shocking.

There's a point in the book quite early on which is a reflection of something that happened in my therapy.

When I was talking about how difficult I was finding the therapy, particularly the instructions that the therapist gave me.

He said, in psychodynamic therapy, you need to say exactly what you're thinking without moderating it.

It's terrifying.

No matter whether it's awkward or difficult, bring your dreams and I will be more silent.

That was his sort of explanation of psychodynamic therapy.

And I remember him that was after sort of four consultation sessions.

And then he said, we're going to try start psychodynamic therapy.

Those are the.

That's what you have to do.

And I spent the whole week panicking about it, like I don't know if I can.

And then I said that to him in the next session.

I was like, this is.

This is really difficult for me because I think I have spent my whole life trying to say the right thing in the moment to create a good environment in the room I walk into or make someone think I'm a nice person, that sort of thing.

And he said, yeah, well, maybe you don't know what to say to me because you don't know what would make me like you.

And then I. I hadn't even really thought about him as like a central character in my therapy journey yet, but that it's almost like a kind of this trigger point that I was like, wow, yes, I do really care whether you like me.

And then it also spiraled from there.

So I guess I wanted to hold on to that aspect of Evelyn's character throughout.

It's so interesting.

I mean, it's just a fascinating topic.

And I think if you look at it from Evelyn's point of view, being in the 60s and it's not something that all her friends are doing, it's like to have that and sort of care.

Because she also is carrying trauma with her as well.

You know, she's going through a massive upheaval in her life.

She's got past trauma and then she's in this really difficult situation.

Whereas I think now most of us would say, you know, we have somebody in our life that we could say, hey, look, I'm going through this therapy.

And it's, you know, we'd have.

But she doesn't have that.

Which makes it even more.

Those scenes when she.

We'll talk about that in a minute.

But when she goes into those scenes when he's asking her to tell her things also.

Oh, I just couldn't.

Yeah, well, yeah, because she's so.

She's so stuck between like wanting to tell him what he wants to hear and also being full of shame about telling him those things.

Yeah.

And it's a real tension for her.

She wants to be the model patient.

Unfortunately, being the model patient actually means sort of just repeating that.

All of those patterns from her past of giving up who she is to please men.

Yeah.

So when we first meet her then.

So as you say, she's given up her career.

She's married, newly married.

Her husband wants babies.

She's not quite ready.

She's got a mother in law who's very interesting character as well.

Where do we meet her emotionally at the start?

What's.

Where is she?

Yeah, she's in a place of real confusion and conflict because she actually really wants to make her marriage work.

She loves Henry.

She thought it was going to be a wonderful marriage.

They had this lovely courtship.

And now the reality is very, very different.

And she says to herself, I'm going to therapy so that I can be a better wife.

That's actually her goal.

But she knows that she's not comfortable yet with having.

It just feels like such a big step when she's just given up her career.

She was living in this lovely flat in Chelsea with her best friend and now she's living in this big house in Pimlico.

And her mother in law keeps appearing unannounced and sort of commenting on her cleaning and her cooking.

So she finds that really, really difficult.

And I suppose one of the things is that she feels she had found some autonomy and independence.

She's taking the contraceptive pill, which at the time the book is set, is very newly available and this gives her a feeling of, I guess, control.

And her husband wants her to stop taking it.

So there's all these conflicts of like, do I want to make.

I want to make my life better?

But she doesn't really know how and she's hoping the therapist will fix it for her.

And of course, therapists do not fix your life for you as much as you might want them to.

And I think, you know, she goes into those sessions hoping he'll somehow like be this kind of God that will heal her and tell her what to do.

But he doesn't.

No, it's a great start to the book because it just sort of really sets the tone.

You really understand her.

And as I said, I felt like I was sort of alongside her and really sort of, you know, as you see, there's in her mother in law's appearance of criticizing, she's sort of looking back at her life.

Her friend Diana's still very independent, living on her own as well.

It's such a great start to the book and so her journey is so interesting to read.

It's so interesting.

What was it that drew you to that time?

Was it specifically to have that sort of opening to talk about?

Yeah, I knew.

I think I was really drawn to writing a novel in the 60s.

Do you know, I really can't remember why.

I love researching the fashion, the music, the food, the weird cocktails.

So it's Something that's very comforting.

It's like a familiar thing for her that has given her a sense of control.

But the reality was very different, that this pill was not available for everyone.

And there was a lot of.

A lot of very taboo attitudes to it.

And there had been a huge amount of debate in Parliament about whether it should be allowed on the nhs.

There are some articles that I found it was like Sex on the State.

The pill make providing this promiscuous life for women.

It was at the doctor's discretion whether they prescribed it, and it was supposed to be, to start off with only for those who needed it for health reasons.

And of course, that's such a vague comment to say, you know, health reasons of not.

Not want.

Needing to get.

Not.

Not getting pregnant.

It was pretty much impossible to get it as an unmarried woman unless you had a really sympathetic doctor.

But even for married women, they.

Some doctors required the husband's permission.

So it was.

I felt that the contraceptive pill, for me, it was like a symbol of both change and autonomy, but also of.

Of how difficult it was to let that happen.

The resistance from so many sort of conservative sectors sort of holding on to the control over women's bodies even though the pill was available.

That's something that really struck me when I was reading, actually.

It's.

Particularly when you think if you were married, you had to ask your husband for it.

It's like.

It's just.

But I said to you as well, like reading it today, it's a historical fiction, but obviously women's reproductive health is back on the table.

Rights are being questioned again.

So it sort of made it sort of feel less historical and quite current in a sort of strange way.

How does that feel for you to sort of explore what was happening in the 60s in light of what's happening today?

Was it quite difficult for you?

Yeah, I had that feeling throughout.

I mean, I live in America at the moment, so that's even more pressing, I think.

And it just made me feel this sense of urgency that we remember how important this contraceptive pill was, is.

And to even consider controlling.

That just feels terrifying.

It feels that it's a.

It's the first step on.

It's not even the first step.

If we think about what's happening to these controlling of women's bodies.

But it's so dangerous to go down that.

That.

That line.

And I suppose one thing that I have been finding quite unsettling is this narrative that you do see in America, particularly from sort of.

Of conservative right leaning groups and also social media, the kind of trad wife movement, this fear that the contraceptive pill is somehow like a.

Like a sinister feminist conspiracy and that, you know, that women should be embracing their natural reproductive functions or whatever it is, however they're describing it.

And it just feels for me so dangerous and such a insidious thing to question whether women have the right to this very important pill.

So I felt that throughout and I hope that maybe reading this book will be a kind of reminder at times of just how far we have come, but we mustn't let ourselves slip back again.

That's what I was thinking when I was reading it.

I was like, you do sort of think how far we've come, but you think if we were to go back, it would be such a huge fallback.

Like it's.

And to sort of see these women having what they have to do to be able to take that control is really shocking.

And it'd just be horrendous if we found ourselves back there.

It would be a Margaret Atwood handmaid's tale thing that.

I love that novel so much because it's, it's, you know, she shows how a few small changes, like declaring a state of emergency, obviously that's a pretty massive thing, but that allows so many rights to be immediately taken away and just how quickly these things can.

Can happen.

I've always felt that that novel is both dystopian but also just incredibly realistic.

Yeah.

Yeah.

It's one of my favorite novels, actually.

I've read it.

I've read it in my 20s, my 30s, and my 40s several times.

And every time I read something different, but every time I read it and I read it, I think last year I was like, it's getting more realistic scarily every time I read it.

And I was like, should be becoming something that we're like, oh my gosh, can you believe people ever thought like that?

But it's like inching.

It's almost like she's an oracle.

Looking, looking forward to what we've seen.

Scarily.

Okay, so one of the themes obviously then are these therapy sessions with Dr. Daly, which I said when I was reading them, I could feel the sort of intensity and awkwardness.

And I really felt that because I was like, I would not want to be in that room at all.

But I loved how you wrote it because it felt really real, and I felt like I was experiencing what she was experiencing.

So I'd love it if you could talk to us about how.

How difficult it was for you to sort of frame those scenes.

Was it lots of redrafting or was it sort of pulling back from your memory of your own experiences?

Yeah.

I do think that it would have been impossible to write this novel without having been through the experience I went through, because I could not have imagined the type of conversation that Evevelyn has with Dr. Daly.

It's not like ordinary life.

You don't have those types of conversations where one person is pouring out their heart, but also in a very awkward way, because they're trying to.

But also not sure how much to say, and then the other person is really silent.

So I think the thing I was trying to hold on to and present through these sessions was the power of silence and his silence.

And if someone is really silent when you want them to speak and you want them to give you reassurance, validation, just, you know, sometimes just like, yeah, that sounds.

That makes sense.

You know, just a little thing, then the what is said, the few words that are said, or the.

The body language, or the placement of the two people in the room become hyper important.

And I think I wanted to show how she fixates on such small things that you wouldn't even notice in another ordinary conversation because of the intensity of the dynamic between them.

Like, she notices every time he leans forward, when he folds his arms, when he takes his jacket off.

She wonders how she should be sitting.

Like, where should she put her hands?

She thinks about what she's going to wear to each appointment and how it presents her.

And yeah, every tiny little detail had significance.

So they did take quite a long time to write because of the importance of each word in the conversation.

But I was drawing on, I guess, the essence and the atmosphere of my own therapy sessions.

Like, there's no repeat of actual sessions, thankfully, in there.

And also because Evelyn has very different issues to what I was bringing to therapy.

But I would say that the.

The atmosphere in the room is similar to what I experienced.

It's written so well because when I found myself sort of wanting to squirm a little bit when I was reading, I felt really uncomfortable.

And I was thinking afterwards, I mean, obviously I read the book, but I was like, I'd love to know I might go and listen to the audiobook, because I'd love to see.

Have you.

Have you listened to the.

It's really good.

I bet.

I don't always listen to the audiobooks or like, much of them, but this one, I. I couldn't stop listening.

It's kind of embarrassing about your own book.

No, it's great.

I love this book.

Yeah, I bet it.

I bet it goes over really well because I was also, like.

It'd be great to see it on screen as well, to sort of watch that sort of going on as well.

So hopefully that would happen as well.

But I must go and listen to the.

Do they use a lot of silences in the audiobook in the sessions?

Do they?

Not.

Not too much, but I think because the silences are written in.

To the sentences and often it's like, there's.

The silences.

Is there.

While I'm describing Evelyn's, like, physical reaction to the silence.

Oh, it's brilliant.

I'll have to go and listen to it.

Okay.

So something that Evelyn's bringing to her therapy sessions are these.

Who horrible nightmares that she's having that are really disturbing for her about snakes, which for me is also just.

No, no, thank you.

I used to be obsessed with.

I had, like, a dream dictionary and I'd wake up and, like, look up my dreams and sort of see what they all meant.

So I'd love to know, was that something.

Did you research into something that was significant?

Obviously, I was thinking about spoilers, but did you find anything that was sort of significant that you could bring through from your research to make these dreams for her?

Yes.

So I had never really been interested in my dreams until my therapist said, keep a dream journal, Write them down and bring them to our sessions.

So being, you know, very compliant, I did so.

And it's interesting, as soon as you start, like, having that dream journal and writing them down, it's amazing how you remember them.

And it becomes very common to remember them.

I was remembering them every night, whereas before, I don't think I had remembered any of my dreams.

So I became interested in that and exploring them with my therapist.

I also read this fantastic book by Alice Robb called why We Dream.

It sort of goes into the science behind it, and that was fascinating.

And yeah, the novel starts with the prologue is her nightmare.

It's like she has this nightmare on repeat, which is what's so unsettling about it.

But I didn't want to keep writing it out in the book because it's not that interesting to listen to other people's dreams.

So I just sort of wanted to get it done in the prologue to Set that atmosphere of what kind of unsettling dream she's having.

She imagines that she is sort of being trans.

Swallowed and then transformed into a snake, which is a very typical dream image, the symbol of the snake, but I wanted it to.

It sort of represents so many different things.

It's like the weight of the patriarchy.

You know, it's very phallic image.

But also she's kind of.

She's drawn to that snake.

There's something monstrous about it that I think she's afraid of in herself.

She's like, am I this demon monstrous figure that is.

You know, there's so much rage, I think, within her.

It's like a kind of inner rage that she's never been able to express about all the trauma and all the things that have happened to her in her past.

It's there sitting within her, and it comes out in the form of this snake.

So that's.

That's why I guess I started with.

With that.

But she.

She then becomes quite obsessed with like, reptilian creatures.

So Evelyn is an artist as well as a model.

She makes jewelry and particularly she loves jewelry that has like snakes and spiders and reptiles and different creatures on it.

Mermaids, that sort of thing.

I was.

When I was writing the book, I read this incredible book by Sarah Clegg about.

It's like 4,000 years of.

Of sirens.

Sirens, serpents and succubi.

And it's like a kind of social history into those kind of demonic female characters and how men have used those characters as a way to control women.

But also women have like, re.

Found their own power and voice and kind of demonic energy through these creatures.

And that really.

I feel like she's trying to sort of what happens throughout the novel is that her relationship with the dream starts to change.

It's so interesting.

And do you know when you said then about people's dreams, like, not being interesting?

It's.

It's nothing worse than you.

Like, I had a terrible nightmare.

And you just start saying, you're like, actually, it's really not that scary at all.

That interesting.

I do because I have really vivid dreams a lot.

So I'll quite often wake up as I'm starting.

Yeah, it's not interesting.

Don't worry about it.

I used to.

I used to tell like some of my dreams to my therapist.

But it's interesting that.

Which ones you choose to tell because there's a choice being made there.

But I also found that he would often interpret the dreams as being about him.

Oh, really?

Sometimes I'm like, maybe, maybe not.

That's so interesting.

It's really hard for them, though, as well.

Let's talk about that.

That sort of.

Because that's the theme of the book.

This sort of blurred lines and sort of power between.

Because actually, as you said that it's like, yes, obviously they're trained and have lots of experience.

But it's so interesting, isn't it, the sort of power dynamic between the two.

Like, you've had somebody who's very vulnerable in there.

So could you talk to us about the sort of research you did into the therapies and about the sort of potential, you know, abuse of power in these situations as well?

Yeah, I really had to go all the way back to, you know, the founder of psychoanalysis, Freud, and in his theories about it.

And he realized that this transference was happening pretty much all the time in which his patients would have this reaction to the therapist.

They'd be projecting so much onto them, and I guess they would see the therapist either.

We'd often start with a kind of positive transference where it'd be like, this is like my perfect father figure or maternal figure who's going to care for me and love me and hold me.

And that's often the first response people will have to a therapist because someone is listening to them in an intimate setting in the way that they might never have been listened to before.

But as the therapy goes on, what often happens is the kind of.

All these much more difficult emotions start coming up and the transference will shift into perhaps hate.

You might start seeing them as actually the very troubling father figure or controlling mother or abusive lover and sort of projecting that onto them.

And.

And I was really interested in this because I. I sort of saw my therapist as like.

As a, you know, this kind of commanding lover, a sadistic, controlling person, like a kind of godlike figure who I thought could supposed to heal, like all these different things.

And I was interested in how you could possibly see someone and in all these ways.

So Freud talked about how this.

Almost talked about it as like a transference cure.

And when you have worked through the transference with the therapist, like talked it through, it's almost like that would be.

When the transference sort of fades, that's a sign of, like, progress and healing.

You're no longer, like, bringing all of these really intense projections onto them.

But of course, when you are turning someone who is this kind of making themselves like a blank slate so that you can project onto them, it's like it's almost unavoidable in the type of therapy that I write about.

It's like psychoanalytical therapy where the therapist tells you nothing about themselves, is very silent, very withholding.

It's kind of unavoidable, this transference when that happens.

There is, of course, a very important responsibility on the therapist to not abuse that.

Because if you're going in saying, I have romantic feelings for you, you're not really saying that you have romantic feelings for that therapist.

You're turning them into someone completely different.

And they need to remember that it's not them, it's the transference.

So you have to respect them.

And of course, there are so many accounts throughout the 20th century of therapists and patients having affairs, and it's.

It's like the absolute no in therapy.

It's seen as actually a form of incest because it's like you.

Because you have turned this therapist into, like, your mother, your father, like everyone.

If they then abuse the power dynamic, the fact that you are seeing them in this way, it's really traumatic for the.

The patient if that happens.

So there's so many developments and protections and ethical discussions about therapy now.

And yes, I'm sure that still does happen in some therapy relationships, but not with the same frequency that it happened in the past.

So I was interested in that.

I did a lot of research into the relationship between therapists and patients and the delicacy of that power dynamic, the responsibility of the patient.

But interestingly, in, like, the 50s, there were some books I was.

I was reading that thankfully out of print now, but they were almost like kind of accounts of therapy by these very strange male therapists from the 50s who really felt that they could cure their patients through having sex with them.

They need to have a corrective emotional expression experience where I can provide this love and care.

And all of this, obviously, is completely ridiculous.

You.

You should be able to talk to your therapist about this, like, what if fantasy.

But it needs to stay in the realm of words.

It cannot be acted out, and it's up to the therapist to hold that.

That line.

So it is.

It is a really delicate power dynamic.

And one of the things that therapists now will mostly be very careful of is this thing called the therapy frame, which is the kind of all the.

The boundaries that make it therapy, because it's this hugely intimate conversation.

And you are talking, especially in this psychodynamic therapy, about, like, you know, fantasies, desires, with the therapist often as the sort of central character in that.

So sessions need to Always end on time, be the same time each week.

Have like, you know, the regular slot.

Always pay for the sessions rather than be given them, like free, that sort of thing.

Have really clear instructions or like marcations around communication outside of therapy.

So you know, you know what to expect from that.

No dual relationships, that sort of thing.

So if all of those boundaries feel safe and secure, the therap the patient is will feel probably more confident to go into their sort of more hidden, more tender feelings.

Absolutely fascinating.

And the thing is, you can see how there's so many things that you could sort of take out of there.

Like, you know, from the therapist point of view as well.

I think it's so interesting.

Something I'd love to just touch on is in your author's note.

I'm just going to read this little section you wrote.

The model patient should not be read as a criticism of the important and often life changing work that people can do in therapy.

Instead, it's an exploration of the problematic power dynamics that can easily pave the way for abuse.

So which obviously we just talked about, which you could see how it could very easily happen.

So how did you then feel when you were sort of broaching writing this?

Because obviously for some people it will be life changing.

They depend on how did you approach it with such sensitivity then?

Yeah, well, while I was writing the novel, I was in this place of great confusion about it because I did feel that the work I was doing in therapy that I'm still doing in therapy was really important for me.

And it was bringing up parts of myself, emotions, things from the past that I had never looked at before, but were there.

They were actually informing the way I was living my life in a very unhelpful way.

And the therapy did bring it to the surface.

It was just really traumatic along the way.

The first year of it was terrible, you know, it was really terrible.

It retriggered an eating disorder.

I was developed.

I developed an autoimmune disease.

I felt like my body was like eating itself from the inside out.

It was awful.

But it changed.

And even when it was awful, I was learning a lot about myself.

So I would not want anyone else to have to go through the intensity of that first year.

I think unfortunately a lot of people do go through that experience.

I think it's important that there's more sort of feeling of safety in the relationship first.

I think I jumped in way too fast and my therapist didn't help sort of support and provide like the very clear therapy frame for me.

I didn't really know what I was doing.

I didn't really understand the work we were doing.

So I certainly feel that there could have been for me more support rather than just the, the digging up of everything, the, you know, I felt like everything was shaken up and unsettled.

I remember using the metaphor once to him that I felt like I went into therapy as like a, as like a really badly knitted jumper and I came out of therapy as like a tangle of wool.

Like it all just, you know, completely disintegrated.

And then gradually over time, I felt like I've been able to re knit that jumper into something a little bit different and a little bit less chaotic.

So I think therapy is so important.

I think anyone who says I don't need therapy is in denial.

But of course not.

It's a really hard thing to access.

It's expensive if you pay for it privately.

The NHS offers very little for people and usually that's a very short course that they can have, which will be useful for things like coping mechanisms, new learning strategies to help with the difficult things people are experiencing.

But to do long term therapy that allows you to really uncover patterns of behavior that repeat themselves that you've been living with your whole life, that's.

It's hard for people to access and in some ways I, you know, I feel very fortunate that I have been able to access it even though it was so hard to start with.

Yeah, well, that's the thing.

I mean, I always say it's so hard, sort of, because you could keep things sort of where you think you can keep things sort of tucked away nice and neatly, but they have their way of sort of creeping into your life until you deal with them.

And it is incredibly hard to sort of look back at things that, you know, have bothered or troubled, but it's the only way to sort of take that step, to sort of find a way to live with, heal or whatever it is.

So, so the Model Patient is then, it is a psychological thriller.

It is a brilliant, brilliant read.

It, it's thought provoking.

There's so many themes in it.

I loved it.

But what is your hope for it, Lucy, other than it being a great read?

What do you want readers to feel when they finish reading the Model Patient?

Yeah, I mean, I think first of all, I hope they enjoy it, you know, I hope it is, it is a fun thriller.

It takes you, it really does take you on a journey.

But I hope it also will encourage a way of looking at therapy, perhaps in a way You've never looked at it before.

I hope it won't put people off therapy.

I hope it might actually be like, oh, that sounds really interesting.

Terrifying, but interesting to go on this journey through your unconscious.

I think there's something really compelling and creative and enticing about being given a space to really delve into your unconscious.

So I hope it'll open questions about that.

But yeah, mostly I hope it'll be an interesting conversation starter about unreliability in our interactions with others and help us to.

Certainly, as I was writing it, I kept thinking about ways in which I might project onto other people insecurities that I am feeling.

I guess the most simple example is, you know, you walk down a street and you wave at someone and they don't wave back.

Does your mind immediately think they hate me, or do you think they're probably not wearing their contact lenses today?

You know, it's that.

And Evelyn is obviously stuck in that where she thinks that she's being manipulated by everyone in her life.

And I think that that is an interesting conversation starter.

I hope it is.

It's a brilliant read.

Really interesting.

I absolutely loved it.

So do grab a copy.

Okay, so we're going to move on to talk then about the five books that you've picked.

But before we do, just to remind listeners that all of these books and the ones we've already mentioned will be linked in the show notes.

They'll be nice and easy for you to find.

So, Lucy, how did you find picking your five?

Was it easy for you?

Not easy.

It wasn't easy, but I guess I kind of went through books that at different points in my life had had a significance rather than trying to be like, what, what are five books right now that I would, you know, absolutely love to read again?

So, yeah, they're very different, aren't they?

Because you could have lists for everything.

It's like when I get going, I'm like, and this one and this one.

Okay, let's start then by hearing about your first book choice.

Yeah, so my first one is the Northern Lights by Philip Pullman.

So I read this when I was a teenager, but I think it's had significance in my life throughout.

At different points in my life for different reasons.

The fact that it's set at Oxford, both the kind of the real Oxford world and also the parallel world.

Oxford University was where I met my husband.

And we both love this, the, the.

All the Philip Pullman books.

And we both particularly really love the, the character of Lyra, the, the way that she's driven by the power of the imagination, dreaming big.

And also, she.

She really doesn't let authority figures make her feel small.

So we were both so drawn to.

To her character, her, that we had a baby eight months ago, and we named her Lyra.

Oh, lovely.

So that's why it's very important to me.

Oh, that's so gorgeous.

I love that.

That's so nice.

Gosh, the only thing I ever had.

Just like I had a cat called Mr. Tumnus because I love the lion, the Witch, the Wardrobe.

I couldn't call my son that.

You know, what's even more special about this is that a friend of mine came to visit me in.

In New York when Lyra was probably about six months.

And she had a gift for me, and it was Philip Pullman's latest book.

And I opened it up and it had.

He.

She'd managed to find a way to get him to write a note to my Lyra in it.

And he'd start it with dear Lyra, then in brackets, real Lyra, not the fictional Lyra.

And it was just this beautiful note about, like, following your dreams, etc.

So special.

That's given me goosebumps.

What a gorgeous gift.

That's so lovely.

It's a beautiful name.

It is such a beautiful name.

His book sort of passed me by for some reason.

So this was actually picked by Beth o' Leary before.

But my daughter and I have started doing.

She's 13.

We started doing budgie reads together, and she asked me about this the other day, and I was like, I'm so excited.

So we're going to start reading them together.

So I'm really looking forward to.

To doing that.

It's so lovely that you and your husband have that same love for it as well.

I love that.

What a special book.

Okay, so let's hear about book number two, then.

Yeah.

So this one is Ballet Shoes by Noel Streetfield.

And yeah, I.

It's one of the first books I remember kind of reading independently, you know, without my.

My mum reading it with me.

I mean, maybe that's a complete.

Completely made up, but that's what I seem to remember.

And so I used to be a dancer.

I trained at the Royal Ballet School.

And this book just really captured my imagination.

It inspired my love of dance.

I think also the three sisters, Pauline, Petrova and Posy, their relationship was just.

It was just wonderful to read it.

I think it really.

Yeah.

Fired up my.

My imagination.

So I'm sure it'll be a book that I read to my daughter one day soon.

Oh, that's so nice.

And you get to read the ones that you love with your kids as they're growing up.

So it inspired your love of dance then, do you think, when you were reading that sort of independently as a little girl, do you think the sort of sparks of maybe writing were all already there, or did that come later for you?

I always loved writing in different ways.

My parents always remind me how I won the Creative Writing cup in primary school.

Well done.

Congratulations.

I know.

My first big achievement.

So, I mean, I don't really remember writing that much, to be honest, because I was so drawn to dance, you know, I was dancing all the time.

I went to a boarding school which was dedicated to dance.

But I ended up not becoming a dancer in the way that I had imagined.

You know, I didn't end up going to the Royal Ballet Company, that sort of thing.

I changed career paths, I went to university, I became an English teacher.

But the.

The way that.

And then my first two books, Clara and Olivia and the Sleeping Beauties, are historical mysteries set in the world of dance.

So in writing those two books, I was able to return to my passion for dance, but in a way that really worked for me.

Oh, I said to you earlier, I haven't read your two previous.

I'm looking forward to that as well.

They sound amazing.

Okay, so what are we.

We're number three.

Should we hear about book number three, then?

Yes.

So this is Fingersmith by Sarah Waters.

I remember reading this and just.

I was shocked by how amazing it was.

It has, I would say, the most perfect twist ever written.

It's Victorian crime, queer romance.

It's about madness, manipulation.

It's just the most perfectly researched historical detail while also being a page turner.

And I think reading that book was very informative for my own writing.

I think I read it probably a few years before, before I wrote my first book, Clara and Olivia, because it really showed me how you can.

You can do multiple things at once in a book.

You can be writing this intricately researched historical novel while taking your reader on this kind of wild page turner y ride.

And I just loved it.

It's such a great book.

It's one of those books where, I don't know, when I read it, I remember being torn.

Like, torn to.

I just could not stop reading.

Loved it.

And I remember being like.

But I cannot remember.

The twist is.

So I'm gonna have to go back and read.

That's the best thing about Perimenopause.

My Brain has become so, like.

Like leaked.

Exactly.

Be shocked for the second time around.

So I think it's definitely drew a reread, and it's never been picked on the show either.

But I know it was a big one.

I can't remember when it was published.

Is it, like, when it came out?

Not sure.

I'll have to check.

But no, it's a great choice.

I'm gonna have to read that one again.

Okay, so let's move on to your fourth book choice.

Yeah.

So this is the Bell Jar by Sylvia Plath.

Yes.

The first book I remember reading that explored mental health.

I think I read it when I was.

I read it when I was a teenager.

And I love the way that Esther Greenwood experiences work.

It starts with her in this New York summer internship and trying to make her way through that.

But also her relationship with female friends, but with men and her interactions with authority figures, particularly the two doctors that.

That she.

That help her for her depression.

One of them does this sort of terrible electric shock treatment that doesn't work on her.

So, yeah, it was really, really fascinating.

And I found that all the themes when I was reading as a teenager were kind of speaking to me in a way.

I couldn't quite put my finger on why, but I knew I was deeply compelled by it.

But reading it multiple times now, I've taught it a few times.

I'm an English teacher.

I've taught.

Yeah, I've taught lots of Sylvia Plath, actually.

I just love Sylvia Plath.

I think I've been able to be able to find ways in which I can directly say that that has influenced me.

And actually the Bell Jar has a kind of cameo role in the Model Patient because Evelyn's best friend Diana is reading it at this lunch they go to.

But it was published under the pseudonym of Victoria Lucas.

And it was quite, really interesting looking at what, like the.

The first edition front cover look like.

Like, what were the early comments and reviews about it.

So, yeah, it's a book that's really stayed with me.

So I haven't read this one.

It was also picked by Alexandra Potter, but you are the first person that's made me pull it off my shelf.

So it has been on my TBR for so long.

It's one of those books that I feel really intimidated by.

Like, I just.

Whenever I look at it, I think, oh, am I gonna get it?

But I'm gonna put this on my goals to read this year.

So I'm gonna be little as well.

Yeah, it's only little.

I think Sylvia Plath has had.

I mean, she had a comeback.

I mean, she's always been.

Everyone's always loved Sylvia Plath, unlike poor Ted Hughes.

But I guess it's almost like the Taylor Swift era of loving a writer who is kind of very introspective and able to explore the complexities of love in a really vulnerable way.

Yeah, I remember when it came up in the Model Patient.

I was like, oh, I wonder if that's going to be one of your book choices as well.

I love that.

Okay, so your final choice then, Lucy, what was your last pick?

Yeah, so I actually have this one with me because I sort of take it around.

It's All About Love by Bell Hooks.

So this is a nonfiction book?

Yeah.

I read this for the first time while I was preparing to write the Model Patient.

Yeah, I was going through this first really challenging year of my therapy.

It helped me to understand, I think, and therefore kind of remove some of the shame I was feeling around the complexity of my desire from first of love and care from this kind of very cold and withholding therapist.

I think reading All About Love gave me a, like a kind of social history and a context for my interactions with, I guess what I would describe as like a patriarchal culture that we've all.

All grown up in.

That's really what this, this book explores is like love or finding love and how difficult that is in a patriarchal world.

Because sometimes I, I guess I have felt, and this is expressed in this book is it's like I was so conditioned to seek approval and to people, please, particularly men, that it was as though I was like part of the patriarchy rather than challenging it at times.

It was like a sort of enabling it.

But Bell Hooks really explains this issue and how that this kind of sexist socialization happens when we're like really small children.

Yeah, she.

I'm just going to get this little quote up.

She says that when we're children, we're taught that assertive self assertive is a threat to femininity.

And accepting this faulty logic lays the groundwork for low self esteem.

And yeah, she says the wounded child inside many females is a girl who was taught from early childhood on that she must become something other than herself, deny her true feelings in order to attract and to please others.

And I felt that I was sort of repeating this in my dynamic with my therapist, Evelyn Westbrook, in the book certainly repeats this.

And it took.

I Would say like two years of therapy before I could start undoing it rather than repeating it.

So interesting.

Is that a new book, Lucy?

No.

So this was all about love?

Was.

Okay.

It's so funny because yesterday I was at a group with some women and we were talking about this.

We were talking about exactly this issue.

So I'm going to actually send this book to everyone that I was chatting to yesterday.

I'm going to get that.

Is it.

So is it essays or is it just so.

Yeah, it's.

It's non fiction but it reads a little bit like essays.

It's her philosophy on, on love and takes you through the different stages of.

Of a woman's life and relationship dynamics.

There's a trilogy of books.

The next one I think is called Communion, which is also excellent, but all about Love I think is.

Yeah, it's probably the most famous one.

I'm definitely going to get that, particularly as a mum of a daughter as well.

I think that sounds like a must read.

Okay, so I know it was hard getting it down to five, Lucy, but if I said you could only read one of those books again, which one would it be?

Yeah, so hard.

I think it would be the Bell Jar.

Even though I've read it many times, I always find something else in it that really resonates.

Maybe because with Sylvia Plath, her writing I just.

I love so much like the poet, her poetry collection, Ariel.

Every poem in there is so beautiful and I love the way that she captures both in Ariel, her poetry and in the Bell Jar like the dualities in woman and the tension between wanting to please others and wanting to be true to oneself and like this kind of oscillation between love and hate, self love and self criticism.

There's always something in there that I can return to and can be important for me, I think as, as also I teach, you know, I teach A level English Literature and I have taught Sylvia Plath quite a few times and just the discussions I have with my students are just the best when we do Sylvia Plath.

So yeah, always.

I love that when it's a book that you go back to and always written, you still love it and you pick different things.

I think that's just a sign of such a great book and a book that's made for you as well, so.

Oh, Lucy, I've absolutely loved this.

It's been so wonderful to chat to you.

Thank you so much.

Yeah, you too.

It's been really fun.

It's been lovely.

Thank you.

I really enjoyed that conversation.

I hope that you have too.

The Model Patient by Lucy Ash is out now.

It is a brilliant read, one that I would highly recommend.

And all of the books that we've talked about today are linked in the show notes, so do go take a look at those.

I'll be back next week chatting to another author, and I really hope that you'll join me for that episode too.

In the meantime, thanks for listening and see you next week.