Lying on the Couch

A willingness to confess to his various mistakes in the course of treating patients made Dr. Yalom's 1989 nonfiction bestseller, Love's Executioner & Other Tales of Psychotherapy, endearing, but one hopes that this satire of the Bay Area psychiatric industry is not another mea culpa in disguise. The two psychiatrists at the center of Yalom's second novel (after When Nietzsche Wept) find themselves entangled in situations for which their clinical training could not have prepared them. Dr. Ernest Lash, who is, in fact, extremely earnest and given to wearing earth shoes and stained ties, decides to experiment with a new, more intimate therapeutic approach, unwittingly playing into the hands of Carol Leftman, a patient determined to ruin his professional reputation because he had encouraged her husband to leave her. Meanwhile, Ernest's former supervisor, the ambitious, self-important Dr. Marshal Streider, is fleeced by a charismatic con man masquerading as a patient. For help, Marshal turns to a lawyer--the very same Carol Leftman who's dogging Ernest. For both Marshal and Ernest, then, the absolute honesty they demand during the therapeutic hour is at odds with the professional ethic of confidentiality that binds both lawyers and shrinks. Yalom is exploring the jungles of what Ernest calls ""wildcat therapy,"" in which therapists are unable to maintain the Olympian mantle of clinical disinterest in encounters with their patients. Whether this is good medicine or not, Yalom doesn't quite say. As absorbing as it is, the novel presents the moral or professional blunders of the analysts as the acceptable price of doing business. $50,000 ad/promo; author tour; Rights: William Morris Agency. (Aug.)