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Parallels between Writing Biographies and Clinical Practice
Impact. Influence. Value.
Esther Urdang
ISBN: 978-0-87101-450-4. 2014. Item No: 4504. 304 pages.
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Parallels between Writing Biographies and Clinical Practice: Impact. Influence. Value offers clinicians an in-depth understanding of the commonalities between the psychological and intellectual processes involved in writing biographical works and those involved in clinical practice. Although these processes often take place beneath the surface, both biographers and clinicians are subjectively involved in all aspects of their work, such as the biases of their theoretical positions and selection and evaluation of evidence.

In this book, lengthy life course portraits of six individuals are presented, vividly illustrating many key clinical concepts, such as the impact of the past, the development of attachments, the trauma of loss, and resilience. Examples include Rudyard Kipling's experience in a foster home, and the impact of blindness and separation on the writer Ved Mehta. This book addresses a need expressed by many practitioners and educators to reintegrate key clinical concepts into practice, such as understanding experiential worlds, applying psychodynamic knowledge, and developing self-aware empathic relationships with clients.

Each biographical narrative alternates with a relevant theoretical chapter, whose content addresses four major themes, integrated with the life course portraits:

  1. Biographers' and clinicians' relationships with their subjects/clients

  2. Examining how subjects/clients represent themselves and present their stories

  3. Understanding the complexities of collecting, evaluating, and interpreting evidence

  4. Studying the evolution of the life course, using the biopsychosocial perspective; illustrating the interweaving of the inner and outer lives of individuals.

Parallels between Writing Biographies and Clinical Practice is a resource intended for students, teachers, and practitioners in social work, and those in the human services and medical professions. It is also intended for a general audience, to heighten critical understanding and enjoyment in the reading of biographies.
About the Author

Section I. Studying Biography and Autobiography

Chapter 1: History and Development of Biographical Writings and Psychobiography

Chapter 2: The Role of Relationships: The Biographer’s Involvement with the Subject and the Autobiographer’s Self-Exploration

Chapter 3: The Impact of Biographer Involvement and Bias: Charlotte Bronte and Her First Biographer, Elizabeth Gaskell

Chapter 4: Ved Mehta: Self-Exploration in Autobiography

Section II. Constructing Biography

Chapter 5: Theoretical Orientation: The Biopsychosocial Framework and the Life Course Perspective

Chapter 6: The Life of Sir Arthur Conan Doyle Viewed through the Biopsychosocial Framework

Chapter 7: The Role of Narrative Theory in Constructing Biography

Chapter 8: The Narratives of Frederick Douglass and Ottilie Assing in the Construction of Their Biographies

Chapter 9: Gathering, Evaluating, and Interpreting Evidence

Chapter 10: Rudyard Kipling: The Challenge of Using Evidence to Construct a Life Story

Chapter 11: Summing Up

I am a clinical social worker and social work educator. I am also hopelessly addicted to biographical writings. Charlotte Bronte was my first in-depth biographical subject, and photographs that I took during a visit to her home, the Parsonage at Haworth, appeared in my office at Boston College. Excerpts from her writings and biographies enlivened my classes. She soon found herself in good company, as other biographical subjects joined her.

Discussions of biographies and autobiographies then appeared in the first and second editions of my textbook, Human Behavior in the Social Environment: Interweaving the Inner and Outer Worlds (Urdang, 2002, 2008); I was impressed with how biographical writings captured so much of human experience. There was the voice of Maya Angelou (1997), poignantly recalling growing up with her grandmother in the South and the support and solidarity she experienced in her black community. Mark Vonnegut (1975) shared his insights into his bizarre world of schizophrenia.

Over time, I came to appreciate how much biographies and autobiographies can tell us about the ways in which people evolve through life; we see individuals overcoming (or succumbing to) adversity and learn how early childhood experiences and relationships affected (or did not affect) them. These readings also shed light on historical, social, and cultural events affecting lives and illuminate the continual interweaving of a person’s inner and outer worlds.

Then I came to realize that biographers struggle with questions that also concern clinical social workers and mental health practitioners: how the subjectivity of the author affects all aspects of the biographical enterprise (as subjectivity affects all aspects of clinical work); how biographers (and clinicians) feel about their subjects (and their clients); and how these feelings can change over time. This can have an impact on the biographer’s representation of the subject to readers and on the clinician’s ongoing relationship to the patient. In both fields, there are decisions to be made about which data to select and who are the significant people in the subject’s (or client’s) life.

My conviction grew that biographical and autobiographical writings in and of themselves, as well as reflective analysis of them, can contribute to clinical education and enrich the general reader. The nonclinical reader of biographies also has an interest in learning how people experience life, what motivates them, what kinds of relationships they have, and what dark secrets may lurk in their backgrounds. How did Rudyard Kipling survive being placed in a rigid and punitive private foster home in England from age six until 12 without seeing his parents, who remained in India? How do we explain the changes in Arthur Conan Doyle, a physician, an intellect, and the creator of Sherlock Holmes, who stunned his friends and much of the public by turning to spiritualism in late adulthood, claiming to have conversations with dead souls, an admiration for mediums, and a belief in fairies?

These thoughts have motivated me to write this volume about reading, studying, and enjoying biographies. The goals of this book are threefold: The first is to emphasize the relevance of the life course perspective, examining how people develop and evolve (or regress) over their life span. This perspective uses the biopsychosocial framework, which interweaves inner and outer worlds.

The second goal is to explore methodological issues embedded in constructing biographies, such as collecting evidence, evaluating "witness" accounts (including correspondence), and handling gaps in information and uncertainties, "the things that go missing" (H. Lee, 2005, p. 5). This exploration can further the development of those critical analytical abilities that can enrich all readers; these skills are necessary for the work of both biographers and clinicians as they delve into the biopsychosocial worlds of their subjects and clients. Does the author share uncertainties with us, as did Glendinning (1999), in her biography of Jonathan Swift, when she acknowledged to the reader her dilemmas about "knowing," including problems of conflicting evidence, lack of data, and the fact that "it is all so long ago" (p. 2)?

Finally, the relationship of the biographer to the subject (or the autobiographer’s self-presentation to the reader) is a major point of interest. What was the autobiographer’s motivation in writing about his or her life or a biographer’s motivation in choosing a particular person as a subject? Did the biographer have personal contact with the subject, and if so, what was its nature? Did the relationship change over time? How the writing of the book affected the writer is an intriguing question to which we cannot always find the answer but which is sometimes revealed. The ways in which these complex processes in the relationship of the biographer or autobiographer with their subject parallel similar processes in the clinician-client relationship are discussed throughout. These discussions should have particular relevance for clinicians.

Doris Kearns and Lyndon Johnson developed a complex emotional relationship during their ongoing contact, as she lived at his ranch while writing his biography. Her discussion of the many examples of Johnson’s " 'transference' and [her] countertransference . . . suggest[ed] that this is likely to be a primary difficulty in nearly any opportunity to do 'psychobiography up close' " (Elms & Song, 2005, p. 307). The well-known transference and countertransference complexities (inner feelings and conflicts unconsciously expressed in relation to one another by patient and therapist) are present in therapy in a similar fashion. Biographers can also have emotional reactions to subjects they do not know. I noted this phenomenon in my past writings:

Biographers also have emotional involvement with their subjects even if they have never met, and even if the subjects have been long dead. Maria Diedrich (1999), for example, wrote the biography of Ottilie Assing (who died 66 years before Diedrich was born), focusing on Assing’s relationship to Frederick Douglass. Diedrich observed that her own family "were served Assing-Douglass fare for breakfast, lunch, and dinner, and for years" (p. viii). (Urdang, 2008, pp. 148-149)

Just as biographers attempt to convey to their readers "how the world looks from inside another person’s experience" (Conway, 1998, p. 6), so too do clinicians seek understanding of their clients’ experiential worlds.

Both biographers and clinicians are also affected by their theoretical orientations, which can affect their search for evidence as well as their interpretation of this evidence. Multiple books have been written about the same person, often with different presentations and perspectives. The proliferation of biographies about Abraham Lincoln, for example, has not ebbed with time; stories of his life continue to be written. What is there about Lincoln that casts this spell over us?

As we look to biographers to answer this, we find no definitive explanation but rather a multiplicity of explanations offered by Lincoln’s many biographers: "The bearded man in the stovepipe hat seems much like a hologram, a medium for our fears and fantasies" (Shenk, 2005, p. 39). Lincoln is not unique among biographical subjects in being a "hologram" onto whom writers can project their own fantasies, perspectives, and agendas. Multiple studies have also been done of others as well. Those of Sigmund Freud, for example, have at times been "sympathetic," while others have created "an enormous number of intellectually and politically charged alternative accounts of Freud and his work" (Runyan, 2005a, p. 21). Biographies of the controversial Charles Darwin follow a similar pattern (Runyan, 2005a).

Biographers can be misled by the ways subjects choose to present (or misrepresent) themselves. For example, Lord Byron "liked to fictionalize himself in his poetry and even his letters" (Barton, 2002, p. 8). Similarly, patients may also impede their therapists from knowing them, using such strategies as "masking, pretending, and denying so that the [patient’s] self-estrangement in the end cannot be fully overcome" (F. Wyatt, 1986, p. 207).

Both biographers and clinicians face ethical dilemmas in terms of protecting privacy and confidentiality. Some people do not want biographies written of them. Thomas Hardy solved this problem by writing his own biography, under the "authorship" of his wife (Tomalin, 2006). Charles Dickens was not alone in burning many of his personal papers and letters to keep them from biographers. Some families withhold important materials (as did Conan Doyle’s family for many years) and may demand editorial and sometimes censorship rights over what is written. Kipling’s daughter fired a number of his biographers and then demanded oversight of Charles Carrington’s work when she selected him as Kipling’s biographer. Clinicians can also be constrained by clients and families who are resistant to intervention or share only partial truths.

It has been argued that autobiographies are more reliable than biographies because they provide an authentic, firsthand portrayal of the subject’s life and experiences. But do all writers wish to share what they know about themselves and their lives? Some take great pains to conceal the truth. Saint Augustine "set the problem for all subsequent autobiographies: How can the self know itself?" (Spengemann, 1980, p. 32). Conan Doyle’s (1924) autobiography omitted details of his life he may have considered shameful (such as his father’s alcoholism and mental illness), while placing emphasis on his own achievements and bravery. Jean Piaget’s autobiographies focused on the development of his psychological theories, omitting details of his personal life (Urdang, 2008; Voneche, 2001).

The Autobiography of Alice B. Toklas was published in 1933, but as Malcolm (2003) pointed out, this was actually written by her partner Gertrude Stein. Then in 1954, Toklas wrote The Alice B. Toklas Cook Book, which was "more than a cookbook and memoir; it could almost be called a work of literary modernism" (Malcolm, 2003, p. 59). Malcolm discussed this conundrum: "Was Stein imitating Toklas when she wrote in Toklas’s voice in the 'Autobiography,' or did she invent the voice, and did Toklas then imitate Stein’s invention when she wrote the 'Cook Book'? It is impossible to say" (p. 59).

So, you may ask, is there value in reading any biographical materials if both biographies and autobiographies are not definitive and are colored by the subjectivities and biases of both the subjects and their writers? Yes, I will argue in this book, there is great value in reading biographical materials. First, we need to accept the premise that people wish both to reveal and to conceal aspects of their inner and outer worlds and that multiple contradictions and paradoxes abound within all of us. We need to relinquish the search for complete knowledge of the subject: "Biography has to omit and to choose. In the process some things go missing" (H. Lee, 2005, p. 36). But if we can accept these limitations, a wealth of knowledge, insight, and pleasure becomes available to us. At the same time, such complexities and contradictions may shed light on deeper truths.

Perhaps, though, the most compelling reason to read biographies is to connect with other people, to learn how others experience life: "We want to know how the world looks from inside another person’s experience, and when that craving is met by a convincing narrative, we find it deeply satisfying" (Conway, 1998, p. 6). Lee (2005) observed that the "endlessly absorbing" motivation is that "we keep catching sight of a real body, a physical life . . . [James] Joyce with a black felt hat, thick glasses and a cigar, sitting in Sylvia Beach’s bookshop in Paris" (pp. 2-3).

Holroyd (2002) highlighted biography’s existential purpose, providing the reader with not only a sense of connection to others but a sense of continuity of the past, present, and future:

By recreating the past we are calling on the same magic as our forefathers did with stories of their ancestors round the fires under the night skies. The need to do this, to keep death in its place, lies deep in human nature, and the art of biography arises from that need. This is its justification. (Holroyd, 2002, pp. 30-31)

This book is intended for students, teachers, and practitioners in social work and the human service and medical professions, such as psychology, psychiatry, medicine, and nursing, as biographical study can contribute to increased clinical knowledge and insight. These studies afford a unique opportunity to examine individual lives over the life span and to apply (and question) clinical theories. It is also written for the general audience of biography readers who wish to increase their understanding of the complexities of life and the intricacies involved in recording the life of oneself or of another and to find a framework for analyzing these works. The general reader may also benefit from the discussions of mental health theory and practice included in this book. Certainly, mental health problems, including eating disorders, bipolar disorders, incest, suicide, and gambling addictions, pervade media coverage today, in both real-life and fictional forms. The discussions of clinical terms and concepts, such as denial, unresolved grief, abandonment, therapy, and transference, are probably familiar to many; if not, in this book these terms can be easily comprehended. In fact, seeing these terms come alive in biographical discussions may further illuminate these concepts for all readers.

Biographical study serves to counter current trends in the mental health fields, which often exclusively favor the application of evidence-based, quantitative measures and cognitive-behavioral and technological approaches to clinical work and which largely de-emphasize exploring the past, developing empathy, and understanding experiential worlds.

The goals of this book are compatible with recent attempts to introduce narrative theory to clinicians and to "humanize" medical education as well: A number of medical schools now include courses in humanities, with some emphasizing studies of narratives, in an effort "to restore a sense of meaning and healing to counter the dehumanizing effects of technological explosion" (Thernstrom, 2004, p. 44).

Writers such as Robert White (Runyan, 2005a) have stressed how the study of individual lives can contribute to increased psychological knowledge of both normal development and psychopathology. Challener (1997), exploring the development of resilience in childhood, found similarities in his autobiographical studies to outcomes from general research.

Studies of lives provide insight into many aspects of the human condition, such as attachment and its vicissitudes, loss, family breakdown, the impact of economic factors and poverty, the effects of physical illness, struggles with anxiety, depression and mental illness, war, cultural values, and cultural conflict. We observe ways people adapt and cope and how love, imagination, creativity, and finding meaning in activities such as politics and religious movements can have healing functions.


The process of choosing these particular subjects was somewhat idiosyncratic and did not follow any given methodology. I was moved by these subjects in different ways, and as I got to know them, I wanted to know them better. I felt that the stories of their lives would contribute insights into varieties of human experience that were interwoven with diverse social, historical, and cultural milieus. However, the book’s underlying orientation and analysis can be applied to studying many other biographical and autobiographical subjects not included.

I followed five of the six subjects over the course of their lives, all but one of whom lived into late adulthood (that is, 65 or older). Charlotte Bronte died prematurely at 39. Ved Mehta, still living, is my only autobiographical subject. He discusses his childhood and his life through his middle adulthood.

With the exception of Ottilie Assing and Ved Mehta, multiple biographies have been written about these subjects, offering readers a range of perspectives about their lives. A multiplicity of perspectives is also provided through the many letters these subjects wrote and received. In addition, they were often the subjects of newspaper or magazine articles or were discussed in biographies of others. Three of the biographical subjects also wrote autobiographies (Douglass, 1845, 1855, 1882; Doyle, 1924; Kipling, 1937), which are sources referred to in their life stories.

Although I did not use this as a selection criterion, all six of my subjects had enormous willpower and determination and exercised forceful self-agency. They all had much to overcome, and they overcame a lot. Each subject was, as Backscheider (1999) described, a "special individual, the person who makes something of life" (pp. 100-101). In addition to strength and resilience, each person also had conflicts, struggles, and vulnerabilities that are part of their portraits.


I have arranged this book according to four major themes: the biographer’s involvement with the subject and the autobiographer’s self-exploration and their clinical parallels; the biopsychosocial framework; narrative theory; and gathering, evaluating, and interpreting evidence. To tackle these themes, I have written chapters that focus on theory and chapters that put those theories into practice by exploring the life of a prominent literary/historical figure, and I have alternated these chapters so that the life stories clearly illustrate the theoretical concepts in the chapters preceding them. For example, chapter 5 introduces the biopsychosocial framework, and chapter 6 illustrates this framework in the presentation of the life course of Arthur Conan Doyle. The life course is a theme illustrated in all the biographies, giving the reader an opportunity to follow the ups and downs of individual’s lives and to compare lives.

Clinical concepts, such as loss, illustrated by Douglass’s grandmother’s coerced abandonment of him under slavery, are interwoven throughout the book. Some theoretical concepts, such as self-objects and disenfranchised grief, are introduced and discussed. It is anticipated that readers unfamiliar with these concepts will gain familiarity with them and their relevance to biographical and clinical material.

Case illustrations have been taken from various sources, including published and unpublished case material. For published material, sources are given; for unpublished case material, the identities of clinicians and clients are not disclosed, and anonymity and confidentiality are maintained.

A brief outline of each chapter is presented below to give the reader an overall sense of the organization of the book and the pairings of the chapters.

Chapter 1 explores the history of biographies and autobiographies, as they have appeared in different forms at different times, shaped by sociocultural and historical forces.

Chapter 2 focuses on some of the ways authors have become emotionally involved in the biographic enterprise. Immersion in a subject’s life, usually over a lengthy period of time, affects biographers in different ways; this may evolve and change over time, with parallels to the therapeutic relationship. This chapter also discusses motivations for writing autobiographies and the impact of the process of self-exploration on the autobiographer.

Chapter 3 presents the life course of Charlotte Bronte, with a particular focus on her relationship to her biographer and contemporary, Elizabeth Gaskell. Gaskell’s motivations for portraying a "tragic" and "pious" image of Charlotte are discussed. The concept of self-objects is exemplified by Charlotte, whose many early losses led to her need for approval, closeness, and security from others.

Also paired with chapter 2 is chapter 4, on Ved Mehta, a contemporary writer born in India, who became totally blind as a result of meningitis when he was almost four years old. How blindness affected his life is a major theme in his autobiographies, which he wrote after his psychoanalysis enabled him to write with new insight. His further explorations of his past through autobiographical writing and his articulation of his struggles with blindness offer rich clinical insights.

Chapter 5 introduces the biopsychosocial framework as the conceptual model used here in the examination of the biographical process. This synthesizing model, which interweaves both inner and outer worlds, is also the foundation of social work practice. The life course perspective, also discussed in this chapter, presents a dynamic and fluid model of life, emphasizing change, transitions, turning points, and the concept of human agency. The biopsychosocial framework applied here emphasizes psychodynamic theory.

The life course of Sir Arthur Conan Doyle is presented in chapter 6, following the biopsychosocial model. Conan Doyle’s life course exemplifies a radical change, as he became an extreme avowed spiritualist. This raises the question of whether this unexpected dramatic shift represented a discontinuity in his identity and life course.

Chapter 7 discusses narrative theory, which focuses on storytelling, looking at how the narrator’s subjectivity influences the narration. The concept of narrative discourse is also stressed – that is, the interactions and reactions of narrators and their audiences. This theory is relevant for the study of biography and has been extensively applied clinically as well.

Chapter 8 gives an account of the life of Frederick Douglass, the renowned abolitionist and former slave and his long-standing relationship with Ottilie Assing, a German journalist. They were involved intellectually, politically, and romantically. Douglass’s narratives (his three autobiographies) and the use of his narratives in his skillful orations were influential in the abolitionist movement. Douglass’s and Assing’s self-presentations were central to their concerns.

Chapter 9 focuses on the process of gathering, reading, evaluating, and interpreting biographical materials, including such variables as perspective and objectivity; these concepts are also relevant for clinicians. Ethical dilemmas such as invasion of privacy and vulnerability are also discussed.

Chapter 10 examines the life of Rudyard Kipling, dealing with the evaluation of evidence as discussed in the last chapter. Kipling’s life course and work present paradoxes and contradictions, such as the major controversy around the validity of his portrayal of his childhood foster home experience. The validity and meaning of data are also a fundamental issue in clinical situations.

As a biography addict, I am certain that biographies are a source of reading pleasure in and of themselves. But I also feel that they can be read with a discerning mind along the various dimensions I will discuss in this book. Clinical processes can also be "read" for what lies behind the scenes, along similar lines. Perhaps you will both enjoy and read with a critical eye what is presented here, as well.
Esther Urdang, PhD, MSS, LICSW, has practiced for many years in mental health and family agencies, hospitals, and private practice. At Boston College Graduate School of Social Work for 27 years, she taught clinical courses as adjunct associate professor and was assistant director of field education. Subsequently, Dr. Urdang was a research advisor at Smith College School for Social Work. Her published papers include "In Defense of Process Recording," "The Discipline of Faculty Advising," "The Video Lab: Mirroring Reflections of Self and the Other," "Becoming a Field Instructor: A Key Experience in Professional Development," and "Awareness of Self – a Critical Tool." She has received the Simmons Alumni Special Recognition Award for her writing, twice for papers and once for the first edition of her textbook: Human Behavior in the Social Environment: Interweaving the Inner and Outer Worlds. She is currently writing its third edition for Routledge Press.