This highly accessible book beautifully explicates and illustrates how collaborative writing between therapists and clients can deepen their relationship and contribute to the success of therapy. In this review I have made a conscious decision to quote liberally from the text to provide the reader with a more direct, first-hand experience of the authors’ distinctive individual and shared written voices.

The idea of incorporating writing into therapy is not new. What is original in this book is the nature of the collaboration between therapist and client. The authors, Trish Thompson (the therapist, she/her, referred to in this review as “Trish”) and Dan X. Harris (the client, they/them, referred to in this review as “Dan”), are inspired, at least in part, by the eminent American psychotherapist Irvin Yalom’s (1974/1991) work Every Day Gets a Little Closer in which Yalom and his client “Ginny” share their written accounts of each therapy session conducted over approximately a year. Yalom’s book underscores the importance of the therapist–client relationship and the different experiences that the therapist and client may have of therapy. Perhaps even more crucially, that earlier work provided the impetus for Trish and Dan to draw out the full implications of their collaborative writing project, especially in terms of the changes that took place for each of them through the therapeutic process. It is the potential of their collaboration or, more accurately, the interdependence of their collaborative efforts, that they are most interested to explore in their own book. As Dan suggests:

That to me is the “radical” bit: how can one part of a pair (the client) be helped by the therapist’s trained knowledge, through a multi-directional exchange that requires vulnerability and sharing from both sides [emphasis added]. (p. 34)

Unlike in Yalom’s (1974/1991) work, Trish and Dan adopted what they call a “co-constructed approach” (p. 111) to writing in which they each contributed both synchronously and asynchronously to shared online documents. This enabled each of them to write either in their own time when convenient or at the same mutually agreed upon time. They also included side comments on each other’s writing to keep the “writing process informal and dialogic” (p. 111).

The book begins with a co-authored introduction providing the context and background to their collaboration. Reference is also made to relevant scholarly literature and to the theoretical notion that their work is a form of “queering therapy” in the sense that collaborative writing “messes with the conventional, pseudo-clear framework of power and identity” (p. 9) in therapy.

The text is divided into three pairs of individual chapters written in the first person. Each pair consists of a chapter written by Trish and the other by Dan. At first glance, this might appear odd given the authors’ stated focus on collaboration. However, these chapters enable each author to speak individually about their “singular and shared experiences” (p. 10) of their time spent together in therapy and other life experiences. The chapters include excerpts from both authors’ past journals about therapy and other aspects of their personal and professional lives. These entries help to ground the surrounding discussion solidly in their respective life experiences. Interspersed between these chapters are three distinctive dialogues in which they discuss their collaborative writing work and associated questions and observations. These dialogues most directly shine a light on the nature and process of their collaboration, both in therapy and beyond in their writing, a collaboration that ultimately culminated in them co-authoring this book.

In Chapter 1, Trish reflects on the influence that Yalom has had on her since completing her Master of Counselling in 2006. She emphasises his insistence on the primacy of the relationship between therapist and client, its importance in the healing process, and his prioritising of what is happening between them from moment to moment in-session (Yalom, 2002). Trish argues persuasively that clients should have “both awareness and input into the exploration of the change process through this relationship, rather than it being a discussion clinicians have with each other or in educational spaces” (p. 13).

Also included here are reflection notes on Trish’s experience of conducting supervision with a group of early career therapists. Again, she is strongly influenced by Yalom in this work, encouraging the participants to be “curious about the intersectionality of themselves as people with their therapist selves and the selves of their clients” (p. 15). The chapter concludes with reflections on notes Trish has made about writing with Dan, and how this process has brought her to fully embrace Yalom’s (1974/1991) insistence that clients and therapists can influence each other in profound ways.

Chapter 2 takes us into Dan’s world as a client. In direct contrast to Trish, they express reservations about Yalom’s (1974/1991) relationship with Ginny in Every Day Gets a Little Closer. They view it as “an example of unequal power relations” (p. 23), underlining how therapist and client can have a different view of therapeutic processes. Dan then critically and powerfully discusses their experience of being diagnosed with borderline personality disorder (BPD) and their journey into gender transition. We learn more about the history of Dan and Trish’s writing collaboration, which began while they were still in therapy, initially taking the form of several journal articles and later this book. Interestingly, as their collaborative writing journey grew, they eventually discontinued therapy. This shift seems to have occurred at least partly because they decided to keep writing together for publication as opposed to only privately to each other. The issue of when best to incorporate collaborative writing in therapy is explored later in the book and in this review.

Dialogue 1, which follows these first two chapters, defines collaborative writing as having to include an “element of working together, not just reporting to each other what we have done individually or independently” (p. 33). Dan also raises the thorny question of the “unequal power dynamic” (p. 35) between therapist and client, and how this could undermine the flattening of the hierarchy between them. Dan challenges Trish’s resistance to the idea of the therapist as “expert”, claiming that clients usually expect the therapist to be in charge of the therapeutic process. Trish then clarifies her own position:

What I reject about the expert stance is creating a vibe that puts me in a position of “all knowing” and bestowing the answers from a superior position, creating some idea of the client as having a deficit that I will “fix”. (p. 39)

However, for Dan, this tension is somewhat relieved by their understanding that the therapist and client may not need to be equally invested in their collaborative writing. While the therapist may seek to be witnessed through the writing, it may be enough for the client to be primarily witnessed in the spoken interactional space of the therapy room.

In Chapter 3, Trish writes movingly of her different experiences of grief for her sister, each of her parents, and her beloved therapy dog Pepper, incorporating excerpts from her writing with Dan and her individual journal. In one of these journal entries she also explores the notion of the therapist having to tread

a fine balance in their work between the self you bring that is real, attuned to the emotions present (no matter to whom they belong) and the self that is the “role”, the one who carries out the task that is required on the day. (p. 52)

When Trish was consumed by grief over the second of these losses, her mother, she felt she had lost sight of this balance and tried too hard to protect her clients from her own very human experience of grief. She began to realise, thereafter, that “grief is better shared, not endured alone” (p. 54), not just in her personal life but with her clients too. The loss of Pepper, in particular, provided the opportunity for her to share her grief with her clients who had known him. She was greatly moved by their empathy and sadness, and this enabled her to express her own grief with them. The combination of entries from her previous writing, including both her notes with Dan and her own journal with her contemporaneous reflections on them, is extraordinarily powerful.

In Chapter 4, Dan explores the nature of collaborative autoethnography and what it means to them and Trish. Rejecting the positivist social science approach to this practice as a form of academic research, they both claim to “value the power of ethnographic accounts to carry their own affective impacts both within and outside the academy” (p. 57). Dan then discusses the distinctiveness of their collaborative writing with Trish in terms of breaking with “the tradition (including Yalom’s mostly) of the tales [about therapy] being told in the therapist’s monologic voice” (p. 58) and that for both of them “it is the multivocal experience that promises a fuller evocative picture of the [therapeutic] practice described, as well as a truer sense of its efficacy” (p. 58). From both authors’ perspectives, an important contribution of their book is how they bring together autoethnography and academic and therapeutic communities.

The remainder of Chapter 4 comprises Dan’s reflections on the value of self-disclosure by therapists about their own lives to their clients. Dan also acknowledges the personal attributes they share with Trish that enabled such a successful written collaboration:

We both love writing, we both have had feedback that we are good writers, we both have spent a lot of our lives in therapy, we are both actively interested in and passionate about the human mind, feelings, relationships and power (and power dynamics) of psychotherapy. (p. 60)

Dan then tells two riveting stories: a deeply evocative and sad one about their mother’s passing, and another very moving one about the period when Trish told Dan she believed they had BPD and the subsequent freedom this diagnosis gave to Dan to begin their subsequent transition from being female. Finally, Dan reflects on the growth of their collaborative writing partnership with Trish during the long COVID-19 lockdown period and beyond, and on their own experiences of BPD diagnosis and treatment.

In Dialogue 2, Dan and Trish reflect on the nature and value of their therapeutic relationship. An important consideration here is the impact the client has on the therapist (as well as vice versa) and how becoming more aware of that impact can be beneficial to both. Dan also talks about finding “the vulnerability and one-sidedness of therapy to feel like power over me which is not negative per se, but uncomfortable” (p. 67). For Trish, this is a central question for the book: “So, what is the way in which you (a client) can receive the skills the therapist (me) has to offer and it not feel like ‘power over’?” (p. 67).

In a later shared document, the authors discuss how writing together enabled Dan to say things “that are too embarrassing face-to-face” (p. 69). They also talk about how knowing more about the therapist—including their vulnerabilities—can help some clients feel safer and less judged, and that the therapist is therefore more human and relatable. However, Dan acknowledges (and Trish agrees) that this may not be the case for all clients: “For others, it’s probably more effective for them to just come in and allow you (the therapist) to ‘work your magic’ in ways they might not understand” (p. 71).

At the end of Dialogue 2, Dan eloquently reflects on the transcendent power of their collaborative writing:

The mysteriousness of writing/literature/co-writing, to me, is that experiencing these moving, beautiful, provocative, aesthetically-curated, symbolic prompts can take us beyond the specificities of the everyday, and bring us closer together without the details that constitute so much of therapeutic treatment. (p. 74)

As Trish suggests, this is the potential sacredness of the space between therapist and client.

In Chapter 5, Trish reflects on writing as a relational process, including journalling, in which

there is a sense of an audience—writing about the self, in search of self while being witnessed by the self. The process takes on an active relational quality as the different parts of the self take on certain roles—the documentor, the reflector, the listener. (p. 78)

She also muses on how the earlier co-writing projects with Dan deepened their connection, increased Dan’s trust in her, and especially tapped into a part of herself “that risks being seen by others as unequivocally human rather than some wise counsel who has the answers. This is hugely uncomfortable at times, but ultimately freeing for us both, as it flattens the hierarchy” (p. 79).

This leads Trish to wonder how the traditionally unidirectional unconditional positive regard that flows from therapist to client in the person-centred tradition might be replaced by “real emotional exchanges between the humans that sit together in search of truth” (p. 80). This reciprocity could include two important forms of self-disclosure from the therapist: firstly, sharing relevant aspects of their own lives and, secondly, expressing their feelings about what a client is revealing to them in therapy (sometimes also called immediacy). Referring to Yalom’s (1974/1991) work with his client Ginny, Trish underscores the very important point that self-disclosure may benefit not only the client but also the therapist: “The exercise of revealing his frustrations and irritations to Ginny liberated him considerably in his subsequent therapeutic work” (p. 81).

Trish then reflects on the value of collaborative email writing between therapist and client. The client is able to expand their story beyond themselves and receive a response from the therapist that provides “an offering of recognition” (p. 82) in her own life for the mutual benefit of them both. In an excerpt from her “Writing with Dan” notes Trish suggests that “if there is written evidence of the therapist’s own vulnerability and humanness, the client may feel less ‘objectified’ as the one who has the problems” (p. 84). Referring to therapy as an act of “loving reciprocity” (p. 86), Trish powerfully makes the case for her full humanity as a therapist to be really seen by her clients. In this way she can see herself “as a flawed therapist who can still have the type of relationship with my clients in which my failings are part of the fabric of the collaboration” (p. 87).

In Chapter 6, Dan documents the changes in their relationship with Trish as the written collaboration between the two people continues to grow. For some time Dan and Trish had three forms of engagement: therapy, co-writing, and sessions in which they “continued to negotiate the terms, boundaries and efficacy of working together in these multiple ways” (p. 89). A key point here is Dan’s questioning of the conventional idea of therapy being a kind of rehearsal for life: “Where exactly is the line between ‘real life’ and ‘real therapy’? I mean, is it possible that this is itself a fantastical (if comforting) therapeutic construct?” (p. 89).

In completing the transition from doing therapy together to co-authorship, Dan asks whether they and Trish have moved from merely “practicing a relationship to having a ‘real’ one” (p. 90). The answer from Dan’s perspective is clearly “no” because their therapeutic relationship had felt alive and genuine well before their collaborative writing partnership had begun. Although their therapeutic relationship had technically finished, it did not end “a kind of shared attention” (p. 92) to the work that they had done as therapist and client. Therein lies the continuity of their collaboration. In describing their careful, “vigilant” move towards an “emerging friendship” built on their co-writing partnership over time, Dan describes having “ambivalent feelings: grief at the loss of one kind of engagement, and satisfaction at the gaining of the new” (p. 92).

Dan acknowledges the complexity of their changing relationship in light of Trish’s ethical commitment to not befriend ex-clients or at least recent ex-clients. They are also interested in how such an ethical commitment “can be honoured, valued, foregrounded even and complicated work can still occur” (p. 92). Dan also speculates about whether “the practices of psychotherapy—like research—might continue to evolve and stretch” (p. 89) to accommodate shifts in the therapist–client relationship. Throughout the book, both Trish and Dan demonstrate a high level of awareness of the care that needed to be taken in their metamorphosis from therapist and client to co-authors, and finally, tentatively, to becoming friends. This process has been an exploratory and multi-layered one. What is most clear is that, for the two of them, the shift from focusing exclusively on their co-writing was accompanied by “a kind of flattening of the hierarchy” (p. 92).

Dan also rightfully wonders in this chapter about whether their shared experiences with Trish might not appeal to some readers, particularly the notion of the client hearing more from the therapist about the therapist’s own experiences. In relation to the therapist’s vulnerability, Dan suggests that “there was a momentum in our co-writing which opened up a new liminal space of Trish saying more about the impact on her of our work together” (p. 94). This led to Trish’s increased disclosure about her personal life, including about her mother’s death. On the other hand, Trish indicated to Dan how difficult it was for her to relinquish her therapist’s role, given her professional commitment to being more receptive to Dan than Dan is to her.

After taking all of these complex factors into account, the authors raise the question of whether collaborative writing “could be a doorway from relational psychotherapy to ending or other modes of work” given its importance in helping Dan transition “from the work in the rooms [sic] to [their] ongoing work outside the room” (p. 94).

In this chapter Dan suggests that, whether or not a therapeutic relationship is a practice zone for real life, collaborative writing “might be a shared space where this reality-checking can increasingly happen” (p. 94). Dan also discusses the therapeutic value of knowing more about Trish’s personal life in terms of helping them to care more about other people and their experiences. Dan also found it easier to digest Trish’s experience of their relationship in writing, especially if they had to receive negative feedback from her.

In conclusion, Dan affirms the value of moving from a therapeutic relationship to one of collaborative writing. Dan also wonders whether the new dynamic of discussing how things are interpersonally between them and Trish could have been created previously in the therapy room. Dan thinks not, given how long they had worked in therapy in the more traditional way. However, they wonder if such a shift might still occur between therapist and client in the therapy rooms of the future.

Dialogue 3 focuses on the end of the authors’ therapeutic relationship and their “new” one as collaborators and friends. Trish suggests that she has gradually become more comfortable to share more about herself with Dan. Furthermore, Dan’s curiosity about Trish’s experience of their interactions and herself in the world has had positive ramifications for her work with other clients. Trish also reflects that their therapeutic relationship came to a natural conclusion because of the increasing time they began to spend on their collaborative writing, which they chose to do for publication rather than solely for therapy. In this sense, the trajectory of the relationship between Trish and Dan is quite distinctive. Another singular aspect of their collaborative writing process was Dan’s status as a professional writer. Working together in this way enabled Trish to view Dan as a master of their writing craft as well as a person experiencing challenges with their mental health: “There was something kind of humbling to have been able to see the struggling parts of you, and see them co-exist with the parts that excel and inspire” (p. 101). Dan also felt that Trish was finally seeing a more balanced version of them, and this was empowering to them.

In Dialogue 3, Dan reflects on the value of co-authoring during therapy, “which is a context in which we’re supposed to be safe, and to be able to speak the unspeakable” (p. 102). Dan mused that it had previously enabled them to engage with a therapist in a less formal way. Additionally, Trish “did seem more dialogic on the page, without taking the necessary focus off me and my treatment” (p. 103). For Dan, co-writing helped offset the awkward moments in face-to-face therapy when eye contact might prevent them both from being fully honest. Dan aptly compares the process to driving a car, in which the driver and front-seat passenger can both stare ahead and still have an uninhibited conversation.

Trish and Dan then return to the question of the when of collaborative writing, and the two agree that its strongest (but not exclusive) therapeutic potential might be as a kind of pathway towards autonomy for clients, and thus it best occurs towards the end of therapy. Dan suggests that therapists and clients who undertake co-writing “experiment with the form, style, language and texture of the words—be it poetry, creative nonfiction, whatever” (p. 105). Dan also encourages therapists not to “come to the writing in an instrumental way, as a ‘tool’ to help them [clients] to open up. Help them (and yourself) to experience the freedom of letting go into the artful play” (pp. 105–106).

The dialogue then moves to Trish articulating some ethical considerations for collaborative writing, including the importance of 1) the therapist negotiating with their client extra charges for the additional time spent on it, 2) the therapist responding authentically and empathically to their client’s writing and communicating how the client’s experience has affected them, 3) clients not feeling they must take care of or protect their therapist, 4) the therapist being clear about what happens to the written work produced, and 5) not engaging in co-writing with clients experiencing severe psychological disturbances with whom the first priorities are care and containment. Dan then follows with some reflections on the relational ethics of co-writing within the modality of autoethnography: “The focus on vulnerability and relationality makes autoethnography a perfect modality for client–therapist collaborative writing, and we have brought this ethic of care into our shared practice throughout” (p. 108).

Dan advocates for such an approach to be used with clients living with BPD to remedy the absence of their voices and lived experience in clinical research studies conducted about them. Trish takes this point further by suggesting that all clinical research needs to include the shared (rather than just the separate) voices of therapists and clients, as she and Dan have done in this book. The book ends with a co-authored conclusion summarising different approaches to co-writing, including various writing prompts for therapists and clients, and a reflection on the value of this shared enterprise.

In this review I have endeavoured to immerse the reader into the rich world of this wonderful book. However, despite all of the direct quotations I have included, I cannot do full justice to the range and depth of original thought and insight as well as the superb lyricism of the full text. To have that more complete experience I urge readers to relish the pleasure of closely reading it from cover to cover.