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Works of literature appearing in this column may be of help in teaching our students how to engage and counsel traumatized clients. Such literary interludes can be productively approached as “thought experiments” conducted by some of civilization's most perceptive and articulate students of human nature. 

Consider the following passages from Tolstoy’s Anna Karenina. In the first of these, Anna engages her sister-in-law whose husband, Anna’s brother, has had an affair with their children’s governess. To be sure, many rules of therapy are violated (e.g. working with a relative, the therapist having her own agenda), but, to be fair, modern psychotherapy had not yet been invented and Anna was only trying to provide the social support now so highly regarded by researchers in our field. Students reading the following passages may benefit by thinking about what is therapeutic in this interaction—and what is not!   

We found Anna’s approach quite sensitive but different therapists may have different views about the quality and effectiveness of her intervention. For example, telling the client that you “understand” may not always have the desired effect. Perhaps our readers will find Anna's therapeutic efforts of interest and will consider discussing them with their students.

“Dolly,” she said, “he has told me.”

Dolly looked coldly at Anna; she was waiting for phrases of conventional sympathy, but Anna said nothing of the sort.

“Dolly, dear,” she said, “I don’t want to speak for him to you, nor to try to comfort you; that’s impossible. But, darling, I’m simply sorry, sorry from my heart for you!”

Under the thick lashes of her shining eyes tears suddenly glittered. She moved nearer to her sister-in-law and took her hand in her vigorous little hand. Dolly did not shirk away, but her face did not lose its frigid expression. She said:

“To comfort me’s impossible. Everything’s lost after what has happened, everything’s over!”

And directly she had said this, her face suddenly softened. Anna lifted the wasted, thin hand of Dolly, kissed it and said:

“But, Dolly, what’s to be done, what’s to be done? How is it best to act in this awful position- that’s what you must think of?”

“All’s over, and there’s nothing more,” said Dolly. “And the worst of all is, you see, that I can’t cast him off: there are the children, I am tied. And I can’t live with him! It’s a torture to me to see him.”

“Dolly, darling, he has spoken to me, but I want to hear it from you: tell me about it.”

Dolly looked at her inquiringly.

Sympathy and love unfeigned were visible on Anna’s face.

Dolly then tells some of the story

…” I can understand being carried away by feeling,” she went on after a brief silence, “but deliberately, slyly deceiving me…and with whom?...To go on being my husband together with her…its awful! You can’t understand…”

“Oh, yes, I understand” I understand! Dolly, dearest, I do understand,” said Anna, pressing her hand.

“And do you imagine he realizes all the awfulness of my position?” 

Dolly resumed. “Not the slightest! He’s happy and contented.”

“Oh, no!” Anna interposed quickly. “He’s to be pitied, he’s weighed down by remorse…”

(Pt. 1, Ch.19, pp 79 – 80)

In the second passage (below) Dolly, in turn, attempts to comfort her sister Kitty about Kitty’s relationship problems. Unfortunately, Dolly seems to lack Anna's empathy and sensitive timing. Students might note the specifics of the differences between the two interventions and how difficult it can be to do unto others as was done to you …

 Dolly begins: “I want to talk to you.”

 “What about?” Kitty asked swiftly, lifting her head in dismay.

 “What should it be about but your trouble?”

 “I have no trouble.”

 “Nonsense, Kitty. Do you suppose I could help knowing? I know all about it. And believe me, it’s of so little consequence….We’ve all been through it.”

 “Kitty did not speak, her face had a stern expression.”

(Pt. 2, Ch. 3, p 141)

If you find this, or past contributions to this column, valuable for yourself or helpful to students as a focus for learning, we would be pleased to receive your feedback.

Thank you!

Harold Kudler, MD
Howard Lipke, PhD


Tolstoy, Leo (1965) Anna Karenina (Constance Garnett, Translator). New York: Modern Library. (Original work published 1877)