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Book Reviews   |    
That's How the Light Gets In: Memoir of a Psychiatrist
Reviewed by Eva Szigethy
Psychiatric Services 2006; doi: 10.1176/appi.ps.57.5.739

by Susan Rako, M.D.; New York, Harmony Books, 2005, 208 pages, $21

Dr. Szigethy is assistant professor of psychiatry at the University of Pittsburgh Medical Center and Children's Hospital of Pittsburgh.

The book That's How the Light Gets In chronicles one woman's reflections on her life journey to gain insight as a way of enriching her current interpersonal relationships and understanding her strengths and limitations as a daughter, parent, student, lover, and healer. Her candid account of the trials and tribulations of her life is aimed at inspiring, empowering, and encouraging readers to search for meaning and fulfillment in their own lives. That woman is author Susan Rako, an articulate, experienced psychiatrist.

Rako artfully weaves together threads of richly descriptive accounts of defining moments in her life over the past 60-plus years with clever interpretive commentary. The resulting product reflects her creative skills as a storyteller and the depth of her scholarly acumen and clinical wisdom. As foreshadowed in the title—taken from a quote from Leonard Cohen, "There is a crack, a crack in everything, that's how the light gets in"—the author courageously invites readers deep into her psyche to facilitate exploration of their own strengths and weaknesses as a means to reach their fullest potential.

Several factors account for the book's success in reaching its objectives. First, Rako convincingly portrays the strong positive and negative emotional valences associated with her narrative accounts that contribute to consolidating these images into permanent, formative memories. Throughout the book, the author stresses the importance of recognizing and embracing "guilt, relief, fear, wonder" as critical, if at times painful, aspects of human growth.

Second, her ability to draw from clinical insights (both her own therapy as well as work with her patients) and from relevant philosophies and quotations of inspirational authors, teachers, and mentors provides an important structural framework to understand her evolution throughout the book, both as a clinician and as a person.

Third, Rako's openness about which therapeutic relationships and modalities are most successful in her self-evolution lends credibility to the more general conclusions she draws about human behavior. Her eclectic approach—which embraces aspects of classical psychoanalysis, object relations theory, Jungian therapy, and even the Cherokee shamanic practice of guided meditation—reminds the reader of the importance of remaining open to new ideas as a way to keep passion and vitality alive both in their lives and with their patients.

The book predominantly targets a female readership and offers inspirational insights to women at all stages of their developmental trajectory. Students, healers, mothers, and patients alike will find themes that resonate with their own experience. Rako addresses issues such as working through a bad relationship with her parents, searching for surrogate parents throughout life, balancing motherhood and career goals, finding spirituality in the most unlikely places, and understanding the importance of women who stand up for themselves, pursue their dreams on their own terms, and find fulfillment in their lives, regardless of how many "cracks" they perceive for themselves.

Rako is certainly qualified to address these difficult issues. She trained as a psychiatrist at Harvard's Massachusetts Mental Health Center and had a thriving private therapy practice for more than 30 years. She is a recognized author and advocate for women's health issues. The trajectory of the author's life—from a shy, introspective, compliant child to an independent thinker and doer willing to challenge existing stereotypes about female societal roles, religious practice, and motherhood—is best captured by a quote from Carl Jung (1) that echoes throughout the book: "Follow that will and that way that experience confirms to be your own."

In summary, this book is a refreshing reminder of each person's potential to take the negative and positive fragments of life and create a cohesive, satisfying life narrative with the plasticity to keep growing and changing until death, or, as the author paraphrases Winnicott, "to be alive when I die."

Adler G (ed): CG Jung Letters, Vol 2:1951-1961. Princeton, NJ, Princeton University Press, 1976
 
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References

Adler G (ed): CG Jung Letters, Vol 2:1951-1961. Princeton, NJ, Princeton University Press, 1976
 
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