Unformatted text preview: Contents
P art O n e
If the Queen Had Balls
The Space of a Step
The Smart One or the Hot One
Namast’ay in Bed
The Beginning of Knowing
Snapshots of Ourselves
The Future Is Also the Present
Welcome to Holland
How Kids Deal with Grief
Harold and Maude
Hold the Mayo
The Whole Package
Without Memory or Desire
P art Tw o
Fridays at Four
What We Dream Of
The First Confession
Therapy with a Condom On
Jail Trader Joe’s
The UPS Guy
Embarrassing Public Encounters
On the Clock
P art T h ree
My Wandering Uterus
Would You Rather?
The Speed of Want
How Humans Change
Integrity Versus Despair
What Not to Say to a Dying Person
P art F o u r
Psychological Immune System
Counseling Versus Therapy
The Hug Don’t Blow It
It’s My Party and You’ll Cry if You Want To
Happiness Is Sometimes
A Pause in the Conversation
About the Author
Connect with HMH Copyright © 2019 by Lori Gottlieb
All rights reserved
For information about permission to reproduce selections from this book, write to
[email protected] or to Permissions, Houghton Mifflin Harcourt Publishing Company,
3 Park Avenue, 19th Floor, New York, New York 10016.
Library of Congress Cataloging-in-Publication Data
Names: Gottlieb, Lori, author.
Title: Maybe you should talk to someone : a therapist, HER therapist, and our lives revealed / Lori
Description: Boston : Houghton Mifflin Harcourt, 2019.
Identifiers: LCCN 2018042562 (print) | LCCN 2018045914 (ebook) | ISBN 9781328663047 (ebook)
| ISBN 9781328662057 (hardback)
Subjects: LCSH: Gottlieb, Lori,—Health. | Psychotherapists—Biography. | Therapist and patient—
Biography. | BISAC: PSYCHOLOGY / Psychotherapy / General. | BIOGRAPHY &
AUTOBIOGRAPHY / Personal Memoirs. | SELF-HELP / Personal Growth / Happiness. | FAMILY
& RELATIONSHIPS /Love & Romance. Classification: LCC RC480.8 (ebook) |
LCC RC480.8 .G68 2019 (print) | DDC 616.89/14092 [B]—dc23
LC record available at
Cover design by Martha Kennedy
Hand lettering © Gill Heeley
Cover photograph © hatman12 / iStock / Getty Images Plus
Author photograph © Shlomit Levy Bard
Illustrations on page 42 copyright © 2019 by Arthur Mount. Emoji art on page 49, from left to right:
Standard Studio via Shutterstock; Sovenko Artem via Shutterstock; Park Ji Sun via Shutterstock;
Rvector via Shutterstock.
“Welcome to Holland,” copyright © 1987 by Emily Perl Kingsley. Reprinted by the permission of the
author. All rights reserved. It is proposed that happiness be classified as a psychiatric disorder
and be included in future editions of the major diagnostic manuals
under the new name: major affective disorder, pleasant type. In a
review of the relevant literature it is shown that happiness is
statistically abnormal, consists of a discrete cluster of symptoms, is
associated with a range of cognitive abnormalities, and probably
reflects the abnormal functioning of the central nervous system. One
possible objection to this proposal remains—that happiness is not
negatively valued. However, this objection is dismissed as
JOURNAL OF MEDICAL ETHICS, 1992 The eminent Swiss psychiatrist Carl Jung said this:
“People will do anything, no matter how absurd,
to avoid facing their own souls.”
But he also said this:
“Who looks inside, awakes.” Author’s Note
This is a book that asks, “How do we change?” and answers with “In
relation to others.” The relationships I write about here, between therapists
and patients, require a sacred trust for any change to occur. In addition to
attaining written permission, I have gone to great lengths to disguise
identities and any recognizable details, and in some instances, material and
scenarios from a few patients have been attributed to one. All changes were
carefully considered and painstakingly chosen to remain true to the spirit of
each story while also serving the greater goal: to reveal our shared
humanity so that we can see ourselves more clearly. Which is to say, if you
see yourself in these pages, it’s both coincidental and intentional.
A note on terminology: Those who come to therapy are referred to in
various ways, most commonly as patients or clients. I don’t believe that
either word quite captures the relationship I have with the people I work
with. But the people I work with is awkward, and clients might be
confusing, given that term’s many connotations, so for simplicity and
clarity, I use patients throughout this book. Part One
Nothing is more desirable than to be released from
an affliction, but nothing is more frightening
than to be divested of a crutch.
—James Baldwin 1
CHART NOTE, JOHN: Patient reports feeling “stressed out” and states that he is
having difficulty sleeping and getting along with his wife.
Expresses annoyance with others and seeks help “managing
Have compassion, have compassion, have compassion . . .
I’m repeating this phrase in my head like a mantra as the forty-year-old
man sitting across from me is telling me about all of the people in his life
who are “idiots.” Why, he wants to know, is the world filled with so many
idiots? Are they born this way? Do they become this way? Maybe, he
muses, it has something to do with all the artificial chemicals that are added
to the food we eat nowadays.
“That’s why I try to eat organic,” he says. “So I don’t become an idiot
like everyone else.”
I’m losing track of which idiot he’s talking about: the dental hygienist
who asks too many questions (“None of them rhetorical”), the coworker
who only asks questions (“He never makes statements, because that would
imply that he had something to say”), the driver in front of him who
stopped at a yellow light (“No sense of urgency!”), the Apple technician at
the Genius Bar who couldn’t fix his laptop (“Some genius!”).
“John,” I begin, but he’s starting to tell a rambling story about his wife. I
can’t get a word in edgewise, even though he has come to me for help.
I, by the way, am his new therapist. (His previous therapist, who lasted
just three sessions, was “nice, but an idiot.”) “And then Margo gets angry—can you believe it?” he’s saying. “But she
doesn’t tell me she’s angry. She just acts angry, and I’m supposed to ask her
what’s wrong. But I know if I ask, she’ll say, ‘Nothing,’ the first three
times, and then maybe the fourth or fifth time she’ll say, ‘You know what’s
wrong,’ and I’ll say, ‘No, I don’t, or I wouldn’t be asking! ’”
He smiles. It’s a huge smile. I try to work with the smile—anything to
change his monologue into a dialogue and make contact with him.
“I’m curious about your smile just now,” I say. “Because you’re talking
about being frustrated by many people, including Margo, and yet you’re
His smile gets bigger. He has the whitest teeth I’ve ever seen. They’re
gleaming like diamonds. “I’m smiling, Sherlock, because I know exactly
what’s bothering my wife!”
“Ah!” I reply. “So—”
“Wait, wait. I’m getting to the best part,” he interrupts. “So, like I said, I
really do know what’s wrong, but I’m not that interested in hearing another
complaint. So this time, instead of asking, I decide I’m going to—”
He stops and peers at the clock on the bookshelf behind me.
I want to use this opportunity to help John slow down. I could comment
on the glance at the clock (does he feel rushed in here?) or the fact that he
just called me Sherlock (was he irritated with me?). Or I could stay more on
the surface in what we call “the content”—the narrative he’s telling—and
try to understand more about why he equates Margo’s feelings with a
complaint. But if I stay in the content, we won’t connect at all this session,
and John, I’m learning, is somebody who has trouble making contact with
the people in his life.
“John,” I try again. “I wonder if we can go back to what just happened
“Oh, good,” he says, cutting me off. “I still have twenty minutes left.”
And then he’s back to his story.
I sense a yawn coming on, a strong one, and it takes what feels like
superhuman strength to keep my jaw clenched tight. I can feel my muscles
resisting, twisting my face into odd expressions, but thankfully the yawn
stays inside. Unfortunately, what comes out instead is a burp. A loud one.
As though I’m drunk. (I’m not. I’m a lot of unpleasant things in this
moment, but drunk isn’t one of them.) Because of the burp, my mouth starts to pop open again. I squeeze my
lips together so hard that my eyes begin to tear.
Of course, John doesn’t seem to notice. He’s still going on about Margo.
Margo did this. Margo did that. I said this. She said that. So then I said—
During my training, a supervisor once told me, “There’s something
likable in everyone,” and to my great surprise, I found that she was right.
It’s impossible to get to know people deeply and not come to like them. We
should take the world’s enemies, get them in a room to share their histories
and formative experiences, their fears and their struggles, and global
adversaries would suddenly get along. I’ve found something likable in
literally everyone I’ve seen as a therapist, including the guy who attempted
murder. (Beneath his rage, he turned out to be a real sweetheart.)
I didn’t even mind the week before, at our first session, when John
explained that he’d come to me because I was a “nobody” here in Los
Angeles, which meant that he wouldn’t run into any of his televisionindustry colleagues when coming for treatment. (His colleagues, he
suspected, went to “well-known, experienced therapists.”) I simply tagged
that for future use, when he’d be more open to engaging with me. Nor did I
flinch at the end of that session when he handed me a wad of cash and
explained that he preferred to pay this way because he didn’t want his wife
to know he was seeing a therapist.
“You’ll be like my mistress,” he’d suggested. “Or, actually, more like my
hooker. No offense, but you’re not the kind of woman I’d choose as a
mistress . . . if you know what I mean.”
I didn’t know what he meant (someone blonder? Younger? With whiter,
more sparkly teeth?), but I figured that this comment was just one of John’s
defenses against getting close to anybody or acknowledging his need for
another human being.
“Ha-ha, my hooker!” he said, pausing at the door. “I’ll just come here
each week, release all my pent-up frustration, and nobody has to know!
Isn’t that funny?”
Oh, yeah, I wanted to say, super-funny.
Still, as I heard him laugh his way down the hall, I felt confident that I
could grow to like John. Underneath his off-putting presentation, something
likable—even beautiful—was sure to emerge.
But that was last week.
Today he just seems like an asshole. An asshole with spectacular teeth. Have compassion, have compassion, have compassion. I repeat my silent
mantra then refocus on John. He’s talking about a mistake made by one of
the crew members on his show (a man whose name, in John’s telling, is
simply The Idiot) and just then, something occurs to me: John’s rant sounds
eerily familiar. Not the situations he’s describing, but the feelings they
evoke in him—and in me. I know how affirming it feels to blame the
outside world for my frustrations, to deny ownership of whatever role I
might have in the existential play called My Incredibly Important Life. I
know what it’s like to bathe in self-righteous outrage, in the certainty that
I’m completely right and have been terribly wronged, because that’s exactly
how I’ve felt all day.
What John doesn’t know is that I’m reeling from last night, when the
man I thought I was going to marry unexpectedly called it quits. Today I’m
trying to focus on my patients (allowing myself to cry only in the tenminute breaks between sessions, carefully wiping away my running
mascara before the next person arrives). In other words, I’m dealing with
my pain the way I suspect John has been dealing with his: by covering it up.
As a therapist, I know a lot about pain, about the ways in which pain is
tied to loss. But I also know something less commonly understood: that
change and loss travel together. We can’t have change without loss, which
is why so often people say they want change but nonetheless stay exactly
the same. To help John, I’m going to have to figure out what his loss would
be, but first, I’m going to have to understand mine. Because right now, all I
can think about is what my boyfriend did last night.
I look back at John and think: I hear you, brother.
Wait a minute, you might be thinking. Why are you telling me all this?
Aren’t therapists supposed to keep their personal lives private? Aren’t they
supposed to be blank slates who never reveal anything about themselves,
objective observers who refrain from calling their patients names—even in
their heads? Besides, aren’t therapists, of all people, supposed to have their
On the one hand, yes. What happens in the therapy room should be done
on behalf of the patient, and if therapists aren’t able to separate their own
struggles from those of the people who come to them, then they should,
without question, choose a different line of work. On the other hand, this—right here, right now, between you and me—
isn’t therapy, but a story about therapy: how we heal and where it leads us.
Like in those National Geographic Channel shows that capture the
embryonic development and birth of rare crocodiles, I want to capture the
process in which humans, struggling to evolve, push against their shells
until they quietly (but sometimes loudly) and slowly (but sometimes
suddenly) crack open.
So while the image of me with mascara running down my tear-streaked
face between sessions may be uncomfortable to contemplate, that’s where
this story about the handful of struggling humans you are about to meet
begins—with my own humanity.
Therapists, of course, deal with the daily challenges of living just like
everyone else. This familiarity, in fact, is at the root of the connection we
forge with strangers who trust us with their most delicate stories and
secrets. Our training has taught us theories and tools and techniques, but
whirring beneath our hard-earned expertise is the fact that we know just
how hard it is to be a person. Which is to say, we still come to work each
day as ourselves—with our own sets of vulnerabilities, our own longings
and insecurities, and our own histories. Of all my credentials as a therapist,
my most significant is that I’m a card-carrying member of the human race.
But revealing this humanity is another matter. One colleague told me that
when her doctor called with the news that her pregnancy wasn’t viable, she
was standing in a Starbucks, and she burst into tears. A patient happened to
see her, canceled her next appointment, and never came back.
I remember hearing the writer Andrew Solomon tell a story about a
married couple he’d met at a conference. During the course of the day, he
said, each spouse had confessed independently to him to taking
antidepressants but didn’t want the other to know. It turned out that they
were hiding the same medication in the same house. No matter how open
we as a society are about formerly private matters, the stigma around our
emotional struggles remains formidable. We’ll talk with almost anyone
about our physical health (can anyone imagine spouses hiding their reflux
medication from each other?), even our sex lives, but bring up anxiety or
depression or an intractable sense of grief, and the expression on the face
looking back at you will probably read, Get me out of this conversation,
pronto. But what are we so afraid of? It’s not as if we’re going to peer in those
darker corners, flip on the light, and find a bunch of cockroaches. Fireflies
love the dark too. There’s beauty in those places. But we have to look in
there to see it.
My business, the therapy business, is about looking.
And not just with my patients.
A little-discussed fact: Therapists go to therapists. We’re required, in fact,
to go during training as part of our hours for licensure so that we know
firsthand what our future patients will experience. We learn how to accept
feedback, tolerate discomfort, become aware of blind spots, and discover
the impact of our histories and behaviors on ourselves and others.
But then we get licensed, people come to seek our counsel and . . . we
still go to therapy. Not continuously, necessarily, but a majority of us sit on
somebody else’s couch at several points during our careers, partly to have a
place to talk through the emotional impact of the kind of work we do, but
partly because life happens and therapy helps us confront our demons when
they pay a visit.
And visit they will, because everyone has demons—big, small, old, new,
quiet, loud, whatever. These shared demons are testament to the fact that we
aren’t such outliers after all. And it’s with this discovery that we can create
a different relationship with our demons, one in which we no longer try to
reason our way out of an inconvenient inner voice or numb our feelings
with distractions like too much wine or food or hours spent surfing the
internet (an activity my colleague calls “the most effective short-term
One of the most important steps in therapy is helping people take
responsibility for their current predicaments, because once they realize that
they can (and must) construct their own lives, they’re free to generate
change. Often, though, people carry around the belief that the majority of
their problems are circumstantial or situational—which is to say, external.
And if the problems are caused by everyone and everything else, by stuff
out there, why should they bother to change themselves? Even if they
decide to do things differently, won’t the rest of the world still be the same?
It’s a reasonable argument. But that’s not how life generally works.
Remember Sartre’s famous line “Hell is other people”? It’s true—the
world is filled with difficult people (or, as John would have it, “idiots”). I’ll bet you could name five truly difficult people off the top of your head right
now—some you assiduously avoid, others you would assiduously avoid if
they didn’t share your last name. But sometimes—more often than we tend
to realize—those difficult people are us.
That’s right—sometimes hell is us.
Sometimes we are the cause of our difficulties. And if we can step out of
our own way, something astonishing happens.
A therapist will hold up a mirror to patients, but patients will also hold up
a mirror to their therapists. Therapy is far from one-sided; it happens in a
parallel process. Every day, our patients are opening up questions that we
have to think about for ourselves. If they can see themselves more clearly
through our reflections, we can see ourselves more clearly through theirs.
This happens to therapists when we’re providing therapy, and it happens to
our own therapists too. We are mirrors reflecting mirrors reflecting mirrors,
showing one another what we can’t yet see.
Which brings me back to John. Today, I’m not thinking about any of this.
As far as I’m concerned, it’s been a difficult day with a difficult patient, and
to make matters worse, I’m seeing John right after a young newlywed
who’s dying of cancer—which is never an ideal time to see anyone, but
especially not when you haven’t gotten much sleep, and your marriage
plans have just been canceled, and you know that your pain is trivial
compared to that of a terminally ill woman, and you also sense (but aren’t
yet aware) that it’s not trivial at all because something cataclysmic is
happening inside you.
Meanwhile, about a mile away, in a quaint brick building on a narrow
one-way street, a therapist named Wen...
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