'Maybe You Should Talk To Someone': A Therapist In Therapy Shares Reflections In New Book

"Aren't therapists supposed to keep their personal lives private? Aren't they supposed to ... refrain from calling their patients names — even in their heads? Aren't therapists, of all people, supposed to have their lives together?"

Those questions are posed by psychotherapist Lori Gottlieb, who, as it happens, doesn't always have it together.

In her new book, “Maybe You Should Talk to Someone: A Therapist, Her Therapist, and Our Lives Revealed,” Gottlieb tells the story of her patients' crises--and her own--to ask fundamental questions about therapy: what is, and what it isn't, and why it matters.

Gottlieb will be speaking at Brookline Booksmith in Brookline at 7 p.m. on Friday.

Lori Gottlieb, psychotherapist, writer for The Atlantic's "Dear Therapist" column, and author of “Maybe You Should Talk to Someone: A Therapist, Her Therapist, and Our Lives Revealed." She tweets @LoriGottlieb1. 

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 the idiots.”Have compassion.
Deep breath.
Have compassion, have compassion, have compassion . . .
I’m repeating this phrase in my head like a mantra as the forty-yearold
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
smiling.”
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 television-industry
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.

Excerpted from MAYBE YOU SHOULD TALK TO SOMEONE: A Therapist, Her Therapist, and Our Lives Revealed by Lori Gottlieb. Copyright © 2019 by Lori Gottlieb. Published and reprinted by permission of Houghton Mifflin Harcourt. All rights reserved.