Maybe You Should Talk to Someone: A Therapist, Her Therapist, and Our Lives Revealed

by Lori Gottlieb

Nothing is more desirable than to be released from an affliction, but nothing is more frightening than to be divested of a crutch.

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?

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.

If this portrait sounds skewed, it is. There are many ways to tell a story, and if I’ve learned anything as a therapist, it’s that most people are what therapists call “unreliable narrators.” That’s not to say that they purposely mislead. It’s more that every story has multiple threads, and they tend to leave out the strands that don’t jibe with their perspectives. Most of what patients tell me is absolutely true—from their current points of view. Ask about somebody’s spouse while they’re both still in love, then ask about that same spouse post-divorce, and each time, you’ll get only half the story.

I’m in a state of shock mixed with bewilderment. I don’t understand how this has never come up. How do you sleep soundly next to a person and plan a life with her when you’re secretly grappling with whether to leave? (The answer is simple—a common defense mechanism called compartmentalization. But right now I’m too busy using another defense mechanism, denial, to see it.)

It boils down to fear—of being exposed, of being found out. Will you spot the insecurities that I’m so skillful at hiding? Will you see my vulnerabilities, my lies, my shame?

Married for twenty years to her college sweetheart, Allison has no idea how to give guidance to single people.

What I really need just hours into this breakup is for somebody to sit with me in my pain, but I also know how helpless it feels to watch a friend suffer and do nothing to fix it. Sitting-with-you-in-your-pain is one of the rare experiences that people get in the protected space of a therapy room, but it’s very hard to give or get outside of it—even for Jen, who is a therapist.

That’s one thing I tell patients who are in the midst of crippling depression, the kind that makes them think, There’s the bathroom. It’s about five feet away. I see it, but I can’t get there. One foot, then the other. Don’t look at all five feet at once. Just take a step. And when you’ve taken that step, take one more. Eventually you’ll make it to the shower. And you’ll make it to tomorrow and next year too. One step. They may not be able to imagine their depression lifting anytime soon, but they don’t need to. Doing something prompts you to do something else, replacing a vicious cycle with a virtuous one. Most big transformations come about from the hundreds of tiny, almost imperceptible, steps we take along the way.

“You seem depressed,” she said with concern. I said I wasn’t depressed; I was just bored. I hadn’t considered that if the only thing that keeps you going all day is knowing you’ll get to turn on the TV after dinner, you probably are depressed.

In order to do their job, therapists try to see patients as they really

are, which means noticing their vulnerabilities and entrenched patterns and struggles. Patients, of course, want to be helped, but they also want to be liked and admired. In other words, they want to hide their vulnerabilities and entrenched patterns and struggles.

He held up a finger—Hang on—but continued to text. When he finished, he looked up at me. “Sorry, what was I saying?” I loved that. Not “What were you saying” but “What was I saying.”

People often mistake numbness for nothingness, but numbness isn’t the absence of feelings; it’s a response to being overwhelmed by too many feelings.

People who come to therapy present snapshots of themselves, and from these snapshots, a therapist has to extrapolate. Patients arrive, if not at their worst, then certainly not at their best. They might be despairing or defensive, confused or chaotic. Generally, they’re in very bad moods.

“Your feelings don’t have to mesh with what you think they should be,” he explained. “They’ll be there regardless, so you might as well welcome them because they hold important clues.”

at some point in our lives, we have to let go of the fantasy of creating a better past. If we don’t accept the notion that there’s no redo, much as we try to get our parents or siblings or partners to fix what happened years ago, our pasts will keep us stuck.

therapy we aim for self-compassion (Am I human?) versus self-esteem (a judgment: Am I good or bad?).

It’s Wendell’s job to help me edit my story. All therapists do this: What material is extraneous? Are the supporting characters important or a distraction? Is the story advancing or is the protagonist going in circles? Do the plot points reveal a theme?

What makes therapy challenging is that it requires people to see themselves in ways they normally choose not to. A therapist will hold up the mirror in the most compassionate way possible, but it’s up to the patient to take a good look at that reflection, to stare back at it and say, “Oh, isn’t that interesting! Now what?” instead of turning away.

Many patients wonder if they bore us with what feels to them like their unremarkable lives, but they’re not boring at all. The patients who are boring are the ones who won’t share their lives, who smile through their sessions or launch into seemingly pointless and repetitive stories every time, leaving us scratching our heads: Why are they telling me this? What significance does this have for them? People who are aggressively boring want to keep you at bay.

He does this as if he’s the only patient I have, not to mention the only “me” in my life. Even suicidal patients will leave their names. I’ve never gotten Hi, it’s me. You told me to call if I was feeling like killing myself.

Say what you will about the wonders of technology, but screen-to-screen is, as a colleague once said, “like doing therapy with a condom on.”

It’s not just the words people say or even the visual cues that therapists notice in person—the foot that shakes, the subtle facial twitch, the quivering lower lip, the eyes narrowing in anger. Beyond hearing and seeing, there’s something less tangible but equally important—the energy in the room, the being together. You lose that ineffable dimension when you aren’t sharing the same physical space.

Whenever one person in a family system starts to make changes, even if the changes are healthy and positive, it’s not unusual for other members in this system to do everything they can to maintain the status quo and bring things back to homeostasis. If an addict stops drinking, for instance, family members often unconsciously sabotage that person’s recovery, because in order to regain homeostasis in the system, somebody has to fill the role of the troubled person. And who wants that role? Sometimes people even resist positive changes in their friends: Why are you going to the gym so much? Why can’t you stay out late—you don’t need more sleep! Why are you working so hard for that promotion? You’re no fun anymore!

If John’s wife becomes less depressed, how can John keep his role as the sane one in the couple?

but when men tell me how they feel in therapy, I’m almost always the first person they’ve said it to. Like my female patients, men struggle with marriage, self-esteem, identity, success, their parents, their childhoods, being loved and understood—and yet these topics can be tricky to bring up in any meaningful way with their male friends. It’s no wonder that the rates of substance abuse and suicide in middle-aged men continue to increase. Many men don’t feel they have any other place to turn.

There’s a magnet that somebody stuck on the refrigerator in our office’s kitchen: PEACE. IT DOES NOT MEAN TO BE IN A PLACE WHERE THERE IS NO NOISE, TROUBLE, OR HARD WORK. IT MEANS TO BE IN THE MIDST OF THOSE THINGS AND STILL BE CALM IN YOUR HEART. We can help patients find peace, but maybe a different kind than they imagined they’d find when they started treatment. As the late psychotherapist John Weakland famously said, “Before successful therapy, it’s the same damn thing over and over. After successful therapy, it’s one damn thing after another.”

Therapists tell their patients: Follow your envy—it shows you what you want.

Even her movements were listless, like the way she sauntered to the sofa in slow motion, a sign of depression known as psychomotor retardation.

Often when patients see our humanity, they leave us.

She was approaching “emotional sobriety”—the ability to regulate one’s feelings without self-medicating, whether that medication comes in the form of substances, defenses, affairs, or the internet.

What most people mean by type is a sense of attraction—a type of physical appearance or a type of personality turns them on. But what underlies a person’s type, in fact, is a sense of familiarity.

Behind my questions lies the assumption that Wendell is a more competent human being than I am. Sometimes I wonder, Who am I to make the important decisions in my own life? Am I really qualified for this?

She ambles toward the door but stops at the threshold, as she often does to ask me a question or say something she should have said during the session. Like John, she’s prone to what we call “doorknob disclosures.”

“Well, sure, the vows say ‘in sickness and health’ and ‘for better or worse’ and all that, but that’s kind of like clicking okay to the terms and conditions when you download an app or sign up for a credit card. You don’t think any of that is going to apply to you. Or if you do, you don’t expect it to happen right after your honeymoon, before you’ve even had a chance to be married.”

I think about how common it is, even in everyday situations, to be jealous of a spouse and how taboo it is to talk about that. Aren’t we supposed to be happy for their good fortune? Isn’t that what love is about?

Almost every woman I see apologizes for her feelings, especially her tears. I remember apologizing in Wendell’s office too. Perhaps men apologize preemptively, by holding their tears back.

It may seem like the patient controls the session, deciding what to say or not, setting the agenda or topic. But therapists pull the strings in our own ways—in what we say or don’t say, what we respond to or hold on to for later, what we give attention to and what we don’t.

“Are you waiting for the other shoe to drop?” I ask. There’s a term for this irrational fear of joy: cherophobia (chero is the Greek word for “rejoice”). People with cherophobia are like Teflon pans in terms of pleasure—it doesn’t stick (though pain cakes on them as if to an ungreased surface). It’s common for people with traumatic histories to expect disaster just around the corner. Instead of leaning into the goodness that comes their way, they become hypervigilant, always waiting for something to go wrong.

I thought of something Wendell had said to me after I’d listed my own regrettable missteps that I took great pleasure in punishing myself for: “How long do you think the sentence for this crime should be? A year? Five? Ten?” Many of us torture ourselves over our mistakes for decades, even after we’ve genuinely attempted to make amends. How reasonable is that sentence?

Actually, I know better. It turns out that sessions to which patients come with neither a crisis nor an agenda tend to be the most revelatory ones. When we give our minds space to wander, they take us to the most unexpected and interesting places.

My good mood is dissipating and I start to question if my contentment was real or if I was experiencing a “flight to health” in Wendell’s absence. A flight to health is a phenomenon in which patients convince themselves that they’re suddenly over their issues because, unbeknownst to them, they can’t tolerate the anxiety that working through these issues is bringing up. Typically, a patient might have a difficult session about a childhood trauma, then come in the next week and announce that therapy is no longer needed. I feel great! That session was cathartic! A flight to health is especially common when the therapist or patient has been away and in that break, the person’s unconscious defenses take hold. I did so well the past few weeks. I don’t think I need therapy