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

by Lori Gottlieb

And still people try to suppress their feelings. Just a week before, a patient had told me that she couldn’t go a single night without turning on her TV, falling asleep to it, and waking up hours later. “Where did my evening go?” she asked from my couch. But the real question was, where had her feelings gone?

Though we travel the world over to find the beautiful, we must carry it with us, or we find it not. —Ralph Waldo Emerson

“We talked about Gabe,” he says quietly. And then he starts crying, a guttural wail, raw and wild, and I recognize it instantly. It’s the sound I heard in the ER back in medical school from the parents of the drowned toddler. It’s a love song to his beloved son.

“Why do you suppose it’s important to her that you talk about Gabe?” He considers this. “I remember after Gabe died, Margo wanted me to talk about Gabe and I just couldn’t. She didn’t understand how I could go to barbecues and Lakers games and seem like a normal person, but that first year I was in shock. Numb. I told myself, Keep moving, don’t stop. But the next year, when I woke up I’d want to die. I kept my game face on but I was bleeding internally, you know? I wanted to be strong for Margo and Gracie, and I had to keep a roof over our heads, so I couldn’t let anyone see the bleeding.

“What happened to your grief then?” I ask. “Well, it got better at first—which, in a strange way, made me feel worse.” “Because the grief had connected you to Gabe?” John looks surprised. “Not bad, Sherlock. Yeah. It was almost like my pain was evidence of my love for Gabe, and if it let up, it meant I was forgetting about him. That he didn’t matter as much to me.” “That if you were happy, you couldn’t also be sad.”

“Exactly.” He looks away. “I still feel that way.” “What if it’s both?” I say. “What if your sadness—your grief—is what allowed you to love Ruby with so much joy when you first saw her?” I remember a woman I treated whose husband had died. When she fell in love a year later—a love all the more sweet because of the loss of her husband—she worried that others would judge her. (So soon? Didn’t you love your husband of thirty years?) In fact, her friends and family were excited for her. It wasn’t their judgment she was hearing—it was her own. What if her happiness was an insult to her husband’s memory? It took her a while to see that her happiness didn’t diminish her love for her husband—it honored it.

Many people don’t know that Elisabeth Kübler-Ross’s familiar stages of grieving—denial, anger, bargaining, depression, acceptance—were conceived in the context of terminally ill patients learning to accept their own deaths. It wasn’t until decades later that the model came to be used for the grieving process more generally. It’s one thing to “accept” the end of your own life, as Julie is struggling to do. But for those who keep on living, the idea that they should be getting to acceptance might make them feel worse (“I should be past this by now”; “I don’t know why I still cry at random times all these years later”). Besides, how can there be an endpoint to love and loss? Do we even want there to be? The price of loving so deeply is feeling so deeply—but it’s also a gift, the gift of being alive. If we no longer feel, we should be grieving our own deaths.

The grief psychologist William Worden takes into account these questions by replacing stages with tasks of mourning. In his fourth task, the goal is to integrate the loss into your life and create an ongoing connection with the person who died while also finding a way to continue living.

“Are you asking for counseling or therapy?” Wendell says at today’s session after I tell him that I have a professional question. He knows I’ll understand the distinction because he’s offered professional guidance twice before. Do I want advice (counseling) or self-understanding (therapy)?

Wendell smiles as if to say, Displacement’s a bitch, isn’t it? We all use defense mechanisms to deal with anxiety, frustration, or unacceptable impulses, but what’s fascinating about them is that we aren’t aware of them in the moment. A familiar example is denial—a smoker might cling to the belief that his shortness of breath is due to the hot weather and not his cigarettes. Another person might use rationalization (justifying something shameful)—saying after he’s rejected for a job that he never really wanted the job in the first place. In reaction formation, unacceptable feelings or impulses are expressed as their opposite, as when a person who dislikes her neighbor goes out of her way to befriend her or when an evangelical Christian man who’s attracted to men makes homophobic slurs.

Some defense mechanisms are considered primitive and others mature. In the latter group is sublimation, when a person turns a potentially harmful impulse into something less harmful (a man with aggressive impulses takes up boxing) or even constructive (a person with the urge to cut people becomes a surgeon who saves lives). Displacement (shifting a feeling toward one person onto a safer alternative) is considered a neurotic defense, neither primitive nor mature. A person who was yelled at by her boss but could get fired if she yelled back might come home and yell at her dog. Or a woman who felt angry at her mother after a phone conversation might displace that anger onto her son.

John points to his tears. “See?” he says. “My fucking humanity.” “It’s magnificent,” I say. We never open the takeout bag. We don’t need the food between us anymore.