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.

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.)

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.

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.

No matter how open we as a society are about formerly private matters, the stigma around our emotional struggles remains formidable.

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

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 nonprescription painkiller”).

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.

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.

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.

By definition, the presenting problem is the issue that sends a person into therapy. It might be a panic attack, a job loss, a death, a birth, a relational difficulty, an inability to make a big life decision, or a bout of depression.

For no reason at all, he’ll send you Amazon packages full of books (books being the equivalent of flowers to you), and at night you’ll both curl up and read passages from them aloud to each other, pausing only to make out.

He’ll let you finish his sandwiches and sentences and sunscreen and listen so attentively to the details of your day that, like your personal biographer, he’ll remember more about your life than you will.

“The thing is,” Boyfriend explains, “I don’t want to have to look at the Legos. I just want to read the paper.” I consider the possibility that an alien has invaded Boyfriend’s body or that he has a burgeoning brain tumor of which this personality shift is the first symptom. I wonder what Boyfriend would think of me if I broke up with him because his teenage daughters wanted me to look at their new leggings from Forever 21 when I was trying to relax and read a book. I don’t want to look at the leggings. I just want to read my book. What kind of person gets away with simply not wanting to look?

Will you spot the insecurities that I’m so skillful at hiding? Will you see my vulnerabilities, my lies, my shame? Will you see the human in my being?

Therapy elicits odd reactions because, in a way, it’s like pornography. Both involve a kind of nudity. Both have the potential to thrill. And both have millions of users, most of whom keep their use private.

“You should go sleep with somebody! Go sleep with somebody and forget about the Kid Hater.” I instantly love Boyfriend’s new name: the Kid Hater.

“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.

Now there would be more time for her passions: running marathons and climbing mountains and baking silly cakes for her nephew.

Young, newly married, and pregnant, with no family history of breast cancer, Julie had been struck by the randomness of the universe. Then, while grappling with how to handle the cancer treatment and the pregnancy, she had a miscarriage.

That night, she dreamed that she was in her sixties and holding her first grandchild.

“Will you stay with me until I die?” Julie asked, and though my instinct was to do what people tend to do whenever somebody brings up death, which is to deny death completely (Oh, hey, let’s not go there yet. Those experimental treatments might work), I had to remember that I was there to help Julie, not comfort myself. Still, at the moment she asked, I was stunned, still absorbing the news. I wasn’t sure I was the best person for this. What if I said or did the wrong thing? Would I offend her if my feelings—discomfort, fear, sadness—came across in my facial expressions or body language? She was going to get only one chance at doing this the way she wanted. What if I let her down?

“Please,” she said. “I know it’s not a picnic, but I can’t go to those cancer people. It’s like a cult. They call everyone ‘brave,’ but what choice do we have, and besides, I’m terrified and still cringe at the sight of the needles like I did as a kid getting my shots. I’m not brave and I’m not a warrior fighting a battle. I’m just an ordinary college professor.” She leaned forward on the couch. “They have affirmations on their walls. So, please?”

And right then, the nature of our work together changed: I was going to help her come to terms with her death. This time, my inexperience might matter.

To avoid an ethical breach known as a dual relationship, I can’t treat or receive treatment from any person in my orbit—not a parent of a kid in my son’s class, not the sister of my coworker, not a friend’s mom, not my neighbor.

“Yes, he’s in his forties,” I say. “High-functioning.” High-functioning is therapist code for “a good patient,” the kind most therapists enjoy working with, often to balance out the patients we also want to work with but who are less high-functioning. High-functioning patients are those who can form relationships, manage adult responsibilities, and have a capacity for self-reflection.

Studies show, and common sense dictates, that most therapists prefer to work with patients who are verbal, motivated, open, and responsible—these are the patients who improve more quickly.

Next Caroline names a good therapist I also know relatively well, so I tell her that he won’t work out for my friend because there’s a conflict—therapist shorthand for “Their worlds collide, but I can’t reveal more.”

conspicuous

Patients, of course, want to be helped, but they also want to be liked and admired.

I look up and I think I see Wendell suppress a smile (I imagine his thought bubble: This wacko’s a therapist . . . who treats couples?) but it’s hard to tell because I can’t see very well. It’s like looking through the windshield of a car without its wipers on during a rainstorm.

Attachment styles are formed early in childhood based on our interactions with our caregivers. Attachment styles are significant because they play out in people’s adult relationships too, influencing the kinds of partners they pick (stable or less stable), how they behave during the course of a relationship (needy, distant, or volatile), and how their relationships tend to end (wistfully, amiably, or with a huge explosion).

Over the years, I’ve handed tissue boxes to patients countless times, but I’d forgotten how cared for that simple gesture can make someone feel.

His eyes are like magnets, and every time I glance away, they seem to find me. His expression is intense but gentle, a combination of a wise elder and a stuffed animal,

In idiot compassion, you avoid rocking the boat to spare people’s feelings, even though the boat needs rocking and your compassion ends up being more harmful than your honesty. People do this with teenagers, spouses, addicts, even themselves. Its opposite is wise compassion, which means caring about the person but also giving him or her a loving truth bomb when needed.

“Here she is!” he says proudly, handing me the phone. I look down at the picture. I happen to love dogs, but Rosie, God bless her, is one of the ugliest dogs I’ve ever seen.

I lower my voice so that he almost has to lean in to hear me. Neuroscientists discovered that humans have brain cells called mirror neurons that cause them to mimic others, and when people are in a heightened state of emotion, a soothing voice can calm their nervous systems and help them stay present. “Whether it’s called love or something else, it doesn’t really matter.”

People don’t always remember events or conversations clearly, but they do remember with great accuracy how an experience made them feel.

She whizzes behind the screen, but I can tell in the split second I see her that she’s pretty, well dressed, and tearful. Then Wendell appears in the waiting area. “I’ll just be a minute,” he says, and he heads into the hallway, presumably to use the restroom. As I wait, I wonder what the pretty woman was crying about.

I’m insufferable and I know it, but I can’t stop.

I repeatedly ask, Am I crazy or is he? (Wendell says neither of us is crazy, which infuriates me.)

One morning, as I drone on about Boyfriend, Wendell scoots to the edge of his couch, stands up, walks over to me, and, with his very long leg, lightly kicks my foot. Smiling, he returns to his seat. “Ouch!” I say reflexively, even though it didn’t hurt. I’m startled. “What was that?” “Well, you seem like you’re enjoying the experience of suffering, so I thought I’d help you out with that.” “What?” “There’s a difference between pain and suffering,” Wendell says. “You’re going to have to feel pain—everyone feels pain at times—but you don’t have to suffer so much.

You’re not choosing the pain, but you’re choosing the suffering.”

This feels strange. I look down at my notes, but I have no interest in reading them right now. I feel exposed, and I have the urge to run.

“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.”

How many times had I said something similar to my own patients? But here I feel as if I’m hearing this for the first time. Don’t judge your feelings; notice them. Use them as your map. Don’t be afraid of the truth.

Wendell nods, then pats his legs twice and stands. The session is over but I want to stay. I feel like we just got started.

I still love TV, but there’s something about the real stories I’m experiencing in person that seduce me and make the imaginary ones feel thin. Friends is about community, but a fake one. ER is about life and death, but they’re fictional. Instead of taking these stories I witness and folding them back into my world at the network, I want real life—real people—to be my world.

Even if you’re lucky enough to be traveling to Italy, you might experience canceled flights and horrible weather. Or your spouse might have a fatal heart attack in the shower ten minutes after the two of you have glorious sex in a luxurious Rome hotel room during a trip to celebrate your anniversary, as happened to an acquaintance of mine.