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

by Lori Gottlieb

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 scientifically irrelevant. —Richard Bentall, Journal of Medical Ethics, 1992

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.

everyone has demons—big,

Remember Sartre’s famous line “Hell is other people”?

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.

By definition, the presenting problem is the issue that sends a person into therapy.

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.”

In my office I can sit through marathon silences, but in my bedroom I last no more than three seconds. “Hey, is something up?” I ask, trying to sound casual, but it’s a rhetorical question if ever there was one. The answer is obviously yes, because in the history of the world, nothing reassuring has ever followed this question.

“If the queen had balls, she’d be the king.” If you go through life picking and choosing, if you don’t recognize that “the perfect is the enemy of the good,” you may deprive yourself of joy. At

Very Angry People aren’t Very Approachable.

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.

During an initial burst of pain, people tend to lash out either at others or at themselves, to turn the anger outward or inward.

There’s a popular saying, a paraphrase of a Robert Frost poem: “The only way out is through.” The only way to get to the other side of the tunnel is to go through it, not around it.

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.

There’s nothing like illness to take away a sense of control, even if we often have less of it than we imagine. What people don’t like to think about is that you can do everything right—in life or in a treatment protocol—and still get the short end of the stick. And when that happens, the only control you have is how you deal with that stick—your way, not the way others say you should.

Finding a therapist is a tricky thing.

Study after study shows that the most important factor in the success of your treatment is your relationship with the therapist, your experience of “feeling felt.” This matters more than the therapist’s training, the kind of therapy they do, or what type of problem you have.

I know this is a common placebo effect: patients often feel hopeful after making that first appointment, before even setting foot in the therapy room.

He knows what all therapists know: That the presenting problem, the issue somebody comes in with, is often just one aspect of a larger problem, if not a red herring entirely.

A supervisor once likened doing psychotherapy to undergoing physical therapy. It can be difficult and cause pain, and your condition can worsen before it improves, but if you go consistently and work hard when you’re there, you’ll get the kinks out and function so much better.

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.

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.

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.

“Not knowing is a good place to start,” he says, and this feels like a revelation. I spend so much time trying to figure things out, chasing the answer, but it’s okay to not know.

I think of a Flannery O’Connor quote: “The truth does not change according to our ability to stomach it.”

“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.”

The things we protest against the most are often the very things we need to look at.

We tend to think that the future happens later, but we’re creating it in our minds every day. When the present falls apart, so does the future we had associated with it. And having the future taken away is the mother of all plot twists. But if we spend the present trying to fix the past or control the future, we remain stuck in place, in perpetual regret.

You lose a leg or a kidney, you’re still you, but lose a part of your brain—literally, lose your mind—and who are you then?

Often people think about bucket lists when somebody close to them dies. That’s what happened for Candy Chang, an artist who, in 2009, created a space on a public wall in New Orleans with the prompt Before I die _____. Within days the wall was completely filled.

People tend to dream without doing, death remaining theoretical.

We think we make bucket lists to ward off regret, but really they help us to ward off death. After all, the longer our bucket lists are, the more time we imagine we have left to accomplish everything on them.

life is the very definition of uncertainty.

(the upside of being a therapist’s child is that nothing gets shoved under the rug; the downside is that you’ll be totally screwed up anyway).

How easy it is, I thought, to break someone’s heart, even when you take great care not to.

Dissection showed us that living is a precarious thing,

the poet Philip Larkin put it best: “They fuck you up, your mum and dad, / They may not mean to, but they do.”

as the saying goes, “Before diagnosing people with depression, make sure they’re not surrounded by assholes”),

(narcissistic personalities aren’t considered good candidates for introspective, insight-oriented therapy due to their struggle to see themselves and others clearly),

people who are demanding, critical, and angry tend to suffer from intense loneliness.

there’s something innately bonding about sharing a meal together.

The answer to an unasked question is always no,

Grief, not surprisingly, can resemble depression,

for most of us, our biggest problem is that we don’t know what our problem is. We keep stepping in the same puddle.

therapy can’t help people who aren’t curious about themselves.

the most powerful truths—the ones people take the most seriously—are those they come to, little by little, on their own.

dreams can be a precursor to self-confession—a kind of pre-confession. Something buried is brought closer to the surface, but not in its entirety.

as Fitzgerald put it, “In a real dark night of the soul, it is always three o’clock in the morning, day after day”),

two hundred years ago, the philosopher Johann Wolfgang von Goethe succinctly summarized this sentiment: “Too many parents make life hard for their children by trying, too zealously, to make it easy for them.”

Some scientists had even come up with a complex mathematical equation to predict happiness based on the premise that happiness stems not from how well things go but whether things go better than expected.