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

by Lori Gottlieb

It is proposed that happiness be classified as a psychiatric disorder and be included in future editions of the major diagnostic manuals under the new name: major affective disorder, pleasant type.

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.

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.

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.” He goes on to explain that all of this perseverating I’m doing, all of this endless rumination and speculation about Boyfriend’s life, is adding to the pain and causing me to suffer.

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

“Do you think I’m a bad person?” she’d ask, and I’d assure her that everyone who comes to therapy worries that what they think or feel might not be “normal” or “good,” and yet it’s our honesty with ourselves that helps us make sense of our lives with all of their nuances and complexity. Repress those thoughts, and you’ll likely behave “badly.” Acknowledge them, and you’ll grow.

Yes, John had likened me to a prostitute, acted as though he were the only person in the room, and felt that he was better than everyone else. But underneath all that, how different, really, was he from the rest of us?

up next to my files is the word ultracrepidarianism, which means “the habit of giving opinions and advice on matters outside of one’s knowledge or competence.”

patients assume that therapists have the answers and we simply aren’t telling them—that we’re being withholding. But we aren’t out to torture people. We hesitate to give answers not only because patients don’t really want to hear them, but also because they often misconstrue what they hear (leaving us thinking, for instance, I never suggested you say that to your mother! ). Most important, we want to support their independence. But

I wonder, Who am I to make the important decisions in my own life? Am I really qualified for this? Everyone

no matter where people fall on those continuums, every decision they make is based on two things: fear and love. Therapy strives to teach you how to tell the two apart. Charlotte

compulsion is a formidable beast. For Charlotte, stability and its attendant joy isn’t to be trusted; it makes her feel queasy, anxious. When you’re a child and your father is loving and playful, then disappears for a while, and later comes back and acts as if nothing happened—and does this repeatedly—you learn that joy is fickle.

It’s just one of those things,” her doctor had said. And for the first time in her life, Julie, who had always lived in the land of rational explanations, was content with this answer. After all, every time the doctors had a reason for something, the reason was devastating. Fate, bad luck, probability—any of those seemed like a welcome respite from a dismal diagnosis. Now when her computer crashed or a pipe burst in the kitchen, she’d say, It’s just one of those things. The phrase made her smile.

surgeon explained that he could create a vagina out of other tissue, and Julie burst out laughing again. “A custom vagina!” she said to Matt. “How about that?” They laughed and laughed and laughed. And then they cried.

was grief: You laugh. You cry. Repeat. “I’m

the same time, I’ll bet that he is touched to his core by this experience, that in some ways it makes him feel, as one man told me in the months before his wife of thirty years died, “forever changed and paradoxically alive.”

Why are we essentially outsourcing the thing that defines us as people?”

second people felt alone, I noticed, usually in the space between things—leaving a therapy session, at a red light, standing in a checkout line, riding the elevator—they picked up devices and ran away from that feeling. In a state of perpetual distraction, they seemed to be losing the ability to be with others and losing their ability to be with themselves. The

we create the space and put in the time, we stumble upon stories that are worth waiting for, the ones that define our lives. And

my life is over, I would say, seemingly out of nowhere, in our very first session—and Wendell would jump right on this. He was picking up where my internship supervisor had left off years earlier. You won’t get today back. And the days were flying by.

Avoidance is a simple way of coping by not having to cope.” “It’s

I think we want the world to be rational, and it was her way of having control over how uncertain life is,” I say. “Once you know a truth, you can’t unknow it, but at the same time, to protect herself from that knowledge, she convinces herself she could never be assaulted again.” I pause. “Did I pass the test?” Wendell

I screw up my life, I can engineer my own death rather than have it happen to me. It may not be what I want, but at least I’ll choose it. Like cutting off my nose to spite my face, this is a way to say, Take that, uncertainty. I

try to wrap my mind around this paradox: self-sabotage as a form of control.

four ultimate concerns are death, isolation, freedom, and meaninglessness.

often maddening for friends and partners to witness, this hamster wheel is part of the process; people need to do the same thing over and over a seemingly ridiculous number of times before they’re ready to change. Charlotte

Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances.” Indeed,

a term for this irrational fear of joy: cherophobia (chero is the Greek word for “rejoice”).

what I say is this: You can have compassion without forgiving. There are many ways to move on, and pretending to feel a certain way isn’t one of them. 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? It’s

thing that has surprised Julie about going through the process of watching herself die is how vivid her world has become. Everything that she used to take for granted produces a sense of revelation, as if she were a child again. Tastes—the sweetness of a strawberry, its juice dripping onto her chin; a buttery pastry melting in her mouth. Smells—flowers on a front lawn, a colleague’s perfume, seaweed washed up on the shore, Matt’s sweaty body in bed at night. Sounds—the strings on a cello, the screech of a car, her nephew’s laughter.

been mistaking feeling less for feeling better.

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

no hierarchy of pain. Suffering shouldn’t be ranked, because pain is not a contest. Spouses often forget this, upping the ante on their suffering—I had the kids all day. My job is more demanding than yours. I’m lonelier than you are. Whose pain wins—or loses? But

Wendell told me that by diminishing my problems, I was judging myself and everyone else whose problems I had placed lower down on the hierarchy of pain.

can’t get through your pain by diminishing it, he reminded me.

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

Sometimes in their pain, people believe that the agony will last forever. But feelings are actually more like weather systems—they blow in and they blow out. Just because you feel sad this minute or this hour or this day doesn’t mean you’ll feel that way in ten minutes or this afternoon or next week. Everything you feel—anxiety, elation, anguish—blows in and out again.

empathy, but if you give it to me, I’ll feel angry and hopeless, because empathy alone won’t solve my very real problem, so what good are you anyway?

strategy, in which the therapist instructs patients not to do what they’re already not doing, is called a paradoxical intervention.

he’s right. In couples therapy, therapists talk about the difference between privacy (spaces in people’s psyches that everyone needs in healthy relationships) and secrecy (which stems from shame and tends to be corrosive). Carl Jung called secrets “psychic poison,” and after all of the secrets I’ve kept from Wendell, it feels good to have this final secret out in the open. I

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.

week, I’d told Wendell again that my greatest fear is leaving Zach without a mother, and Wendell said that I had two choices: I could give Zach a mother who’s constantly worried about leaving him motherless, or I could give him a mother whose uncertain health makes her more acutely aware of the preciousness of their time together. “Which

explained to her that even in the best possible relationship, you’re going to get hurt sometimes, and no matter how much you love somebody, you will at times hurt that person, not because you want to, but because you’re human. You will inevitably hurt your partner, your parents, your children, your closest friend—and they will hurt you—because if you sign up for intimacy, getting hurt is part of the deal. But,

I went on, what was so great about a loving intimacy was that there was room for repair.

call this process rupture and repair, and if you had parents who acknowledged their mistakes and took responsibility for them and taught you as a child to acknowledge your mistakes and learn from them too, then ruptures won’t feel so cataclysmic in your adult relationships. If, however, your childhood ruptures didn’t come with loving repairs, it will take some practice for you to tolerate the ruptures, to stop believing that every rupt...

Every laugh and good time that comes my way feels ten times better than before I knew such sadness.” For

Yalom, the psychiatrist, wrote that it was “far better that [a patient make progress but] forget what we talked about than the opposite possibility (a more popular choice for patients)—to remember precisely what was talked about but to remain unchanged.” Rita’s

Almost is always the hardest, isn’t it?” she said one afternoon. “Almost getting something. Almost having a baby. Almost getting a clean scan. Almost not having cancer anymore.”

you have to take a leap of faith and experience something before its meaning becomes apparent.