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

by Lori Gottlieb

Most big transformations come about from the hundreds of tiny, almost imperceptible, steps we take along the way.

Do I miss him, or do I miss the idea of him?

The truth is, every day since the breakup has been worse than the night of the breakup itself because now a glaring void has opened up in my life.

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. He knows that most people are brilliant at finding ways to filter out the things they don’t want to look at, at using distractions or defenses to keep threatening feelings at bay.

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.

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.

Because therapists know that at first, each patient is simply a snapshot, a person captured in a particular moment. It’s like a photo of you taken from an unfortunate angle and with a sour expression on your face. There might also be a photo in which you’re glowing, caught opening a present or mid-laugh with a lover. Both are you in that fraction of time, and neither is you in your entirety.

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

There is a continuing decision to be made as to whether to evade pain, or to tolerate it and therefore modify it.

Whenever I hear about saintly parents, I get suspicious. It’s not that I’m looking for problems. It’s just that no parent is a saint.

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

(Borderline types tend to couple up with narcissists, and we see that pairing often in couples therapy.)

things like these concert tickets become an almost welcome external acknowledgment of your loss—not only of the person but of the time and company and daily routines, of the private jokes and references, and of the shared memories that now are yours alone to carry.

I’ve sat with patients who describe their grief as “monstrous” and “unbearable”; one patient, quoting something she had heard, said it made her feel “alternately numb and in excruciating pain.”

Grief, not surprisingly, can resemble depression, and for this reason, until a few years ago, there was something termed the bereavement exclusion in our profession’s diagnostic manual. If a person experienced the symptoms of depression in the first two months after a loss, the diagnosis was bereavement. But if those symptoms persisted past two months, the diagnosis became depression. This bereavement exclusion no longer exists,

Then there’s the fact that losses tend to be multilayered. There’s the actual loss (in my case, of Boyfriend), and the underlying loss (what it represents).

That’s why for many people the pain of a divorce is only partially about the loss of the other person; often it’s just as much about what the change represents—failure, rejection, betrayal, the unknown, and a different life story than the one they’d expected.

We all have a deep yearning to understand ourselves and be understood. When I see couples in therapy, often one or the other will complain, not “You don’t love me” but “You don’t understand me.” (One woman said to her husband, “You know what three words are even more romantic to me than ‘I love you’?” “You look beautiful?” he tried. “No,” his wife said. “I understand you.”)

“Too many parents make life hard for their children by trying, too zealously, to make it easy for them.”

Happiness equals reality minus expectations. Apparently, you can make people happy by delivering bad news and then taking it back

So many of our destructive behaviors take root in an emotional void, an emptiness that calls out for something to fill it.

“Insight is the booby prize of therapy” is my favorite maxim of the trade, meaning that you can have all the insight in the world, but if you don’t change when you’re out in the world, the insight—and the therapy—is worthless. Insight allows you to ask yourself, Is this something that’s being done to me or am I doing it to myself? The answer gives you choices, but it’s up to you to make them.

Often people talk about suicide not because they want to be dead but because they want to end their pain. If they can just find a way to do that, they very much want to be alive.

“The opposite of depression isn’t happiness, but vitality.”

The internet can be both a salve and an addiction, a way to block out pain (the salve) while simultaneously creating it (the addiction). When the cyber-drug wears off, you feel worse, not better.

I thought, I’m going into this future with Boyfriend, focus on that. Which is also why I ignored any hints that we might not be well suited for each other. If that future went away, I would have to contend with an unwritten book and a failing body.

It turns out that we weren’t that different after all. In the hopes of making it work with a person he genuinely enjoyed, he wanted to postpone his confession for the same reason I did: so that we could continue to be together even though we couldn’t.

She hated the fact that she was almost seventy and still analyzing interactions with men with the same obsessiveness she had in college. She hated feeling like a girl with a crush, foolish and helpless and confused.

Everyone wages this internal battle to some degree: Child or adult? Safety or freedom? But 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.

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.

“You have two ears and one mouth; there’s a reason for that ratio”),

You won’t get today back.

Feeling your sadness or anxiety can also give you essential information about yourself and your world.

People wanted a speedy solution to their problems, but what if their moods had been driven down in the first place by the hurried pace of their lives? They imagined that they were rushing now in order to savor their lives later, but so often, later never came. The psychoanalyst Erich Fromm had made this point more than fifty years earlier: “Modern man thinks he loses something—time—when he does not do things quickly; yet he does not know what to do with the time he gains except kill it.” Fromm was right; people didn’t use extra time earned to relax or connect with friends or family. Instead, they tried to cram more in.

The 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 therapy room seemed to be one of the only places left where two people sit in a room together for an uninterrupted fifty minutes. Despite its veil of professionalism, this weekly I-thou ritual is often one of the most human encounters that people experience.

Then again, as the writer Philip K. Dick put it, “Strange how paranoia can link up with reality now and then.”

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

What we fear isn’t just dying in the literal sense but in the sense of being extinguished, the loss of our very identities, of our younger and more vibrant selves. How do we defend against this fear? Sometimes we refuse to grow up. Sometimes we self-sabotage. And sometimes we flat-out deny our impending deaths. But as Yalom wrote in Existential Psychotherapy, our awareness of death helps us live more fully—and with less, not more, anxiety.

Uncertainty, I’m starting to realize, doesn’t mean the loss of hope—it means there’s possibility. I don’t know what will happen next—how potentially exciting! I’m going to have to figure out how to make the most of the life I have, illness or not, partner or not, the march of time notwithstanding.

Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

I think about how there’s nothing in the world like laughing with my dad. I think about how knowledgeable he is on almost any topic and how fully he loves me and how kind he is—not just to me, but to everyone.

Infant (hope)—trust versus mistrust Toddler (will)—autonomy versus shame Preschooler (purpose)—initiative versus guilt School-age child (competence)—industry versus inferiority Adolescent (fidelity)—identity versus role confusion Young adult (love)—intimacy versus isolation Middle-aged adult (care)—generativity versus stagnation Older adult (wisdom)—integrity versus despair

I point out to her that pain can be protective; staying in a depressed place can be a form of avoidance. Safe inside her shell of pain, she doesn’t have to face anything, nor does she have to emerge into the world, where she might get hurt again.

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?

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.

Just as your physiological immune system helps your body recover from physical attack, your brain helps you recover from psychological attack. A series of studies by the researcher Daniel Gilbert at Harvard found that in responding to challenging life events from the devastating (becoming handicapped, losing a loved one) to the difficult (a divorce, an illness), people do better than they anticipate. They believe that they’ll never laugh again, but they do. They think they’ll never love again, but they do. They go grocery shopping and see movies; they have sex and dance at weddings; they overeat on Thanksgiving and go on diets in the New Year—the day-to-day returns.

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. For John, on Gabe’s birthday, on certain holidays, or simply running in the background, there will always be pain. Hearing a certain song in the car or having a fleeting memory might even plunge him into momentary despair. But another song, or another memory, might minutes or hours later bring intense joy.

A young man who keeps putting off finding a job might be told in therapy that he can’t look for a job; a woman who won’t initiate sex with her partner might be told not to initiate it for a month. This strategy, in which the therapist instructs patients not to do what they’re already not doing, is called a paradoxical intervention.