August 19, 2019

A Therapist’s Tell-All Book

Anyone who has spent time in a therapist’s office has wondered: “What is my therapist thinking?” An even more unsettling question is: “What is my therapist saying when she talks to her own therapist? Both of these questions are answered — and much more is put on public display — in Lori Gottlieb’s smart, funny, high-spirited and highly confessional memoir of her life and work, “Maybe You Should Talk to Someone: A Therapist, Her Therapist, and Our Lives Revealed” (Houghton Mifflin Harcourt).

Gottlieb is a practicing therapist in Los Angeles, but that’s not everything you need to know about her. She is also the author of four previous books (starting with the best-seller “Stick Figure”), and she contributes the “Dear Therapist” column to The Atlantic. She is a frequent talking head on the subject of psychotherapy on television. And her newly published book is already a hot item — it appeared on The New York Times best-seller list immediately after publication, and it is in development at ABC as a television series starring Eva Longoria.

The success of Gottlieb’s tell-all is hardly surprising. She takes us to places where many readers have never gone before, both inside on our own heads and inside hers. She tells us secrets that most therapists keep to themselves, including secrets about herself. And she describes her own tumultuous course of therapy after she finds herself in a sudden relationship crisis that begins when she asks her boyfriend, “Hey, is something up?” For a working therapist, it’s a fraught question.

“The answer is obviously yes, because in the history of the world, nothing reassuring has ever following this question,” she writes. “When I see couples in therapy, even if the initial response is no, in time the true answer is revealed to be some variation of I’m cheating, I maxed out the credit cards, my aging mother is coming to live with us, or I’m not in love with you anymore.”

“Lori Gottlieb takes us to places where many readers have never gone before, both inside on our own heads and inside hers.”

The most vulnerable readers may not be thrilled to know how they come across to their therapists: “[I]f I’ve learned anything as a therapist, it’s that most people are what therapists call ‘unreliable narrators,’” Gottlieb writes. She is open about the trade secrets of her profession: “High-functioning is therapist code for ‘a good patient,’ the kind most therapists enjoy working with,” she writes. And she discloses that even therapy can have a placebo effect: “[P]atients often feel hopeful after making that first appointment, before even setting foot in the therapy room.”

Sometimes, Gottlieb describes what goes on in the therapy room with such brutal honesty that we began to feel sorry for the clueless patient. She describes one man named John who “is telling me about all of the people in his life who are ‘idiots’ ” and who wonders out loud if “it has something to do with all the artificial chemicals that are added to the food we eat nowadays.” The patient concludes: “That’s why I try to eat organic. So I don’t become an idiot like everyone else.” Gottlieb stifles a yawn and it comes out as a burp. “Of course,” she writes, “John doesn’t seem to notice.” Her conclusion? “Today he just seems like an asshole.”

But Gottlieb is no less candid when it comes to telling the truth about herself. She is so shattered by her confrontation with her boyfriend that she shows up at her office the next day in a pajama top that says “Namast’ay in Bed.” She carefully considers what she will tell her own therapist, Wendell, at their next session, but when she enters his office, “all that comes out is a torrent of tears.” She points out that insight is overvalued as the goal of therapy: “ ‘Insight is the booby prize of therapy’ is my favorite maxim of the trade,” she quips.

“So while the image of me with mascara running down my tear-streaked face between sessions may be uncomfortable to contemplate,” she confesses, “that’s where this story about a handful of struggling humans you are about to meet begins — with my own humanity. … Of all my credentials as a therapist, my most significant is that I’m a card-carrying member of the human race.”

While she is honest about what therapy can and cannot accomplish, she is also hopeful. “Why would we choose a profession that requires us to meet unhappy, distressed, abrasive or unaware people and sit with them, one after the other, alone in a room?” she muses. “The answer is this: Because therapists know that at first, each patient is simply a snapshot, a person captured in a particular moment. … Therapists have to be interpreters of those blurry snapshots, aware that patients need them to be fuzzy to some extent, because those first snapshots help to gloss over painful feelings that might be invading their peaceful inner territory. In time, they find out that they aren’t at war at all, that the path to peace is to call a truce with themselves.”

So Gottlieb wants her readers to understand the inner workings of therapy itself. For that reason, and entirely aside from its sheer entertainment value, “Maybe You Should Talk to Someone” is the book that you should read if you’re contemplating therapy or if you’re already in it.


Jonathan Kirsch, author and publishing attorney, is the book editor of the Jewish Journal.