Book notes: Maybe You Should Talk to Someone by Lori Gottlieb

Maybe You Should Talk to Someone: A Therapist, HER Therapist, and Our Lives Revealed by Lori Gottlieb

Synopsis:

“From a New York Times best-selling author, psychotherapist, and national advice columnist, a hilarious, thought-provoking, and surprising new book that takes us behind the scenes of a therapist’s world – where her patients are looking for answers (and so is she).  

One day, Lori Gottlieb is a therapist who helps patients in her Los Angeles practice. The next, a crisis causes her world to come crashing down. Enter Wendell, the quirky but seasoned therapist in whose of­fice she suddenly lands. With his balding head, cardigan, and khakis, he seems to have come straight from Therapist Central Casting. Yet he will turn out to be anything but.

As Gottlieb explores the inner chambers of her patients’ lives – a self-absorbed Hollywood producer, a young newlywed diagnosed with a terminal illness, a senior citizen threatening to end her life on her birthday if nothing gets better, and a 20-something who can’t stop hooking up with the wrong guys – she finds that the questions they are struggling with are the very ones she is now bringing to Wendell.  

With startling wisdom and humor, Gottlieb invites us into her world as both clinician and patient, examining the truths and fictions we tell ourselves and others as we teeter on the tightrope between love and desire, meaning and mortality, guilt and redemption, terror and courage, hope and change.  

Maybe You Should Talk to Someone is revolutionary in its candor, offering a deeply personal yet universal tour of our hearts and minds and providing the rarest of gifts: a boldly revealing portrait of what it means to be human and a disarmingly funny and illuminating account of our own mysterious lives and our power to transform them.” -Audible

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Opening thoughts:

I got this recommendation from the Silent Book Club that I go to every month or so. The organizer highly recommended it and I think a few other people who attend recommended it too. I’m sure this will be a good book as all of the recommendations I’ve gotten from the club were top notch. I think the reviews online are also really good, but I have no idea what this could be about aside from a therapist getting therapy.

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Key notes:

Part One

Chapter 1: idiots

• There is something likable in everyone
• One of the most important steps in therapy is helping people take responsibility for their current predicaments
  • Once they realize they can and must construct their own lives, they are free to generate change

Chapter 2: if the queen had balls

• Every story has multiple threads, and we tend to leave out the threads that don’t jive with our current perspective.
• 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

Chapter 3: the space of a step

• Most big transformations come about from hundreds of tiny almost imperceptible steps along the way

Chapter 4: the smart one or the hot one?

Chapter 5: Namaste in bed

• Loss of trust is hard to repair
  • Freud argued that the physician should be in penetrable to the patient and like a mirror reflect nothing but what is shown to him 
• Therapist have to make a calculation to assess the value of a personal disclosure during a session
  • Is this information helpful for the patient to have?
  • When done well, self-disclosure can bridge some distance with patients who feel isolated in their experiences and can encourage more openness
  • But if it’s perceived as inappropriate or self-indulgent, the patient can feel uncomfortable and starts to shut down
• You can do everything right in life, 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

Chapter 6: finding Wendell

• Studies show that the most important factor in the success of your treatment is your relationship with the therapist, your experience of feeling felt

Chapter 7: the beginning of knowing

• A therapeutic alliance is a trust that has to develop before any work can get done
  • In the early sessions, it’s always more important for the patients to feel heard and understood then it is for them to gain insights or make any changes

Chapter 8: Rosie

• We can’t teach patients to be relational if we aren’t relational with them
  • One psychotherapist school of thought is that all problems are relational
• When working with couples on empathy, she’ll often say, “before you speak, ask yourself what is this going to feel like to the person I’m speaking to”
• Numbness is in the absence of feelings, it’s a response to being overwhelmed with too many feelings

Chapter 9: snapshots of ourselves

• Therapists know that they are simply seeing a snapshot of a person at a particular angle at a particular time
• When people first come in, therapists are imagining them down the line
  • That image allows for them to hold the hope that the patients can’t hold for themselves
• Creativity is the ability to grasp an essence of one thing in the essence of some very different thing and smash them together to create some entirely new thing
  • That’s what therapists also try to do with their patients

Chapter 10: the future is also the present

• Everyone feels pain at times but you only suffer because you choose to
• “The truth does not change according to our ability to stomach it” 
• Changing our relationship to the past is a staple of therapy
  • However, our relationship with the future also informs the present
  • Our notion of the future can be just as powerful of a roadblock to change as the past 

Chapter 11: goodbye, Hollywood

Chapter 12: welcome to Holland

• In the short story, it’s about how you may have planned to go to Italy but you end up in Holland. But instead of being sad and focusing on what you missed out on, you should enjoy what you have in Holland
  • This is an analogy for how we should approach life when it redirects us into another path
• It’s our honesty with ourselves that help us make sense of our lives with all of their nuances and complexity
  • Repress those thoughts and you’re likely to behave badly
  • Acknowledge them and you’ll grow 

Chapter 13: how kids deal with grief

Chapter 14: Harold and Maude

Chapter 15: hold the Mayo

• One way to get a sense of someone’s past is to ask them “what’s three adjectives come immediately to mind in relation to your mom’s or dad’s personality“

Chapter 16: the whole package

Chapter 17: without memory or desire

• We all have a deep yearning to understand ourselves and to be understood

Part 2

Chapter 18: Friday’s at four

• Therapy can’t help people who aren’t curious about themselves

Chapter 19: what we dream of

• Collective unconscious refers to the part of the mind that holds ancestral memory, or experience that is common to all humankind
  • Dreams can be interpreted on the subject level, meaning how they relate to common themes on our collective subconscious
• Sometimes we dream about our fears and are punished for our joy
• Dreams can be a precursor to self confession, a kind of pre-confession

Chapter 20: the first confession

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

Johann Wolfgang von Goethe

• Book reference: Worried All the Time
  • “Cardinal rules of good parenting: moderation, empathy, temperamental accommodation with ones child are simple and not likely to be improved upon by the latest scientific findings”
• All the books say happiness = reality – expectations
• Reader’s note: This is directly related to the book I just read Solve for Happy
• She’s talking about the book she’s been trying to write but feeing disconnected from the topic

Chapter 21: therapy with a condom on

• Doing video therapy sessions is like therapy with a condom on
  • It’s not just the visual cues or body language you notice in person, there’s also the energy in the room being together in the same physical space.
• Whenever one person in a family system starts to make changes, even positive ones, it’s not unusual for other members in the system to do everything they can to maintain the status quo and bring things back to homeostasis
• It’s less socially acceptable for men to talk about their feelings
  • While women feel cultural pressure to keep up their physical appearance, men feel that pressure to keep up their emotional appearance
  • Women tend to confide in friends or family, but men hardly talk to anyone about their feelings 

Chapter 22: jail 

• You are your own jailer 
• Freedom involves responsibility
  • There’s a part of most of us that find responsibility frightening 
• Therapy work is an intricate dance between support and confrontation

Chapter 23: Trader Joe’s 

Chapter 24 hello family

• The opposite of depression isn’t happiness, but vitality
• Touch is a deep human need
  • It is well documented that touch is important for our well-being throughout our entire lifetimes
• Adults who are touched regularly live longer
  • The term is skin hunger

Chapter 25: the UPS guy

• Instead of psychiatry, her medical school dean suggested she get a graduate degree in clinical psychology and work with people the way she wanted, which was deeper and longer term in 50 minute sessions

Chapter 26: embarrassing public encounters

Chapter 27: wendell’s mother

Chapter 28: addicted

Chapter 29: the rapist

• In projection, a person attributes their beliefs to another person
• Call projective identification, the patient sends their beliefs into another person

Chapter 30: on the clock

Part three

Chapter 31: my wandering uterus

Chapter 32: emergency session

• It’s important to disrupt the depressive state with action
  • Creating social connections can find a daily purpose, a compelling reason to get out of bed in the morning

Chapter 33: karma 

• Sometimes patients will do a door knob confession on their way out for a variety of reasons

Chapter 34: just be

• Sometimes people need to accept themselves and others as they were
  • But sometimes in order to feel better, you need a mirror held up to you 

Chapter 35: would you rather? 

Chapter 36: the speed of want

• Patience requires endurance and effort 
• At first she thought people wanted therapy to feel less anxious or depressed, or to have less problematic relationships
  • However, she found this common element of loneliness, a craving for but a lack of strong human connection
    • They rarely expressed it this way, but she could tell
• The second people felt alone, usually in between small activities, they picked up their electronic devices and ran away from that feeling
  • In a state of perpetual distraction, they seem to be losing the ability to be with others and losing their ability to be with themselves 

Chapter 37: ultimate concerns

• Avoidance is a simple way of coping without having to cope
• Four existential fears or ultimate concerns:
  • death
  • isolation
  • freedom
  • meaninglessness
• Our awareness of death helps us live more fully and with less, not more, anxiety

Chapter 38: Legoland 

• She found out her tough and distant patient John actually had a six-year-old son who died in a car accident they were all in
• Losing somebody you love is such a profoundly lonely experience, something only you endure in your own particular way
• Therapists use the term flooding to describe when a patient’s nervous system is in overdrive
  • When people feel flooded, it’s best to wait a bit for their nervous system to reset

Chapter 39: how humans change

• One theory says that change occurs through sequential stages such as:
  1. Precontemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
• Therapists can’t initially change behavior, but they can help patients see themselves better and ask the right questions until something happens either internally or externally that leads them to do their own persuading

Chapter 40: fathers

• Book reference: Man’s Search for Meaning by Viktor Frankl
• Therapists are trained to listen to what patients aren’t saying
• Sharing difficult truths might come with a cost, the need to face them
  • But there’s also a reward, freedom
  • The truth releases us from shame

Chapter 41: integrity versus despair

• You can have compassion without forgiving
  • Forced forgiveness does not work
  • There are many ways to move on, and pretending to feel a certain way isn’t one of them
• Many of us torture ourselves for decades, even after we’ve genuinely attempted to make amends

Chapter 42: My Neshama

• There is a concept therapist use called unconditional positive regard
  • It doesn’t mean the therapist necessarily likes the client, it means they are warm and non-judgmental, and most of all genuinely believes in the clients ability to grow if nurtured in an encouraging and accepting environment
  • Unconditional positive regard is an attitude not a feeling

Chapter 43: what not to say to a dying person

• Her patient says people can just say “I’m sorry” or any expression of how they feel about her
  • What helps most when someone tells you that they’re dying is a hug or simply saying “I love you”
• At the end of the day, love wins

Chapter 44: boyfriends email 

Part Four

Chapter 46: the bees

• The inability to say no is largely about approval seeking
  • The inability to say yes, however, is more about lack of trust in oneself

Chapter 47: Kenya

• There’s no hierarchy of pain. Suffering shouldn’t be ranked because pain isn’t a contest
• You can’t get through your pain by diminishing it, you get through it by accepting it and figuring out what to do with it
  • You can’t change what you’re denying or diminishing

Chapter 48: psychological immune system

• Feelings are like weather systems, they blow in and out

Chapter 49 : counseling versus therapy

• Getting advice is counseling
  • Acquiring more self understanding is therapy
• The best way to defuse an emotional landmine is to expose it
• A paradoxical directive is when you tell someone not to do something that they say they can’t do
  • The idea is that is a patient believes a behavior or symptom is out of their control, then making it voluntary or something they can choose not to do will call that belief into question
• In relationships, privacy is good but secrets are toxic 
• As you heal inside, you become more adept at healing others
  • Therapy, like in other areas, you get better as you gain experience on both sides as a therapist and as a patient 
• In therapy, like everything else, once you know the basics you can skillfully improvise
  • There are rules and you are trained to adhere to them for a reason
  • But she has learned when rules are bent with thoughtful intention, it’s broadens the definition of what effective treatment can be

Chapter 50: deathzilla

• Research shows that people tend to remember experiences by how they end
• One litmus test for termination of therapy is whether or not they carry the therapists voice in their heads and applying it to situations and eliminating the need for therapy

Chapter 51: dear Myron

Chapter 52: mothers

• Displacement is shifting a feeling towards one person onto a safer alternative it’s considered a neurotic defense
• The nature of life is change. The nature of people is to resist change
• The more you welcome your vulnerability, the less afraid you’ll feel

Chapter 53: the hug

• John was proud to share photos of his family and his good review from the New York Times on his show about how his character is revealing a deeper side

Chapter 54: don’t blow it

• What makes self-sabotage so tricky is that it attempts to solve one problem, alleviate abandonment anxiety, by creating another, making her partner want to leave
• After writing heartfelt emails to her three adult kids telling her side of the story and apologizing, one of her daughters responded and said that her mom getting her life together is making them think that they can get theirs together now

Chapter 55: it’s my party and you’ll cry if you want to

• Almost is always the hardest
  • Many people avoid trying for what they really want in life because it’s more painful to get close to the goal but not achieve it than not to have taken the chance in the first place

Chapter 56: happiness is sometimes

• Often in therapy, change happens gradually then suddenly
• She was touched that John shared with her that he feels like she has the most complete picture of his humanity and despite only hearing the negative side, he feels like she knows that there’s good in him and that she really gets/understands him
  • She was so moved by that statement would never forget, and by his willingness to share

Chapter 57: Wendell

• To people, therapy can be like into the depths of their thoughts and feelings it’s like going into a dark alley, they don’t want to go there alone
  • People come to therapy to have someone to go there with

Chapter 58: a pause in the conversation

• We grow in connection with others
  • Everyone needs to hear that other person’s voice saying I believe in you and I can see in you possibilities you might not see yet
    • They imagine that something different can happen in some form or another
    • In therapy we say, “let’s edit your story”
• Relationships in life don’t really end, even if you never see the person again
  • Every person you’ve been close to lives on somewhere inside you

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Main ideas / Themes:

• Helping people take responsibility for their current predicaments empowers them to generate change
• A therapeutic alliance is a trust that is needed before work can be done. Patients need to feel heard and understood. However, therapy work is an intricate dance between support and confrontation
• Therapists imagine patients down the line and hold the hope that they can’t hold for themselves
• Creativity is the ability to grasp an essences of two separate things and smash them together to create some entirely new thing
• Everyone feels pain, but you only suffer because you choose to
• You cannot change what you deny, diminish, or refuse to acknowledge
• We are our own jailers. Freedom involves responsibility which scares us
• The opposite of depression isn’t happiness but vitality
• Disrupt the depressive state with action. Creating social connections can help find a daily purpose or compelling reason to get out of bed
• Most people want therapy because of an underlying element of loneliness, lacking strong human connections
• Avoidance is a simple way of coping without having to cope
• Therapists help patients see themselves better and ask the right questions until something happens internally or externally
• Unconditional positive regard towards a patient means being warm, non-judgmental, and believing in their ability to grow
• Counseling is getting advice. Therapy is acquiring more self-understanding
• Privacy is good, but secrets are toxic
• The nature of life is change. The nature of people is to resist change
• “Almost” is always the hardest
• We grow in connection with others. Everyone needs to “I believe in you and can see possibilities in you”
• Every person you’ve been close to lives on somewhere inside you

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Closing thoughts:

Another really good book recommendation. It really reminds me of the Mel Robbins book and Audible series I’ve read when she goes into her coaching/counseling sessions and helps people work through their issues and get to the root cause of the problem.

I also really enjoy how the book gives a lot of practical insight and advice across a broad range of instances. Her clients are so varied, and the storytelling is so good that it’s not hard to get into the characters, empathize, and understand their struggles. I love how as you hear about these session and follow along, the layers of each person gets peeled back and you start to really get learn about them. It’s like you start to become friends with them and start cheering them on.

I also love the twist that the therapist has her own therapist. It shows that she’s still learning and growing herself. She has her own issues that she still needs to work through. It goes to show that it helps to have yourself sorted out first before trying to help others. But doesn’t mean you can’t add value as an objective, 3rd party with professional expertise, even if you don’t have it fully together yourself.

Overall, a great story and a great read I highly recommend!

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One Takeaway / Putting into practice:

One of my favorite takeaways/reminders from this book:

• We are our own jailers. We have to accept responsibility in order to change. However, our freedom involves responsibility, which scares us

I think this is a good reminder that often times we let our fear paralyze us and we make excuses for not acting or changing. I know this is the case for myself. I’ll make excuses for why I’m not accomplishing what I set out to do. However, it stems from my fear of being responsible for the outcome. Because if I fail, it was because of me. I have to remember that the same thing that holds me back is also what empowers me to change.

Easier said than done, but knowing the truth and acting upon it are the first steps.

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Nutshell:

Therapist Lori Gottlieb breaks down the therapy process through stories with her clients. She also shares her own journey in therapy along with insights learned along the way.

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Similar books:

• Solve for Happy by Mo Gawdat
• Eleanor Oliphant Is Completely Fine by Gail Honeyman
• Man’s Search for Meaning by Viktor Frankl
• Everything is F*cked by Mark Manson
• Take Control of Your Life with Mel Robbins
• Girl, Wash Your Face by Rachel Hollis
• Where Should We Begin? by Esther Perel
• Kick Ass with Mel Robbins
• Mating In Captivity by Esther Perel
• Mindset by Carol Dweck

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Rating:

4.5/5

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