May is Mental Health Month — a time to come together to raise awareness about mental health issues, work to expand access to care, and support those who are struggling. This month we’re speaking to experts in the field about their therapeutic work, as well as their own experience and challenges with mental health.
When Lori Gottlieb was a new therapist beginning her practice in Los Angeles, seeing clients dealing with a host of issues, she hadn’t expected this to be the time she experienced a crisis of her own. She began seeing a therapist, a seasoned veteran of the field named Wendell.
Lori, in her conversations with Wendell, gained new insight into her own life, but also, as she grew, new perspective on the experience of her clients she met with each week: a recently engaged young person with a terminal illness, a senior citizen at the end of their rope, a shallow and narcissistic Hollywood producer. Through this experience, she found that she and her clients were all struggling with similar questions: how we change and understand ourselves in relation to others.
We discussed her work and new book, Maybe You Should Talk to Someone, via email.
The book offers such a lovely, nuanced view of therapy because we get to see you in the dual role of therapist and client — can you tell us a little bit about how you decided to become a therapist, what pushed you to seek therapy, and how your relationship with your therapist, Wendell, impacts how you now think of your own work?
I became a therapist later in life, after I’d worked developing films and television series and then as a journalist for many years. But I think all of my work experience is related in that it deals with story and the human condition. First I was working with rich fictional stories about human struggle, then I was helping people to tell their real-life stories, and now, as a therapist, I’m helping people to change their stories.
Therapists, of course, go through life just like everyone else, and when an unexpected crisis happened in my life, I sought help for it.
What was interesting about being a therapist in therapy, though, is that you want to just be a person in the room — you want to take off your therapist’s hat — but I was both learning how to be a better human being and learning, by watching, how to be a better therapist. At the time I write about in the book, I was a relatively new therapist and Wendell was much more experienced. He was wholly himself in the room in a way that I hadn’t grown into in my own practice yet.
At one point he brought up a cartoon about the ways in which we self-sabotage and trap ourselves and it’s not an exaggeration to say that it changed not just my life, but also the lives of many of my patients because I later shared it with them, too.
We work with a lot of therapists obviously, they’re often very discreet when it comes to sharing details of their personal life with clients — how is it to be more candid about your life and the things you’ve struggled with?
I think there’s a difference between sharing parts of your experience in a book versus in therapy. Therapists are very cautious and intentional when it comes to self-disclosure and our litmus test is: Is this in the best interest of the patient? How, specifically, will having this information help them? So we do it rarely and strategically.
But with Maybe You Should Talk to Someone, there are two main themes: One is that we grow in connection with others. The other is that we’re more the same than we are different. I wanted to bring people behind the curtain, into the therapy room with me, but I didn’t just want to be the expert, the clinician. I wanted to show the more human side of therapists, too, and I felt it would be somewhat fraudulent if I wasn’t willing to be as vulnerable with the reader as my patients were.
In the book, I wanted to walk the walk. I like to say that my most significant credential as a therapist is that I’m a card-carrying member of the human race. Nobody wants to talk to a robot or someone who hasn’t lived life. Without my humanity, I’d be useless to my patients.
You talk in the book a lot about what it takes for people to change; what are a few of the biggest blockers that keep people from making important adjustments in their life — how do we get “unstuck”?
Change is hard because along with change — even positive change — comes loss. We have to give up habits that, while perhaps not the healthiest, at least feel familiar and protect us in some way. And then we have to venture into the new, which comes with uncertainty. Many times people know exactly what they need to do to change — the question isn’t “What should I change” but “Why don’t I do it?”
We tend to cling to our old patterns and ways of being like a safety net. I know I should drink less but I don’t know what my days will be like without it, so I’ll keep drinking. I know I should choose partners who are appropriate for me, but I’m afraid of showing up in that way with someone — what if they reject the truth of who I am? There’s going to be some discomfort with change, and knowing that upfront can help people to take small steps forward.
We always say, “Insight is the booby prize of therapy.” You can have all the insight in the world, but if you don’t make changes out in the world, the insight is useless. So as therapists, we encourage change in every session.
Why do you think so many people are resistant to therapy and what should they know that might encourage them to take the first step?
That’s a great question and one of the main reasons I wrote this book. I wanted to demystify therapy and show people what therapy is (and isn’t) by letting them peer in on actual therapy from both sides — with me as a clinician and me as a patient. Many people who could benefit from therapy don’t reach out to try it because of their misconceptions.
It’s not about talking about your childhood ad nauseam. It’s about understanding how the past informs what you’re doing in the present so you can make positive changes now and move forward. And it’s very different from talking to your friends or family. A therapist will hold up a mirror to you and help you to see your reflection in a new way.
We all have blind spots, ways of shooting ourselves in the foot over and over, patterns that we just aren’t aware of. A therapist will help you to see those, to learn to relate better to yourself and other people in your life, to navigate your difficulties more smoothly in the long-term.
In addition to your practice, you also write an advice column for The Atlantic. We often say that therapist’s don’t necessarily offer “advice” per se — perhaps you could talk about why therapists don’t give advice, what they offer instead, and how writing an advice column has informed your practice?
We don’t tend to offer prescriptive advice because we want you to learn how to make your own choices, to learn how to think about your situation from a broader perspective and to anticipate the consequences of your decisions by reflecting on them differently before you make them.
We’ll help you to figure out what’s right for you, rather than tell you what we might do because what I might do might not be the best thing for you to do. Remember, it’s your life to live, not mine.
Ultimately, we want to empower you and encourage your independence. Even in my “Dear Therapist” column for The Atlantic, I don’t tend to give very prescriptive advice like, “Break up with your boyfriend” or “Yes, you should have another baby.” I share with readers what a therapist might be thinking if presented with that problem in therapy — here’s how I see it, here’s how you might benefit from the bigger picture, here’s your role in it, and here are some options you can consider. But the choice is yours. We offer you the skills to make better decisions but we don’t make the decisions for you.
I see many of the same issues in my practice and in the letters submitted to my column and in both cases, I’m considering not just the story, but the person’s flexibility with the story. I’m listening for the music under the lyrics — what’s the underlying struggle or pattern that got you into this situation? What is your role in it? How much of that can you see, and how much will I be trying to help you see?
What, in your experience, is the most transformative aspect of psychotherapy?
There are so many! But I think the experience of what we call “feeling felt” — being accepted for who you are and being able to share the truth of who you are in ways that’s hard for many of us to do.
Sometimes we carry around so much shame that we hide the truth of who we are not just from the people in our lives who are close to us, but also from the therapist and even from ourselves.
So it’s not just being understood, but also being helped to understand something you couldn’t already see that will lead to a kind of emotional and relational freedom that you hadn’t experienced when you first started therapy.
You talk about therapy being a bit “old-fashioned” — do you think technology can help modernize and broaden access to care without spoiling the benefits of the therapeutic process that helps us slow down and be more mindful?
I don’t know that I’m old-fashioned so much as a believer in the power of being in a room with another human being, face-to-face, in the same physical space, where you can hear each other breathe and pick up on the energy in the room in way you can’t with technology.
At the same time, many of us are busy and there are ways of connecting using all of the benefits that technology offers. Technology offers tremendous access for care and may even feel more comfortable for some people. I’m all for people connecting with skilled therapists in any way that works for them. I think technology also has a way of reducing stigma, of making therapy seem more like any other way of reaching out for something you’re in need of.
What do you think the future holds for therapy?
Therapy is something that I believe will never go away — struggle is part of the human condition and so is the desire for understanding and connection. And I think people are starting to value their emotional health in the way they value their physical health.
If you’re having chest pains, you’ll get them checked out by your doctor before you have a massive heart attack. But if you’re having emotional pain, often people will wait until they’re having the equivalent of an emotional heart attack before getting it checked out. And I think that’s changing now.
In the future, the stigma will be reduced even more because more people are becoming aware that it’s normal to reach out for emotional help. In fact, it’s a sign of strength and well-being.
Lori Gottlieb is a psychotherapist and New York Times bestselling author who writes the weekly “Dear Therapist” advice column for The Atlantic. She is a sought-after expert on relationships, parenting, and hot-button mental health topics in media such as The Today Show, Good Morning America, CBS This Morning, Dr. Phil, CNN, and NPR. Her most recent book is Maybe You Should Talk to Someone. Learn more at LoriGottlieb.com or by following her @LoriGottlieb1 on Twitter.
Author photo by Shlomit Levy Bard