Maybe You Should Talk to Someone: An Interview with Lori Gottlieb

Lori Gottlieb is a psychotherapist and author of The New York Times best seller, Maybe You Should Talk to Someone. She writes The Atlantic’s weekly Dear Therapist advice column, and also writes regularly for The New York Times. She has appeared on The Today Show, Good Morning America, CBS This Morning, CNN, and NPR.

According to Lori, her most significant credential is not her license or rigorous training, but the fact that she’s “a card-carrying member of the human race.”

In Maybe You Should Talk to Someone, readers join Lori on her intimate journey, and into her practice, for a deeply personal and revelatory tour of hearts and minds from both sides of the couch—to quite possibly life-changing effect. We had a chance to interview Lori about the book, her work doing couples therapy, and the impact therapy has on our relationships.

How have you been influenced personally and professionally by the Gottman Method?

In my practice, I’m always looking for two things at the same time: what’s not working in these people’s lives, and also what is working. In other words, I’m scanning for strengths so that we can build on those. The Gottman Method has a very positive orientation. It has taught me how to help couples find the positive points of connection that get buried underneath the distress or conflict. There’s often so much love beneath everything else—and also so much more to discover about one another. This tended to get short shrift before John and Julie really revolutionized the work in this way.

I also appreciate how easy it is to teach people about some common destructive behaviors, such as the Four Horsemen, in a way that they can readily understand. Just as I like to help couples catch their partner doing something positive (and to tell their partner about it!), I like to help them catch themselves doing something that isn’t contributing to the kind of relationship they want. Once they can see themselves engaging in those behaviors, they start to see their role in their difficulties more clearly. And that’s hopeful and liberating—because it’s something concrete that’s in this person’s power to change!

Maybe You Should Talk to Someone covers all types of relationships (parent relationships, romantic relationships, friendships, therapist-patient relationships). Is there any type of relationship you explored that surprised you when you were writing the book?

Yes, in the book, I write about a young woman who’s newly married and finds out when she returns from her honeymoon that what she thought was a sign of pregnancy was actually an indication of breast cancer. It later ends up being terminal cancer, to everyone’s shock.

“Will you stay with me until I die?” she asked me, and I said I would. And although our relationship was one of the most profound I’ve had with a patient and was full of surprises, the relationship I write about that surprised me the most was her relationship with her husband.

She and her husband talked about the hardest of hard topics—that they were in this together but that in the end, he would get to live and she wouldn’t. But they also talked about the kinds of things all couples experience—envy, anger, selfishness, competing ambitions, loss, grief—with an honesty that’s rare. They really went to all of these places, and their relationship was so much richer for it. It shouldn’t take a terminal illness for couples to show up in this way, to be so vulnerable and honest, and to discover that even in darkness, there’s joy in this intimacy, in loving each other in such a complete way.

The book discusses the complexities and dynamics of the therapeutic relationship one-on-one. You also see couples. How does the dynamic change with three in the room?

That’s such a great question, because when people come to therapy, I’m listening not just to the story they’re telling, but also their flexibility with their story. Who are the heroes and who are the villains? Is the protagonist moving forward or going in circles? What would the other “characters” in the story say if they could tell their version of this story? We all have a tendency to tell a story in a particular way, which is the way we see it—but we all have blind spots. So my job as a therapist is to hold up a mirror to people so that they can see themselves more clearly, and in ways that others might see them.

With couples, though, I’m not just hearing one version of the story—I’m hearing two. And that allows each person to consider the story from a more fluid perspective. Oh, I saw it this way, but you see it that way. I thought you were trying to hurt me, but you were hurt yourself. I thought you weren’t listening to me, but I wasn’t hearing you either. Having more than one narrator allows people to learn something about themselves and their partners in a more immediate and powerful way.

Also, I always say that I’m listening for the music under the lyrics. Meaning, I’m listening for the struggle or pattern underneath the content of the story. And I can hear that music so much more easily when I can watch a struggle or pattern play out in real time in a session. I don’t have to rely on one person’s account of something that happened after dinner two nights before. I can see an interaction as it happens in front of me and intervene right there on the spot.

One of your more, shall we say, “challenging” patients in the book writes for a TV show, which later introduces a therapist character. Soon, a TV adaptation of Maybe You Should Talk to Someone will join the ranks of shows that give us a glimpse into what happens in therapy sessions. What do you hope to shine a light on? What are other shows getting right and wrong about therapy?

There are two main themes to the book. One is that we grow in connection with others. The other is that we’re more the same than we are different. I think that bringing readers into my therapy room where they can get to know my patients, and also into my own therapy sessions where I am the patient, shows our shared humanity. It normalizes our struggles and helps people to feel less isolated in them. We all struggle—nobody is immune to struggle, no matter what their lives look like on the outside—and at our core we all want the same things. Ultimately, we want to love and be loved, but often we have trouble doing that.

In many TV shows, the therapist character is portrayed in one of two ways—the stodgy, ultra-contained, distant therapist, or the therapist who’s a train wreck outside the office. Neither of these reflects the therapists I know.

I want the TV version of Maybe You Should Talk to Someone to be about a person who happens to be a therapist, as opposed to the expert up on high. As a therapist, my greatest tool is my humanity—without it, I’d be useless. And I want the show to highlight our shared humanity, because that makes therapy more accessible, and also makes people more compassionate toward one another.

This book is juicy, heartbreaking, and cathartic all at once. How do you hope it influences the perception of therapists and the experience of going to therapy?

I hope that it demystifies what therapy really is so that for people who haven’t tried it, it’s not mysterious or scary or strange. We don’t get to see people in therapy—real people, not characters on TV or in movies—so in my book, I wanted people to be a fly on the wall and see for themselves what therapy is and isn’t, and also how transformative it can be. I wanted them to see the many heroic moments that often nobody sees.

Patients inevitably experience a feeling of closeness with their therapist, and that can make their partners jealous. How does one share what’s going on in therapy with a partner? Should it be shared?

There’s a difference between privacy and secrecy. Carl Jung called secrets “psychic poison” because secrets can be so corrosive. But we all need some privacy. Just because you’re married doesn’t mean that you share every thought, feeling, or detail of your day with each other. Therapy can be a place where one partner can work on an individual issue and as that improves, the relationship improves. But when that person’s partner wants to know, “Hey, honey, what happened in therapy today?” that can feel intrusive and also may come with a hidden agenda: You need to be fixed. You’re the problem. Or: I’m impatient with your progress. You need to change more quickly.

That said, there are times when you want to share something from your own therapy with your partner—maybe you discovered something interesting that you’re excited about, or you had a particularly powerful or moving experience that will help your partner to understand something important about you and bring you two closer. But the two relationships—the one with the therapist and the one with your partner—are not in competition. They’re both very close, but in different ways. And that’s a good thing.

You write, “It is impossible to get to know people deeply and not come to like them,” but in the therapeutic relationship, the disclosure isn’t mutual. Is that why we want our therapists to like us so much?

It’s hard to have rich emotional experience with someone and not become curious about them. What is my therapist’s life really like? What does my therapist think of me? And, of course, Does my therapist like me?

Most people come to like their therapists very much, and it goes both ways. The fact that we admire and respect our patients, and genuinely come to like them, and that their lives matter to us, is a form of disclosure we can—and should—share. Therapy is a profound human encounter and why should we pretend otherwise? The fact that we aren’t robots is what makes this process so effective.

Of course, there are many reasons why therapists don’t disclose information about their personal lives, but that doesn’t mean we have to hide our experience of the patient. In the book, I write about the time that I asked my own therapist if he liked me, and I included it because his answer was so candid and beautiful and unexpected. I wanted people to see that exchange as it might relate to their relationships with their own therapists.

Since you also write an advice column, we would love to get some advice! How can people get the most out of their sessions? What are the keys to the best, most productive or satisfying therapeutic relationship?

I have two pieces of advice here! The first has to do with how people start their sessions. Often on the drive over to therapy, people think, “I’m about to go to therapy. What do I want to talk about today?” And by the time they’re sitting on the couch in my office—and this goes for both individuals and couples—they’ve got their opening line all ready to go.

With couples it might be a rehash of something that happened over the weekend, but I don’t find it effective to discuss the fight of the week. The most productive sessions tend to be those in which there’s no agenda, no point to prove, where you come in and take some breaths, feel your body, ground yourself, and see where your mind goes. Wherever that is tends to be what they really need to be talking about. Not the rehearsed script.

My second piece of advice is related to one of my favorite maxims: “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. You can understand, intellectually, why you do what you do in your relationship, but if you leave therapy and don’t use that knowledge to change your behavior—your reactivity, your tendency to withdraw or escalate or be easily injured, whatever it is—you’ll come to therapy each week but still have the same troubled relationship.

If you want to get the most out of therapy, you’re going to have to do something different after you leave each week.

What is your advice for someone on the fence about going to therapy? What are the biggest barriers?

There’s still stigma attached to therapy because we don’t place value on our emotional health the way most of us do with our physical health. If you notice that something’s feeling “off” with your body, you’ll probably go get that checked out by your doctor before you have, say, a heart attack. But if something feels “off” emotionally or with their relationship, people tend to ignore that. They try to pretend the feelings aren’t there, but feelings don’t go away just because they’re inconvenient.

In fact, the more you try to suppress them, the bigger they get, and what might happen is that you’ll wait until you have the equivalent of an emotional heart attack before you call a therapist. And then it’s harder to treat than it would have been if you’d gone to talk to a therapist earlier on. But stigma prevents many people from calling. This has to change, and we can do that by talking more openly about therapy in the way we talk freely about going to our internist or chiropractor.

With couples, there’s the added misperception that if they go to couples therapy, it means they’re on the brink of divorce. But the couples who come because they feel it’s a sign of strength or a vote of confidence in the relationship—that their relationship matters to them enough to work through whatever might be going on—tend to be more resilient as a result.

I even see couples who are about to get married and are very happy together, but who want to learn the skills to talk to each other about sensitive topics that often require compromise and negotiation, like money or sex or in-laws or kids. I hope the perception of therapy is changing from thinking that it’s only for people who are in great distress to understanding that it’s also for people who want to relate better so that they don’t end up in great distress later on.

I always say to people who might benefit from therapy, “You only get one life, and you don’t know how long it will last. What are you waiting for?”

Lori’s book, Maybe You Should Talk to Someone, is available now. To learn more about Lori, visit her website, or connect with her on Twitter.

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