By David Canfield
April 04, 2019 at 09:00 AM EDT
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Houghton Mifflin Harcourt; Leigh Manacher

“There are two tropes of the therapist in our culture,” Lori Gottlieb says. “The very removed person — who uh-huhs and [is] a very blank slate — and the hot mess.” Her challenge, in writing her memoir Maybe You Should Talk to Someone, was to create a new trope: the human being.

The Atlantic‘s “Dear Therapist” columnist has written a book that entirely reframes the way we think about psychotherapy, paralleling her patients’ lives with her own and demystifying her practice as a place for meaningful human relationships — especially important in the digital age. (She writes in a foreword that she received permission from her patients, and altered details to avoid exposing any identities.) Optioned for an ABC series by Eva Longoria, Talk depicts Gottlieb’s own journey coming off an ugly breakup. She can be petty, judgmental, obsessive. She feels real. And as we come to know her patients — a grieving father, a terminally ill young woman — she movingly depicts our collective longing for lasting connection.

In an extensive interview, EW spoke with Gottlieb about the ethics of writing the book, what she discovered about herself, and why she hopes Maybe You Should Talk to Someone changes the way you think about therapy. Read on below. The book is now available for purchase.

ENTERTAINMENT WEEKLY: You talk about getting permission and things like that in the book, but I wanted to start by asking you: On a deeper level, how did you come to the decision to write this and tell your patients’ stories?
LORI GOTTLIEB: I turned down a parenting book [Laughs], and I ended up writing something that I thought would be more meaningful to me, personally, which is a book about what’s going on with our happiness in our culture. At the time, I was starting my practice. It ended up being what I call the “stupid miserable happiness book” because it was just not getting at what I wanted people to see about the human condition. I was seeing that up-close-and-personal in the therapy room. I wanted to bring people behind the curtain with me and see what I was seeing. That’s how I ended up writing about what we’re all struggling with, but through the lens of the people I was seeing.

In the books I’ve read or know of that are written by therapists, the focus — insofar as the reader gets to go into the therapy room — is really on the patient and how it impacts the patient. For you, it’s obviously important you show the other side and how it affects the therapist. Did that feel new for you?
I think it’s a very new book for me and probably for the reader. There’s this idea — which I think keeps a lot of people out of therapy, actually — that the therapist is this expert up on high. Which of course we want: We want someone with expertise, that’s why we’re going to them. But we’re also human. As I say in the book, despite my training and my credentials and all of those things that are important, I feel like my most important credential is that I’m a card-carrying member of the human race. I know what it’s like to be a person. I don’t think anybody wants to go and talk to a brick wall. I don’t mean that we’ve experienced the same things, but that we’ve struggled with the daily problems of living. That’s what makes us so effective as therapists.

In the book, I talk about a colleague who’s been going through fertility issues, and she was in a Starbucks when her doctor called and said that her fetus wasn’t viable. [My colleague] burst into tears — and her patient, who saw her, never came back. Of course, we don’t want our therapists sobbing in the therapy room, or taking that call in the therapy room. That’s uncomfortable and creepy. But if your therapist doesn’t have a normal human reaction to normal pain, I would trust that therapist even more knowing that she did have a normal human reaction to something that was painful. I wanted to show that we’re more the same than we are different, and that’s a good thing. That’s something that’s very important in the relationship between therapists and patients. We are more similar because we do understand. We might not be in your circumstance, but we understand what it’s like to be a person.

Did you struggle at all with what you chose to reveal about yourself? Because, as you say, this isn’t the typical space the therapist occupies in our culture.
Most therapists are just normal people. In terms of what I revealed, yes I revealed a lot, but I wasn’t a hot mess. I was having a normal reaction to something that was very shocking. And then I found out that, actually, it was about all these other things — which I think happens to most people in therapy. I was just being a normal human. Is it risky to show that you’re a normal person when you’re a therapist? Yes! That’s why my profession is so weird. In any other profession, you can be a normal person and nobody blinks. You, David: You can be a reporter, and you can be a normal person. Nobody’s like, “Oh, that’s so weird, I don’t want to know that.” As a therapist, we’re held to a different standard. But I also think that standard keeps people isolated in a lot of ways. That’s where a lot of stigma around our emotional health comes from. If even a therapist can’t be a normal person, then the stigma is never going to go away.

I found it especially moving when you challenge yourself and your judgments. There’s Julie, the young terminally ill patient who spends her Saturdays working at Trader Joe’s, and you working through why that’s so important to her.
All of the people that I write about are in some ways mirrors of each other and mirrors of me. They look like very different people — all five of us, the four people and me — with different backgrounds, different issues, different phases of life, all of that. But I think our core struggles about meaning and being loved and loss and grief, all of those themes overlap in all of our stories.

You mentioned wanting to hit a particular feeling in our culture right now. What does this book speak to on a larger level?
On a larger level, the book is asking the question: How do we grow and change, and how do we connect? The answer is that we grow in connection with others. In the therapy room, those relationships — it’s a very weird construct because, from day one, you know you’re going to say goodbye, yet you’re going to form very intimate relationships with people and then say goodbye. But people grow through those connections. It’s a very intense relationship. A lot of the reason that people are so unhappy — on a very global, general level — is this epidemic of loneliness. We have so many people around us, we’re so hyperconnected, we can be in contact with anyone at the touch of a finger, but we don’t feel connected. The therapy room is one of the very few places where you sit face-to-face with another person for an extended period. There are no screens, no devices, no pinging. You look into the other person’s eyes. It lowers you heart-rate, it improves your immune system. All of these physiological effects of just being present with another person. I think a lot of people are really lonely, and a lot of people don’t know how to connect, especially people who grew up in this culture — the immediate-gratification culture — they don’t know what that’s like. It’s important for people to be intentional about their relationships, be intentional about how they’re connecting.

I think about how therapy is so much about boundaries, too, in contrast to the instant-gratification culture. When, say, your patient John orders you lunch every week, it’s a crossing of a boundary, but it’s also a way of connection — there’s a space for that kind of intentionality to happen.
Right. That’s the thing I really learned from going to my therapist, which was that he was much more experienced than I was, but he was so himself in the room. It wasn’t as if he was talking about his personal life in the room — he very rarely did so — but he felt very comfortable bringing his personality into the room, and bringing his humanity into the room. With John, when he wanted to order the lunches, I think as a newer therapist, a lot of people might have said — and I was tempted to say — “We don’t do that here.” But I realized that it was a way of connecting with him. It was a way of making contact.

You came in with a pretty clear goal of what you wanted to explore, but what did you discover as you went about writing the book?
It definitely did take shape as I wrote. In the first draft, you’re writing for yourself, and you have to imagine — or at least I do — that no one’s going to see this. The first draft is your most unfiltered draft. What’s funny about that is when I turned it into my editor, she said, “Wow, You seem so together!” She was right. Without even realizing it, I had edited myself. I went back and said, “I really did have this idea of not really letting go.” I had to let myself go in the way I let my patients go. That was the hardest thing, but it was also liberating — in my second draft, in what I turned in after, I was completely unedited. I really wanted to show how I really was at that time, and not an idealized version of what I was like at that time.

Do you hope this changes the way people view therapy?
Absolutely. I hope that it shows what therapy actually is, and not what they may think that it is. In movies and television shows, sometimes there are ideas that just aren’t what modern therapy looks like. Ultimately, therapy is about one person in conversation with another person as they try to help somebody understand themselves better. We’re trying to hold up a mirror to people in a really compassionate way, but in a different way than your friends will. Your friends put a filter over the mirror: Here’s the pretty version of you, you’re so great, I support you, that’s terrible what your boss said! I talk in the book about the difference between wise compassion and idiot compassion. Idiot compassion is when you don’t want to rock the boat, you want to help the person feel better. But sometimes the way that you want to help them is more harmful to them than your honesty would’ve been. In the therapy room, we very much traffic in truth and honesty. We do it with compassion, but we also want to show you the ways that you’re shooting yourself in the foot. We don’t want to waste your time and money. We want to say, “I want you to see something that you’re doing that might be getting in your way.” Then we can look at it. Then we know what we’re talking about. If we pretend it’s not there, we’re getting nowhere.

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