Lori Gottlieb’s bestselling memoir, “Maybe You Should Talk To Someone” is a rollicking read that happily blurs the lines between patient and therapist. Gottlieb is a psychotherapist with a successful practice in Los Angeles, and she is no stranger to writing having helmed the “Dear Therapist” column every week for The Atlantic. Then one day, her fiancée dumps her. Gottlieb, it turns out, is about to take the very advice she has doled out thousands of times: “Maybe you should talk to someone.”
Her memoir is that journey from therapist to patient, and readers will delight in the pulling back of the curtain. It highlights what therapists are really thinking, and also, yes, even from a professional’s standpoint, being in therapy is harder than it looks. In telling her patients’ stories, as well as her own, we see an intimate look at the courage, risk, and ultimately reward, of caring for our own mental health.
In a juggling act of perspective, Gottlieb shines. Her voice is assured as a therapist. She is consistently entertaining, and at times irreverent, and the structure of her writing moves easily between the patients she’s seen (anonymized and at times conflated into a single character) and her own story.
The book’s inspiration, after all, is her own “presenting problem,” or the reason one seeks therapy. For Gottlieb, it was her up-until-now wonderful boyfriend, who tells her that he wants to marry her, were it not for the fact that she had a kid. Gottlieb, the therapist, suddenly finds herself in dire need of one herself. She finds Wendell.
Wendell becomes her therapist, and in her first session with him, she breaks down in tears.
“After a bunch of emphatic Mms, Wendell asks a question: “Is this a typical breakup reaction for you?” His tone is kind, but I know what he’s getting at. He’s trying to determine what’s known as my attachment style.”
What follows in the chapter is a back-and-forth of Wendell, the therapist, asking pointed questions to Gottlieb, the therapist-turned-patient, who assesses his every question with both what she the clinical psychologist thinks, and how she the patient should answer.
“Relieved, I go back to talking about the Boyfriend, rehashing the whole thing.
But he knows.
He knows what all therapists know: That the presenting problem, the issue somebody comes in with, is often just one aspect of a larger problem, if not a red herring entirely. He knows that most people are brilliant at finding ways to filter out the things they don’t want to look at, at using distractions or defense to keep threatening feelings at bay.”
Gottlieb’s journey to therapist had a few pit stops. She attended Stanford Medical School, and had a professor comment that she was the only one in a Doctor-Patient Class to open the conversation with a new patient with “How do you feel?”
The professor chastised the rest of the class, saying that should be their first question. For Gottlieb, it was the most obvious first question. She went on to drop out of med school in order to have more time for life and things like having a family, and decided to write instead.
She spends the next few years publishing hundreds of articles, writing for the hit television show ER, and once her son is born she finds herself back in school studying once again. This time she goes for clinical psychology. Her background as a therapist, a writer, and a med school dropout all add to her shine in these pages.
Halfway through the book, in Chapter 31 Gottlieb shares her ordeal with trying to figure out what was happening to her body. After a relaxing vacation, a furious rash took over her body. Her doctor ran some tests and told her it was a random allergy.
Then she became overly fatigued, inexplicably weak, and after more tests showed some markers for autoimmune disease, but nothing specific. A rheumatologist suspected fibromyalgia, which cannot be diagnosed with a test. Instead, they treated the symptoms with off-label-use antidepressants, and if that improved her symptoms, then it would confirm fibromyalgia.
“Soon I was at that CVS often, picking up cortisone creams for bizarre rashes, antibiotics for unexplained infections, and antiarrhythmics for my irregular heart rate.”
Many tests and doctors later, and a year in, Gottlieb developed hand and jaw tremors. A neurologist tells her she has conversion disorder, a mental condition where a person experiences blindness, paralysis, or other neurologic conditions, with no identifiable underlying neurologic pathology. An internist disagrees. Her self-proclaimed medical mystery tour continues, adding yet another thing to mentally manage, another thing to deflect. If it all seems like a lot, it is. Gottlieb, like her patients, has a lot to unpack.
Threaded alongside Gottlieb’s own journey to mental health therapy, her sessions with Wendell, and her decompressions with friends, are vicariously wondrous stories about her former patients. For many, this may be the meat of the book. Gottlieb can set a scene, with some laugh-out-loud humor and almost over the top wit to boot.
If you struggle with your mental and psychological well being, mental health disorders, or mental health challenges as a side effect of medicine, there is much in these pages you will find relatable. By showing us the inflection points of life that bring people to therapy, as well as Gottlieb’s skilled and empathetic care as a therapist, and her parallel conversation of understanding and overcoming the hardest parts of living, “Maybe You Should Talk To Someone” is a riveting look at therapy from both sides of “the couch.”