Therapist Lori Gottlieb: "Therapy Is About Being Both Vulnerable and Accountable"

Psychotherapist, advice columnist, and best-selling writer, Lori Gottlieb, MFT’s most recent book is Maybe You Should Talk to Someone. She tells Inverse it originally started out as a book about happiness, but couldn’t capture what she was experiencing during therapy sessions with her patients — the real-life struggles they face, their pain, the joy, and the moments between. She eventually canceled that book idea and its contract altogether.

“Later, I realized what I really wanted to capture was these people’s lives, so I thought, Why don’t I just write that?,” Gottlieb tells Inverse. “That was the impetus for this book, and then as I was thinking about this book and telling these stories and how vulnerable they were being — of course, anonymously — I thought it was disingenuous for me, because I was going through an upheaval in my own life.

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“It would be unfair to leave out that whole part of the story, and one of the things I wanted to do with this book is to reduce stigma around our mental health and allow people to know that they are not alone. I like to say, to say we are more the same than we are different.

I decided to become the fifth patient in the book and include my own story as I go through therapy at the same time.

The following interview has been edited for clarity and brevity.

You’re a therapist who has her own therapist. In what ways do you find yourself using what you learn from therapy?

It’s interesting when you’re a therapist and you go to see a therapist because you have to really take your therapist hat off and just be a person in the room. At the same time, there were so many things that he did that were really effective for me. Sometimes I would drive from his office to my office and find myself repeating whatever he said that was very impactful for me. It was almost like he was Cyrano.

You learn a lot, I think, by watching someone else do therapy — and not just watch them but have the visceral experience of being in therapy with them.

Is there anything that you’ve learned that you think could be particularly helpful for people who are feeling that stress on their mental well-being but maybe haven’t taken the step yet towards seeing a therapist?

I think that the reason a lot of people don’t seek therapy is because they kind of minimize their problems. People think, Well, I have a roof over my head and food on the table, so how bad can my anxiety, or depression, or grief really be? I think it is really dangerous when people do that. If something was wrong with your body — if you were experiencing chest pain or something like that — you would go to the cardiologist before you have a heart attack.

But with our emotional well-being, we treat it very differently from our physical well-being. If something feels off emotionally, people won’t generally get that checked out. We say, Oh, it’s not that bad until it becomes really bad, and you’re having the equivalent of an emotional heart attack, and that’s when people often end up in therapy. That’s a shame because they’ve suffered unnecessarily for so long when they could have just called and maybe it wouldn’t have gotten that bad.

Your book discusses what it takes to make changes in your life. What advice do you have for peoplew haven’t taken the steps yet to actually make a change?

In the book, I talk about how we have this phrase, “Insight is the booby prize of therapy.” You can have all the insight in the world about why you do what you do, or why you’re feeling depressed or anxious, but if you don’t make changes out in the world, that insight is useless. You can say, Oh, I understand why I feel this way.

Then what are you going to do? What is your agency in that? We can’t control all of our external circumstances, but we can control our response to them, and sometimes there are things about our external circumstances that we can change. Often times, we don’t realize that until we get into therapy.

"Therapy is about being both vulnerable and accountable"

Therapy is about being both vulnerable and accountable, and I think it’s important for people to realize that. You’re going to have to be vulnerable but at the same time accountable in the sense that, in between sessions, you need to be doing something different out in the world. It’s not just you come in every week, you talk about something, and then you leave. You come in, you talk about it, you apply it out in the world, and that’s how you grow and change in your struggles.

Now that this book is out in the world, how do you hope that people apply it to their lives?

I wrote the book so that people would see themselves in it, which might sound strange because you’re following these other people. But I really felt that there’s a universality to all of our struggles. We all have the same kind of universal questions, like, How can I love and be loved? and How can I deal with pain?; How can I become unstuck? Those are things we all struggle with.

I think that sometimes it’s easier to see ourselves through the lens of somebody else’s story. So far, the reaction to the book has been that people really find that it’s helpful to them personally; they see some of what they do in their own lives. They see how they’ve been stuck, or how they are holding themselves back, or the certain patterns that they are in. It helps them not only see themselves but the people that they are close to — whether those are partners, friends, children, or parents. That has been really gratifying.

A version of this article first appeared as the Sunday Scaries newsletter. Sign up for free to receive it on Sundays.