review

The View from the Therapist's Chair: A Review of Maybe You Should Talk To Someone by Lori Gottlieb

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There’s an old adage in the therapy world that therapists are best equipped to help others walk through difficult experiences when we’ve done our own therapeutic work. It can seem strange to imagine your therapist getting help, but the truth is that many of us do. And when we do, it makes us better at helping others.

Lori Gottlieb is a psychotherapist who entered the field later in life. While she was a therapist in private practice, she ran into her own personal issues and decided it was time for her to seek out therapy for herself.  This is the story of her parallel process: what she was experiencing in her own therapy and personal life and how those were impacted by what was happening in her sessions with her patients.   

As a therapist myself, this book resonated with me deeply.  In some ways, it felt like my own personal diary.  Hearing her walk through her struggles and describe them in clinical language that is familiar to me from grad school helped me to relate even more deeply to the story.  This book reminded me of things I know but often forget about my field of work and practicing psychotherapy.

At the same time, there were elements that were tough and challenged me as a therapist.  Reading this book helped me humbly reconsider the way I approach therapy and run my sessions.

Whether you are currently in therapy, are considering beginning now, or are a therapist who is hoping to begin your own journey through therapy, I’d recommend taking a glance at this book.  Here are a few of my takeaways.

Good therapists are self-aware enough to seek out their own therapy when needed.

We all go through difficulties in life and moments of grief or trauma, including therapists.  Therapists especially need of extra support because we are holding the pain of the stories of the people we help. 

What therapists learn from their own experiences in therapy informs their work with you.  You can often feel it in how they hold themselves in sessions.  In fact, I recommend you ask your therapist if he or she does their own therapy to find out this fact.

Most of our problems boil down to relationships and connection (or lack thereof) with others.

Think about what you seek out help for in therapy.  How many of those issues are directly or indirectly related to relationships?  The therapeutic relationship becomes essential in healing when you realize this fact. 

Your therapist likely genuinely loves and cares for you.  You share a lot of vulnerable parts of your story with them, which invites intimacy.  I feel that way about my own clients.

The therapeutic relationship also provides a corrective process to “repetition compulsion.” Repetition compulsion involves looking to receive love in the same way you did from parents as a child, even though it may have been abusive or harmful, because that feels normal.  Therapy can teach you that it feels good to be cared for and loved in a healthy way.

Good work in therapy is slower than you might expect.

Patience is a skill that is both developed by participating in psychotherapy and also needs to continue developing as healing happens on its own timeline.  You’ll take many small steps toward health over a long period of time.  Gottlieb says, “A supervisor once likened doing psychotherapy to undergoing physical therapy.  It can be difficult and cause pain, and your condition can worsen before it improves, but if you go consistently and work hard when you’re there, you’ll get the kinks out and function so much better.”  Each of those small steps or transformations has a big impact. 

Most big transformations come about from the hundreds of tiny, almost imperceptible, steps we take along the way.
— Lori Gottlieb

Don’t be afraid to show your vulnerabilities.

Gottlieb says that patients often put on their best faces in therapy when what psychotherapists want is to see the real, human parts of who you are.  We want to see what’s not working, and that usually means you’ll have to engage with uncomfortable feelings and face the parts you’re hiding in the process. 

In a story Gottlieb shares about her own therapist, she says that his eyes communicate a clear message to her. “In this room I’m going to see you, and you’ll try to hide, but I’ll still see you and it’s going to be okay when I do.”  This is the essence of a strong therapeutic relationship, and it is what I aim for. 

I expect that there will be resistance in therapy: lying, posturing, hiding parts of yourself.  You’re going to be trying to maintain an illusion, and my goal is to break through it.  It’s okay if you resist this process: it can feel vulnerable and uncomfortable. Recognize the resistance when it comes, and be willing to talk about it.

Acceptance is the key to healing.

This book explores the concept of acceptance in depth.  She learns to accept the fact that she doesn’t always know why she does what she does.  Not everything will end with a neat and tidy bow, because that isn’t realistic.  In therapy, you’ll learn how to recognize and accept feelings, including anger, and what lies underneath those emotions.  You’ll come to understand your resistance, avoidance, and hesitancy.

You’ll learn about how you picked up coping mechanisms to survive when you were younger that may no longer be the best choice for you.  What are you using to protect yourself and avoid reality?  Instead of being afraid and denying these things, accept that they are there and be curious about what they have to teach you.

One pattern I notice in clients is that they beat themselves up for feeling pain when they compare their lives to how difficult others have it around the world.  If you have this thought, realize that it is not fair to you and not fair to your experience of pain to compare like this.  Gottlieb repeats several times in this book that, “There is no hierarchy of pain.”  What you’re facing is what you’re facing, and it’s affecting you differently than it would anyone else.  It’s fruitless to compare it to someone else and come up feeling bad about yourself for hurting.

You are the one doing the work of therapy.

Therapy is about a series of small steps you take to heal.  I, or any other therapist for that matter, can’t do this work for you.  It would actually hurt you if I tried.  I can’t save you – you need to learn to come to your own rescue.  I can’t make choices for you, and you’ll find that I often counter requests for advice with further questions.  Giving advice hurts rather than helps: you need to come to your own decisions. 

This book taught me to be more reflective about what happens in my sessions with my clients and to integrate who they are as a person into what causes distress for them.  When I have a good understanding of who is sitting across from me, I can allow them to do the hard work of therapy and simply gently guide them in the direction.

Rather than steering people straight to the heart of the problem, we nudge them to arrive there on their own, because the most powerful truths – the ones people take the most seriously – are those they come to, little by little, on their own.
— Lori Gottlieb

And finally, learn to be kind to yourself.

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As Gottlieb reminds us, “Most of what we say to ourselves we’d never say to people we love or care about, like our friends or children.  In therapy, we learn to pay close attention to those voices in our heads so that we can learn a better way to communicate with ourselves.” Practice kindness toward yourself by changing the words you use to speak to yourself into ones you might share with a loved one instead.

How Focus on the Essential Could Save Your Life

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When you wake up in the morning, are you overwhelmed with the many tasks on your to-do list?  Maybe you’re a parent who feels stretched too thin between caring for children and keeping up with work tasks.  Or perhaps you feel under the thumb of the “tyranny of the urgent,” where every task seems to be top priority.  Maybe the things that really matter to you are slipping through the cracks.

How freeing might it be to focus on just one thing at a time?

Essentialism: The Disciplined Pursuit of Less by Greg McKeown* is a slim volume that helps you focus on one priority at a time instead of trying to spread your time and energy over too many tasks.  He helps you hone in on what’s important instead of what’s urgent.  He encourages trimming down on non-essential tasks in order to focus on what is truly vital to your well-being and your values.  He offers practical steps on how to define your priority, or “essential intent,” cut down on extra tasks, and create time to do what’s most important to you.

If you don’t prioritize your life, someone else will.
— Greg McKeown

Impacts from Essentialism

He shatters the expectation of multiple “priorities.”

McKeown talks about the history of how we view the word “priority.”  In the past, calling something a priority meant it was the number one thing in your life at the top of the list.

But now the meaning of the word has changed.  We have “priorities” in the plural.  When we spread our priorities over multiple areas, then everything becomes a top priority and you can’t juggle it all.  You end up failing in some areas, struggling with decision fatigue from the weight of choices between priorities, and feeling less satisfied.

Instead, McKeown suggests focusing on one “essential intent” as a top value, truly making it your top priority.  This makes decisions easier as you hold up this top priority as the main factor in making deliberate decisions.

You don’t have to do it all.

Focusing on one essential intent takes you out of the trap of “I have to do it all” and allows you to make choices that support what you value.  It can be easy to fall victim to outside circumstances or urgent tasks.  You can feel out of control and powerless to change.

In truth, you do have a choice.  You can choose to respond to that “urgent” request or stay late at work to catch up, or you can choose an alternative behavior that supports your values.  When you frame decisions as choices, you’re more likely to feel more power and control over your life.  Choices can be hard, but they put you back in the driver’s seat of your own life.

You have permission to say “no.”

It can be difficult to say “no” to urgent tasks, especially when they feel constant and demanding.  Not only does McKeown encourage you to say “no: in order to make your essential intent most important, but he also gives practical, step-by-step advice on how to say “no.” Realizing you cannot do everything and being willing to say “no: allows you to give others the opportunity to step in and showcase their own strengths or abilities. 

I can do anything but not everything.
— Greg McKeown

Your “no” can still be hard.

What makes saying “no” more difficult is that it involves a trade-off.  Typically we are saying “no” to something that is good in order to say “yes” to the best.  Acknowledging the reality of the trade-offs and the potential for missing out or feeling disappointed allows you to accept those feelings as normal.

How to Apply Essentialism in Daily Life

Discover what you value.

Find a time and space where you can reflect without distractions or interruptions.  Get out a journal or a pad of paper and write down a list your priorities and values.  Look through this list and identify which of those values leads you to feel truly alive.  Clarify your vision as a way to identify your essential intent.

Choose one priority to focus on for the next week.

As you reflect on this list, choose your essential intent for the upcoming week.  Let it guide your decisions.  When you’re called on to make a choice, pause and ask whether or not it supports your priority.  You might focus on family, mental health, friendships, taking care of your body, an aspect of your work – you name it.  Whichever goal you focus on, allow your decisions to reflect what will best contribute to that goal. 

Identify your obstacle.

What is most likely going to get in the way of you sticking to your essential intent?  A demanding boss?  A tantrum-throwing toddler?  An unsupportive spouse?  Endless lists of work tasks?  Plan ahead for these obstacles and seek to address them in advance.  This preventative approach will save you from reacting in the moment to urgent interruptions. Create a routine that will help you avoid doubt or questioning your priority.

Pause before saying “yes.”

When someone makes a request of you, don’t automatically say “yes.”  This automatic response feels polite and avoids conflict, but you may regret it later.  Either tell the person you’ll get back to them or take 24 hours before you respond.  During that time, consider whether saying “yes” will support your essential intent for the week.  After some time has passed, if your response is not a 100% “yes” and in alignment with your essential intent, then the answer is no.

Give a clear “no.”

While it can be difficult to say “no,” communicating that no is more effective than a noncommittal yes where you will avoid or have difficulty with completing the task.  McKeown offers several ways to say “no” in the book, some of which involve suggesting another person who could complete the task, creating a compromise, or using humor.  Regardless, know that saying “no” will feel awkward and uncomfortable at first, but with practice, it becomes easier. 

Celebrate.

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Any change you make toward creating your one essential priority is worth celebrating, even if it feels tiny.  Find a way to celebrate the small victories.  Using this form of positive reinforcement helps you give yourself credit for changes you make.  If you deal with anxiety or depression, giving yourself credit as an important part of overcoming the negative messages you repeat to yourself.  Allow yourself to feel happy and enjoy the feeling of making a change.