therapist reads thursdays

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.

Fairy Tale Farce: A Review of The Wizard of Oz and Other Narcissists by Eleanor Payson

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What comes to mind when you hear the word “narcissist”?  The word gets thrown around a lot today as a synonym for selfishness.  The millennial generation gets stereotyped as narcissistic because of increased focus on the self or use of social media to present an image.  But narcissism in its truest form is more insidious and damaging than the stereotype we assume.

In her book The Wizard of Oz and Other Narcissists, Eleanor Payson outlines how to recognize both the overt and covert narcissist, different relationships you might find yourself in with a narcissist, and how to set boundaries to keep your sense of self intact.

According to the DSM-5, someone with narcissistic personality disorder (NPD) is characterized by:

  • Grandiosity and self-importance

  • Need for excessive admiration

  • A lack of empathy

  • Preoccupation with fantasies of success, power, love, beauty, or brilliance

  • Belief in personal uniqueness or specialness

  • Sense of entitlement

  • Envy of others

  • Belief that others are envious of him/her

  • Arrogant or haughty behaviors or attitudes

  • Manipulative behavior with others 

For a narcissist, his excessive self-absorption is a protection against unconscious but powerful feelings of inadequacy.
— Eleanor Payson

While a diagnosis of narcissistic personality disorder requires at least five of these criteria, someone with narcissistic traits can have milder symptoms.  You might notice that he or she is sensitive to criticism, has rigidity and criticism toward others but leniency toward the self, and projects his or her own issues on others. 

NPD individuals can never admit wrong and are expert manipulators to convince you that they are right.  They can often be dismissing of your needs, leading to a non-reciprocal relationship.  If you don’t serve a purpose to the narcissist, they don’t give you the time of day.

Addiction, by its very nature, is narcissistic.  While sex and love addiction doesn’t necessarily correlate to NPD, many narcissistic traits are present in addiction, such as lack of empathy, manipulative behavior and gaslighting, entitlement, fantasy, and a sense of uniqueness.

What I Learned from This Book

Overt and covert narcissists are different, with the covert narcissist more difficult to detect.

Overt narcissists are what we would typically imagine: someone who is charismatic, engaging, and loves the spotlight.  You often feel special at first when this individual pays attention to you, but they become less interested in you when the spotlight is off of them.  They have many friends, usually at a superficial level.  They crave admiration and support, which their charm allows them to receive.

Covert narcissists are less showy, drawing you in by being attentive and listening, but eventually becoming controlling and detached when you disagree.  They express anger in passive-aggressive ways, and you struggle to determine where you stand with them because they are aloof and indifferent. This type of narcissist blends in well with helping or service professions, such as church involvement or counseling.  They gain a sense of power or value from association with their “cause.”

Relationship with a narcissist involves loss of the authentic self.

The inadequacy the NPD individual feels is mitigated by seeing others as an extension of the self.  Thus, when you are in relationship with the narcissist, it becomes easy to lose awareness of your true self.  You might not be aware of your own emotions and have intense negative beliefs about yourself, stemming from the criticisms of the NPD.  You can end up developing codependency and caretaking for the NPD.  You might focus more on the expectations of others instead of your own desires. 

The confidence we so desperately need comes only from our authentic self.
— Eleanor Payson

Understanding your own strengths and value is the path to getting to know your authentic self.  Learning who you truly are can help you see the flaws in the NPD’s thinking about you more clearly.  This will then lead to more resilience to negative messages about yourself.

Notice early and get out if you can.

The major takeaway this book offers is education on how to recognize a narcissistic person.  If you aren’t already in relationship with an NPD individual, or if you’re in the early stages where you still have the freedom to leave, this book offers you the opportunity to learn about warning signs and take action.  Payson emphasizes multiple times that believing you can change a narcissist is risky behavior: the best way to deal with narcissists is to set boundaries or leave while you still have the chance. 

Boundaries and self-care are essential.

Yet once you’re entrenched in a relationship with a narcissist, assertiveness becomes indispensable.  When I work with partners of sex addicts, boundaries and self-care are the first areas I target as necessary for empowerment.  Therapy can help you as you explore how to set effective boundaries with the goal of giving yourself a voice and speaking up for yourself.  Know that this will likely require practice with safe people first, as the narcissist is a master manipulator that can twist the conversation.  You’ll also need to learn new strategies for setting boundaries.

Your primary work involves developing the ability to validate your thoughts, feelings, and needs along with an ability to stand up for yourself in the relationship.
— Eleanor Payson

Your reactions are a clue to discerning the narcissist.

When you are always trying to please someone else or gain their approval with a corresponding loss of self-esteem, you might be dealing with a narcissist.  You may notice yourself becoming the primary giver, ending any reciprocity in the relationship.  You might find yourself caught in lose-lose situations regularly.  The pain associated with these reactions is like a light turning on in the dashboard of your car: it’s an indicator of the need to change.

There are a variety of situations where you might have contact with a narcissist.

In particular, the parent-child relationship is explored at length in the book, likely because it can lead to repetition of patterns from childhood in adult years, or addictive tendencies that arise as coping strategies from a traumatic childhood.  If you are a child of a narcissist, you must to understand that the parents’ behaviors aren’t your fault.

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Beyond the parent-child relationship, you might see a NPD individual in a romantic relationship, friendship, work relationship, or even service professional.  In the workplace, Payson recommends communicating everything in writing, getting emotional support outside of work, and involving a third party in discussions.  If you’re in the process of looking for a therapist, she recommends interviewing your mental health professional and checking out a few options before making a final decision.

Ultimately, this book offers both warning and empowerment.  Payson gives you the skills to recognize the narcissist in your midst before you become established in relationship with him or her.  Yet she also offers empowerment to learn about your authentic self, practice assertiveness, set boundaries, and stand up for yourself.

Learning to Be Yourself Again: A Review of Codependent No More by Melody Beattie

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If you’ve been the spouse, child, sibling, or in another connected relationship with an addict, you know the havoc it can wreak on your sense of self and peace.  It can affect your self-esteem and make you feel like you’re crazy or out of control.  You may begin to feel like your life is dictated by the addict’s using and your efforts to manage the aftermath of his or her addiction.

With sex and love addiction, particularly for spouses of the addicts, this takes its own unique toll.  Partners can feel responsible for their spouse’s behaviors because the issue is sexual.  Sometimes addicts will blame their spouses for “not getting it at home,” so they seek sex out elsewhere.  Even if the addict isn’t blaming the spouse, he or she may still deal with insecurity about body image, sexuality, worth, and value.  This can lead to behaviors that could be deemed codependent.

What is codependency?

Codependency, or co-addiction, is the name derived from early models of helping those married to addicts.  Codependency is a word that describes dysfunctional relationships where there is an over-dependence on another individual to provide you with security, safety, sense of self, or value.  It involves losing yourself in someone else.

A codependent person is one who has let another person’s behavior affect him or her, and who is obsessed with controlling that person’s behavior.
— Melody Beattie

Unfortunately, in recent years, codependency has gotten a bad reputation. Spouses felt blamed or held responsible for their spouse’s acting out, as this communicated they had to change for their spouse to stop using. This does not sufficiently address the reality of the trauma caused by a significant other’s addiction.  While codependency may exist for some of these individuals, the pain of the trauma needs to be addressed and healed before looking at the possibility of codependency.

Codependency is still worth exploring, however, because it can shed light on how behaviors can change as a result of trauma.  Understanding codependency can help men and women feel empowered to change their lives through understanding the dynamics of control in a relationship.  In particular, if you find yourself in these types of relationships repeatedly, it is beneficial to take a look at some of these characteristics and see if you might benefit from a change.

Codependent No More

Melody Beattie, the author of the book Codependent No More*, began writing about codependency in 1986 when there were very few resources available to the public about codependency.  Her pioneering work in the study and treatment of codependence has paved the way for healing for many spouses and significant others of addicts.  This book and its corresponding workbook* have helped many men and women learn the skills they need to overcome codependency and learn the skills to take care of themselves. 

What I’ve Learned

You don’t need to define yourself as “codependent” or find yourself in an addictive relationship to benefit from the lessons of this book.  If you are in these types of relationships, however, or if you are a partner of a sex and love addict, then the following words will have particular resonance for you.

The only person you are in control of is yourself.

This is one of the hardest lessons to live by practically.  You know what’s best for others and you want to help them see what you see, but often that leads to controlling behaviors and obsessive thoughts.  Detach from the problems you aren’t in control over and allow yourself to focus only on those circumstances that are within your control.

When we attempt to control people and things that we have no business controlling, we are controlled.
— Melody Beattie

Understanding your own emotions is key.

Often in codependency, you can become reactive and not always know what’s triggering your anger.  Understanding the variety of emotional experiences you are having can help you learn more adaptive ways of coping.  Know that your emotions are not bad in themselves: how you react to them can have negative consequences, but welcome your emotions as indicators that something is not right. Explore how your ability to name and feeling emotions has been impacted by past trauma, either from your family-of-origin or from your relationship with an addict or other dysfunctional individual.

Moving from victim to victorious empowers you to make the best choices for yourself.

Viewing oneself as a victim of circumstance or of the addict is often justified in some way, but it keeps you feeling trapped and hopeless rather than empowered to change.  You might feel paralysis because you don’t think you have the power to make decisions to take care of yourself.  In her book Moving Beyond Betrayal*, Vicki Tidwell Palmer identifies the importance of both communicating needs and setting boundaries to get your needs met.

The surest way to make ourselves crazy is to get involved in other people’s business, and the quickest way to become sane and happy is to attend to our own affairs.
— Melody Beattie

Notice when you’re feeling like a victim and/or your needs aren’t being met and explore that further.  What might be leading you to feel that way?  What ways might you be acting in a way that reinforces the message that you are a victim (ie. through rescuing or enabling)?  What are your needs?  Can you meet them on your own or do you need help?

Break the value-based messages of shame, being “good enough,” or faulty Christian teaching.

Codependent thoughts and behaviors can be intensified by feelings of shame.  Perhaps you learned lessons as a child that you were only valuable or given attention when you served others. It could be that denying your own needs and caregiving was how you demonstrated that you were a true Christian.  The Biblical truth of serving others may have been twisted such that you think you ought to accept abuse and harm without complaint because that’s the “Christian” thing to do.

Identify what messages of shame are driving your tendency to care more for others than for yourself, whether coming from your faith background or from family relationships.  Understand how those are influencing your present day and seek to affirm the reality of your value outside of what you can give to others.

Self-care is more than just a trend.

Beattie defines self-care as an attitude or perspective toward yourself and your life that reminds you that you are responsible for yourself and your own well-being.  It is a reminder that you cannot depend on the object of your obsession to take care of you perfectly and without fault.  Self-care involves kindness and grace toward yourself with corresponding loving actions.

Practice self-acceptance and remind yourself that you are okay in this present moment.  Identify your needs and set goals for self-care to learn that you are capable of making decisions to care for yourself.  Include fun and play in your self-care as you get to know the inner child within you that may have been harmed by past caregivers.  Exercise and take care of your physical health for the added mental health benefits.

Acceptance doesn’t mean settling.

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Practicing acceptance is a helpful add-on to releasing control of others.  When you acknowledge that you are the only person you can control, it requires you to admit that you are powerless over others’ behaviors.  But acceptance doesn’t mean you have to be okay with the way things are.  Instead, use acceptance to acknowledge the truth of where you are right now and assess the reality of what it will take to change.  Practicing acceptance is for you, not the other person, because it allows you to experience peace.  It may require moving through stages of grief before you can adequately feel acceptance.  Meet with a trusted friend or counselor to help you move through this grief to a place of acceptance.