Gottlieb and other tales of psychotherapy


Back in 2004, when I was in Bangalore and still fresh out of college, I was mesmerized by a book with a title that asked you to kill the Buddha if you met him. The murderous Zen title notwithstanding, the book was written by a psychotherapist who drew parallels between literary characters and his patients. I wanted to read more such books, but as I said, I was in India and it was 2004. Only in the last year have I delved deep again into the realm of psychotherapy.

To be honest, I have never actually set foot in a therapist’s office. Perhaps I’m avoidant. Maybe I can intellectualize it all and write another blog entry about some of the ideas that particularly resonated with me. In that case, let’s hope I’ve internalized them well.

“Maybe You Need to Talk to Someone”

“Therapy elicits odd reactions because, in a way, it’s like pornography. Both involve a kind of nudity. Both have the potential to thrill. And both have millions of users, most of whom keep their use private.” –Lori Gottlieb

Lori Gottlieb is a psychotherapist. Note the present tense, because she started off as a literature major and a Hollywood screenwriter. She gave up on Hollywood, went to medical school, decided that being a doctor has become too transactional and finally settled for clinical psychology. I think this path is important, because she became a therapist late and by choice. It also gives her a gift for writing and drama, which is in full display in her book, Maybe You Need to Talk to Someone.

This book is a memoir insofar as it talks about Lori having a crisis after a breakup in mid-life and then seeking her own therapy. But the book is also tapestry of several other threads. These threads are the stories of some of Lori’s patients. They look prototypical: a man who thinks everyone else is “idiotic”, a teenager with addiction issues, a lonely old woman who has trouble finding love, and a young woman who is dealt a death sentence by cancer.

Along the way, Lori drops in many concepts about our minds and relationships. She does not believe in “idiot compassion”. Instead, she gives “loving truth bombs”, such as: “if the queen had balls, she’d be the king”. There’s a beautiful chapter called Welcome to Holland: we’ve all made plans to Italy, but for some reason our plane flew to Holland and now we’re forced to be there. Can we see the beauty in Holland, even when we see other Dutch people travelling to Italy and telling us what they saw?

Yet, Lori is aware of the limitations of insight. She calls insight the “booby prize of therapy”, because unless it translates into action and reform, it really has no meaning by itself. As Freud said, repetition compulsion is a very strong force, drawing us back into habitual patterns of mistakes and defense mechanisms. Denial is not a river in Egypt, but displacement is a bitch.

Unable to confront existential truths of death, isolation, freedom and meaninglessness (Yalom), nor prepared for the changes that come in every decade (Erikson), nor equipped with a “Redo” button for our lives, we come up with elaborate stories we tell ourselves again and again.

Sometimes these stories become sentences we give to ourselves, as Lori’s therapist asks at one point: “for the mistakes you made long ago, how long of a sentence do you think is enough? Isn’t 20 years long enough of a sentence?”

If our selves are a sad sack, are we any better in relationships? No, we “seek familiarity” and “marry our unfinished business”. The philosopher Schopenhauer put it very well when he said we are like porcupines huddled on a chilly night: come too close and we start hurting each other, go too far and we start to shiver.

All this may seem very dense if you only read the few paragraphs above, but the book is 400 pages long (don’t complain – Lori says her original draft was 600 pages) and as I said earlier, it’s mostly just people and stories, with nuggets of therapy wisdom sprinkled here and there. It’s as if you’re forced to stop and think about the problem from a therapist’s point of view. Another book I read, Philippa Perry’s Couch Fiction, achieves this differently: it is a graphic novel, with therapist notes appearing at the bottom. I like Lori better.

Recommendations

I will end this post with some recommendations in this genre.

Irvin Yalom’s Love’s Executioner is a great read similar to Gottlieb, and his existential psychotherapy is something that appeals to me personally. If you like something concise, Grosz writes little stories about his patients in The Examined Life. Alain de Botton’s School of Life has a collection of beautifully written, jargon-free essays in An Emotional Education. It is medicinal: best taken a few pages at a time before bed.

On TV, I particularly loved In Treatment (HBO). This drama series, with Gabriel Byrne as the therapist in Seasons 1-3, happens almost entirely within his office. There is some therapy in The Sopranos (HBO again), but it seems more like a plot device. I have also liked listening to Esther Perel in her podcast, Where Should We Begin.

If you want to read something more formal, McWilliams is a great textbook about personality types, and Myers' Psychology for AP served me well for a broad survey of psychology as a field. Oxford’s Psychotherapy: A Very Short Introduction is a pocket-sized book that gives you a survey of psychotherapy in perhaps 2 hours.

See also