ESSENTIAL READING
The structural trick of this book is what makes it work. Gottlieb writes about four of her patients and, in alternating chapters, about her own sessions with her therapist after a sudden breakup.
So you watch her be perceptive about other people and obtuse about herself, in the same book, at the same time. That is the argument, delivered as form rather than assertion.
THE BOOK
Maybe You Should Talk to Someone was published in 2019.
The four patients are a television producer who is contemptuous of nearly everyone, a woman in her thirties with a terminal diagnosis, a woman approaching seventy who has decided to end her life on her next birthday if nothing changes, and a young woman whose drinking and relationship patterns keep repeating.
Their stories run in parallel over roughly a year, and Gottlieb's own runs alongside. Identifying details are changed and she is explicit about that.
THE AUTHOR
Lori Gottlieb had an unusual route to the chair. She worked in film and television development, went to medical school, left, became a journalist and eventually trained as a clinical psychologist.
That history is why the book is readable. She writes like someone who was a professional storyteller before she was a therapist, which is also, not coincidentally, the subject.
THE CENTRAL IDEA
The book's thesis is that people arrive with a story about their life, that the story is usually not accurate and that the therapy is largely the work of finding out what has been edited.
Gottlieb makes this literal. The television producer's account of himself changes completely once something he has been leaving out arrives. The woman who has decided on an end date turns out to be describing a different problem than the one she named. In every case the presenting complaint is real and is not the thing.
The second idea is what she calls idiot compassion, borrowed from Buddhist teaching. It is the reflexive kindness that agrees with whatever a person says about their situation, tells them they are right and confirms that everyone else is the problem. It feels supportive and it keeps people exactly where they are. The alternative is harder and is what a good therapist, and a good friend, actually offers.
The third is her treatment of change and its cost. She keeps returning to the fact that people resist change even when they are suffering, because the current arrangement contains a version of themselves that would have to be given up. The identity built around the problem is frequently the thing being defended, not the problem.
WHAT IT IS USEFUL FOR
It makes self-knowledge feel human rather than clinical, which is a real service.
For anybody who has considered therapy and has no idea what it actually involves, this is the most accurate picture available in a readable book. It shows the boring parts, the slow parts and the sessions where nothing happens.
It is also useful for people who read a great deal of psychology and can produce a fluent account of their own patterns. The book is a demonstration that fluency and accuracy are different things, delivered by someone with clinical training who is visibly wrong about herself for most of the book.
READ IT WITH THIS IN MIND
It is memoir and case narrative, not evidence. Nothing here is a finding and it should not be read as instruction.
There has also been reasonable discussion about how much of a patient's material belongs in a book, even with details changed. Gottlieb addresses it, and readers can decide whether they find the answer sufficient.
It is emotionally heavier than the premise suggests. One of the four storylines is a young woman dying, and it is handled well and is not easy.
For a colder, shorter version of the same insight, this shelf has The Examined Life.
IF YOU TAKE ONE THING
You are an unreliable narrator of your own life, and so is everybody advising you.
That is not a reason for despair. It is a reason to want somebody in the room who is not inside the story.