Your Kindle Notes For:

Maybe You Should Talk to Someone: A Therapist, HER Therapist, and Our Lives Revealed

Lori Gottlieb

Last accessed on Tuesday March 21, 2023

57 Highlight(s) | 2 Note(s)

Some highlights have been hidden or truncated due to export limits.

Yellow highlight | Page: 2 Note | Page: 2

Nothing is more desirable than to be released from an affliction, but nothing is more frightening than to be divested of a crutch. —James Baldwin

Note:

Yellow highlight | Page: 6 Note | Page: 6

I know a lot about pain, about the ways in which pain is tied to loss. But I also know something less commonly understood: that change and loss travel together. We can’t have change without loss, which is why so often people say they want change but nonetheless stay exactly the same.

Note:

Yellow highlight | Page: 9 Note | Page: 9

These shared demons are testament to the fact that we aren’t such outliers after all. And it’s with this discovery that we can create a different relationship with our demons, one in which we no longer try to reason our way out of an inconvenient inner voice or numb our feelings with distractions like too much wine or food or hours spent surfing the internet (an activity my colleague calls “the most effective short-term nonprescription painkiller”).

Note:

Yellow highlight | Page: 9 Note | Page: 9

One of the most important steps in therapy is helping people take responsibility for their current predicaments, because once they realize that they can (and must) construct their own lives, they’re free to generate change.

Note:Own caring about X

Yellow highlight | Page: 11 Note | Page: 11

the presenting problem is the issue that sends a person into therapy.

Note:

Yellow highlight | Page: 11 Note | Page: 11

Whatever the problem, it generally “presents” because the person has reached an inflection point in life. Do I turn left or right? Do I try to preserve the status quo or move into uncharted territory? (Be forewarned: therapy will always take you into uncharted territory, even if you choose to preserve the status quo.)

Note:

Yellow highlight | Page: 14 Note | Page: 14

“It never felt like the right time to bring it up.” (When my therapist friends hear this part of the story, they immediately diagnose him as “avoidant.” When my nontherapist friends hear it, they immediately diagnose him as “an asshole.”)

Note:

Yellow highlight | Page: 15 Note | Page: 15

I think about patients who present ideal scenarios and insist that they can only be happy with that exact situation. If he didn’t drop out of business school to become a writer, he’d be my dream guy (so I’ll break up with him and keep dating hedge-fund managers who bore me). If the job wasn’t across the bridge, it would be the perfect opportunity (so I’ll stay in my dead-end job and keep telling you how much I envy my friends’ careers). If she didn’t have a kid, I’d marry her. Certainly we all have our deal-breakers. But when patients repeatedly engage in this kind of analysis, sometimes I’ll say, “If the queen had balls, she’d be the king.”

Note:

Yellow highlight | Page: 16 Note | Page: 16

He hesitated to tell me, he says, because he didn’t want to be a jerk. The defense rests and is also very sorry. “You’re sorry?” I spit out. “Well, guess what. By trying NOT to be a jerk, you’ve made yourself into the world’s BIGGEST jerk!”

Note:

Yellow highlight | Page: 19 Note | Page: 19

the countries with the most therapists per capita are, in descending order, Argentina, Austria, Australia, France, Canada, Switzerland, Iceland, and the United States.)

Note:

Yellow highlight | Page: 26 Note | Page: 26

I hadn’t considered that if the only thing that keeps you going all day is knowing you’ll get to turn on the TV after dinner, you probably are depressed.

Note:

Yellow highlight | Page: 35 Note | Page: 35

You can also go on PsychologyToday.com and sort through profiles in your area.

Note:

Yellow highlight | Page: 51 Note | Page: 51

In idiot compassion, you avoid rocking the boat to spare people’s feelings, even though the boat needs rocking and your compassion ends up being more harmful than your honesty. People do this with teenagers, spouses, addicts, even themselves. Its opposite is wise compassion, which means caring about the person but also giving him or her a loving truth bomb when needed.

Note:

Yellow highlight | Page: 79 Note | Page: 79

People tend to dream without doing, death remaining theoretical.

Note:

Yellow highlight | Page: 90 Note | Page: 90

He complains that his wife is depressed (although, as the saying goes, “Before diagnosing people with depression, make sure they’re not surrounded by assholes”),

Note:

Yellow highlight | Page: 91 Note | Page: 91

I’m curious about John’s childhood because of his narcissism. His self-involvement, defensiveness, demeaning treatment of others, need to dominate the conversation, and sense of entitlement—basically, his being an asshole—all fall under the diagnostic criteria for narcissistic personality disorder.

Note:

Yellow highlight | Page: 92 Note | Page: 92

In outpatient practice, we mostly see patients in cluster B. People who are untrusting (paranoid), loners (schizoid), or oddballs (schizotypal) don’t tend to seek out therapy, so there goes cluster A. People who shun connection (avoidant), struggle to function like adults (dependent), or are rigid workaholics (obsessive-compulsive) also don’t look for help very often, so there goes cluster C. The antisocial folks in cluster B generally won’t be calling us either. But the people who experience difficulty in relationships and are either extremely emotional (histrionics and borderlines) or married to people like this (narcissists) do make their way to us. (Borderline types tend to couple up with narcissists, and we see that pairing often in couples therapy.)

Note:

Yellow highlight | Page: 112 Note | Page: 112

Jack Kornfield said: “A second quality of mature spirituality is kindness. It is based on a fundamental notion of self-acceptance.” In therapy we aim for self-compassion (Am I human?) versus self-esteem (a judgment: Am I good or bad?

Note:

Yellow highlight | Page: 118 Note | Page: 118

Honesty is stronger medicine than sympathy, which may console but often conceals. —Gretel Ehrlich

Note:

Yellow highlight | Page: 138 Note | Page: 138

Whenever one person in a family system starts to make changes, even if the changes are healthy and positive, it’s not unusual for other members in this system to do everything they can to maintain the status quo and bring things back to homeostasis. If an addict stops drinking, for instance, family members often unconsciously sabotage that person’s recovery, because in order to regain homeostasis in the system, somebody has to fill the role of the troubled person. And who wants that role? Sometimes people even resist positive changes in their friends: Why are you going to the gym so much? Why can’t you stay out late—you don’t need more sleep! Why are you working so hard for that promotion? You’re no fun anymore!

Note:

Blue highlight | Page: 150 Note | Page: 150

PEACE. IT DOES NOT MEAN TO BE IN A PLACE WHERE THERE IS NO NOISE, TROUBLE, OR HARD WORK. IT MEANS TO BE IN THE MIDST OF THOSE THINGS AND STILL BE CALM IN YOUR HEART.

Note:

Yellow highlight | Page: 153 Note | Page: 153

Why do we keep our radios tuned to the same static-ridden stations (the everyone’s-life-is-better-than-mine station, the I-can’t-trust-people station, the nothing-works-out-for-me station) instead of moving the dial up or down? Change the station. Walk around the bars. Who’s stopping us but ourselves?

Note:

Yellow highlight | Page: 154 Note | Page: 154

I’ll say to a patient who has bought the ring but can’t seem to find the right time to propose to his girlfriend, “I don’t think you’re sure you want to marry her,” and he’ll say, “What? Of course I am! I’m doing it this weekend!” And then he goes home and doesn’t propose, because the weather was bad and he wanted to do it at the beach. We’ll have the same dialogue for weeks, until one day he’ll come back and say, “Maybe I don’t want to marry her.” Many people who say, “No, that’s not me,” find themselves a week or a month or a year later saying, “Yeah, actually, that’s me.”

Note:

Yellow highlight | Page: 162 Note | Page: 162

While suicidal thoughts—known as suicidal ideation—are commonplace with depression, most people respond to treatment and never act on those hopeless impulses. In fact, it’s as patients begin to get better that the risk for suicide increases. During this short window, they’re no longer so depressed that eating or dressing seem like monumental efforts but they’re still in enough pain to want to end it all—a dangerous mix of residual distress and newfound energy. But once the depression lifts and suicidal thoughts subside, a new window opens. That’s when the person can make changes that improve life significantly over the long term.

Note:

Yellow highlight | Page: 163 Note | Page: 163

A therapist is supposed to be a container for the hope that a depressed person can’t yet hold,

Note:

Yellow highlight | Page: 165 Note | Page: 165

“The opposite of depression isn’t happiness, but vitality.”

Note:

Yellow highlight | Page: 193 Note | Page: 193

It’s not that people want to get hurt again. It’s that they want to master a situation in which they felt helpless as children. Freud called this “repetition compulsion.” Maybe this time, the unconscious imagines, I can go back and heal that wound from long ago by engaging with somebody familiar—but new. The only problem is, by choosing familiar partners, people guarantee the opposite result: they reopen the wounds and feel even more inadequate and unlovable.

Note:

Yellow highlight | Page: 266 Note | Page: 266

I try to wrap my mind around this paradox: self-sabotage as a form of control. If I screw up my life, I can engineer my own death rather than have it happen to me. If I stay in a doomed relationship, if I mess up my career, if I hide in fear instead of facing what’s wrong with my body, I can create a living death—but one where I call the shots.

Note:

Yellow highlight | Page: 266 Note | Page: 266

Death, of course, is an instinctive fear that we often repress but that tends to increase as we get older. What we fear isn’t just dying in the literal sense but in the sense of being extinguished, the loss of our very identities, of our younger and more vibrant selves. How do we defend against this fear? Sometimes we refuse to grow up. Sometimes we self-sabotage. And sometimes we flat-out deny our impending deaths. But as Yalom wrote in Existential Psychotherapy, our awareness of death helps us live more fully—and with less, not more, anxiety.

Note:

Yellow highlight | Page: 268 Note | Page: 268

the fourth ultimate concern: meaninglessness.

Note:

Yellow highlight | Page: 277 Note | Page: 277

It’s the not knowing that torments John. I think about how it’s the not knowing that torments all of us. Not knowing why your boyfriend left. Not knowing what’s wrong with your body. Not knowing if you could have saved your son. At a certain point, we all have to come to terms with the unknown and the unknowable. Sometimes we’ll never know why.

Note:

Yellow highlight | Page: 280 Note | Page: 280

I think, too, about how there are many ways to defend oneself from the unspeakable. Here’s one: you split off unwanted parts of yourself, hide behind a false self, and develop narcissistic traits. You say, Yeah, this catastrophic thing has happened, but I’m A-Okay. Nothing can touch me because I’m special. A special surprise. When John was a boy, wrapping himself in the memory of his mother’s delight was a way to shield himself from the horror of life’s utter unpredictability. He may have comforted himself this way as an adult too, clinging to how special he was after Gabe died. Because the one certainty that John can count on in this world is that he is a special person surrounded by idiots.

Note:

Yellow highlight | Page: 289 Note | Page: 289

“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

Note:

Yellow highlight | Page: 310 Note | Page: 310

these comments are meant to comfort, but they’re also a way of protecting the speakers from the uncomfortable feelings that somebody else’s bad situation stirs up. Platitudes like these make a terrible circumstance more palatable for the person saying the words but leave the person experiencing the adversity feeling angry and alone.

Note:

Yellow highlight | Page: 310 Note | Page: 310

One thing that has surprised Julie about going through the process of watching herself die is how vivid her world has become.

Note:

Yellow highlight | Page: 316 Note | Page: 316

Just as I don’t want a meaningless relationship, I don’t want to write a meaningless book, even though by now I’m three-fourths done. If death and meaninglessness are “ultimate concerns,” it makes sense that this book I care little about has plagued me—and also that I turned down the lucrative parenting book before that.

Note:

Yellow highlight | Page: 316 Note | Page: 316

Wendell has helped me to let go of the story that everything would have worked out for me if I’d married Boyfriend, and there’s no point in holding on to the parallel story that the parenting book would have made everything work out for me too—both are fantasies. Certain things would have been different, sure. Ultimately, though, I’d still be itching for meaning, for something deeper. Just like I am now, with this stupid happiness book that my agent says I have to write for all kinds of practical reasons.

Note:

Yellow highlight | Page: 323 Note | Page: 323

Just a week before, a patient had told me that she couldn’t go a single night without turning on her TV, falling asleep to it, and waking up hours later. “Where did my evening go?” she asked from my couch. But the real question was, where had her feelings gone?

Note:Mom

Yellow highlight | Page: 326 Note | Page: 326

Though we travel the world over to find the beautiful, we must carry it with us, or we find it not. —Ralph Waldo Emerson

Note:

Yellow highlight | Page: 331 Note | Page: 331

much of what therapists do is work in the present, where we bring awareness to what’s going on in people’s heads and hearts in the day-to-day. Are they easily injured? Do they often feel blamed? Do they avoid eye contact? Do they fixate on seemingly insignificant anxieties? We take these insights and encourage patients to practice making use of them in the real world. Wendell once put it this way: “What people do in therapy is like shooting baskets against a backboard. It’s necessary. But what they need to do then is go and play in an actual game.”

Note:

Yellow highlight | Page: 332 Note | Page: 332

The inability to say no is largely about approval-seeking—people imagine that if they say no, they won’t be loved by others. The inability to say yes, however—to intimacy, a job opportunity, an alcohol program—is more about lack of trust in oneself. Will I mess this up? Will this turn out badly? Isn’t it safer to stay where I am?

Note:

Yellow highlight | Page: 332 Note | Page: 332

when I was complaining about the way a relative would try to make me feel guilty, my father quipped, “Just because she sends you guilt doesn’t mean you have to accept delivery.”

Note:

Yellow highlight | Page: 333 Note | Page: 333

you don’t drop all of your defenses at the same time. Instead, you release them in layers, moving closer and closer to the tender core: your sadness, your shame.

Note:

Yellow highlight | Page: 333 Note | Page: 333

“I just don’t want to wake up five years from now and never have had any kind of relationship,” she says. “Five years from now, a lot of people my age won’t be single anymore, and I’ll be the girl who hooks up with a guy in the waiting room or her neighbor and then tells the story at a party like it’s just another adventure. Like I don’t even care.” “The cool girl,” I say. “The one who has no needs or feelings and just goes with the flow. But you do have feelings.” “Yeah,” she says. “Being the cool girl feels like shit.” She’s never admitted this before. She’s taking off her beekeeper suit. “Is ‘like shit’ a feeling?” she asks. “It sure is,” I say.

Note:

Yellow highlight | Page: 336 Note | Page: 336

There’s no hierarchy of pain. Suffering shouldn’t be ranked, because pain is not a contest.

Note:

Yellow highlight | Page: 336 Note | Page: 336

by diminishing my problems, I was judging myself and everyone else whose problems I had placed lower down on the hierarchy of pain. You can’t get through your pain by diminishing it, he reminded me. You get through your pain by accepting it and figuring out what to do with it.

Note:

Yellow highlight | Page: 343 Note | Page: 343

researcher Daniel Gilbert at Harvard found that in responding to challenging life events from the devastating (becoming handicapped, losing a loved one) to the difficult (a divorce, an illness), people do better than they anticipate. They believe that they’ll never laugh again, but they do. They think they’ll never love again, but they do. They go grocery shopping and see movies; they have sex and dance at weddings; they overeat on Thanksgiving and go on diets in the New Year—the day-to-day returns.

Note:

Yellow highlight | Page: 344 Note | Page: 344

feelings are actually more like weather systems—they blow in and they blow out. Just because you feel sad this minute or this hour or this day doesn’t mean you’ll feel that way in ten minutes or this afternoon or next week.

Note:

Yellow highlight | Page: 348 Note | Page: 348

This strategy, in which the therapist instructs patients not to do what they’re already not doing, is called a paradoxical intervention. Given the ethical considerations involved, a therapist has to be well trained on how and when to use paradoxical directives, but the idea behind them is that if patients believe that a behavior or symptom is beyond their control, then making it voluntary, something they can choose whether or not to do, calls that belief into question. Once patients realize that they’re choosing a behavior, they can examine the secondary gains—the unconscious benefits it offers (avoidance, rebellion, a cry for help).

Note:

Yellow highlight | Page: 348 Note | Page: 348

“living on borrowed time”: our lives are literally on loan to us. Despite what we think in our youth, none of us have all that much time.

Note:

Yellow highlight | Page: 350 Note | Page: 350

In couples therapy, therapists talk about the difference between privacy (spaces in people’s psyches that everyone needs in healthy relationships) and secrecy (which stems from shame and tends to be corrosive). Carl Jung called secrets “psychic poison,” and after all of the secrets I’ve kept from Wendell, it feels good to have this final secret out in the open.

Note:

Yellow highlight | Page: 355 Note | Page: 355

we’re all time-traveling into the future and at exactly the same rate: sixty minutes per hour.

Note:

Yellow highlight | Page: 366 Note | Page: 366

Displacement’s a bitch, isn’t it? We all use defense mechanisms to deal with anxiety, frustration, or unacceptable impulses, but what’s fascinating about them is that we aren’t aware of them in the moment. A familiar example is denial—a smoker might cling to the belief that his shortness of breath is due to the hot weather and not his cigarettes. Another person might use rationalization (justifying something shameful)—saying after he’s rejected for a job that he never really wanted the job in the first place. In reaction formation, unacceptable feelings or impulses are expressed as their opposite, as when a person who dislikes her neighbor goes out of her way to befriend her or when an evangelical Christian man who’s attracted to men makes homophobic slurs. Some defense mechanisms are considered primitive and others mature. In the latter group is sublimation, when a person turns a potentially harmful impulse into something less harmful (a man with aggressive impulses takes up boxing) or even constructive (a person with the urge to cut people becomes a surgeon who saves lives). Displacement (shifting a feeling toward one person onto a safer alternative) is considered a neurotic defense, neither primitive nor mature. A person who was yelled at by her boss but could get fired if she yelled back might come home and yell at her dog.

Note:

Yellow highlight | Page: 369 Note | Page: 369

“The nature of life is change and the nature of people is to resist change.”

Note:

Yellow highlight | Page: 379 Note | Page: 379

risks she’s taken to begin to move from a position of ossification to one of openness, from self-flagellation to something closer to self-acceptance.

Note:

Yellow highlight | Page: 383 Note | Page: 383

I’ve told her about the many relationships I’ve seen implode simply because one person was terrified of being abandoned and so did everything in his or her power to push the other person away. She is starting to see that what makes self-sabotage so tricky is that it attempts to solve one problem (alleviate abandonment anxiety) by creating another (making her partner want to leave).

Note:

Yellow highlight | Page: 390 Note | Page: 390

deathbeds themselves are often a stew of drugs, fear, confusion, weakness. That’s why it’s especially important to be the people we want to be now, to become more open and expansive while we’re able.

Note:

Would you like to take some notes?

You haven’t created any notes for this book yet. You can add or remove bookmarks, highlights, and notes at any location in a Kindle book.

Learn more about notes and highlights

Sorry, we''ve experienced a problem. Please try again.