Maybe You Should Talk to Someone: A Therapist, Her Therapist, and Our Lives Revealed
This is a book that asks, “How do we change?” and answers with “In relation to others.” The relationships I write about here, between therapists and patients, require a sacred trust for any change to occur. In addition to attaining written permission, I have gone to great lengths to disguise identities and any recognizable details, and in some instances, material and scenarios from a few patients have been attributed to one. All changes were carefully considered and painstakingly chosen to remain true to the spirit of each story while also serving the greater goal: to reveal our shared humanity so that we can see ourselves more clearly. Which is to say, if you see yourself in these pages, it’s both coincidental and intentional.
A note on terminology: Those who come to therapy are referred to in various ways, most commonly as patients or clients. I don’t believe that either word quite captures the relationship I have with the people I work with. But the people I work with is awkward, and clients might be confusing, given that term’s many connotations, so for simplicity and clarity, I use patients throughout this book.
Patient reports feeling “stressed out” and states that he is having difficulty sleeping and getting along with his wife. Expresses annoyance with others and seeks help “managing the idiots.”
Have compassion, have compassion, have compassion . . .
I’m repeating this phrase in my head like a mantra as the forty-year-old man sitting across from me is telling me about all of the people in his life who are “idiots.” Why, he wants to know, is the world filled with so many idiots? Are they born this way? Do they become this way? Maybe, he muses, it has something to do with all the artificial chemicals that are added to the food we eat nowadays.
“That’s why I try to eat organic,” he says. “So I don’t become an idiot like everyone else.”
I’m losing track of which idiot he’s talking about: the dental hygienist who asks too many questions (“None of them rhetorical”), the coworker who only asks questions (“He never makes statements, because that would imply that he had something to say”), the driver in front of him who stopped at a yellow light (“No sense of urgency!”), the Apple technician at the Genius Bar who couldn’t fix his laptop (“Some genius!”).
“John,” I begin, but he’s starting to tell a rambling story about his wife. I can’t get a word in edgewise, even though he has come to me for help.
I, by the way, am his new therapist. (His previous therapist, who lasted just three sessions, was “nice, but an idiot.”)
“And then Margo gets angry—can you believe it?” he’s saying. “But she doesn’t tell me she’s angry. She just acts angry, and I’m supposed to ask her what’s wrong. But I know if I ask, she’ll say, ‘Nothing,’ the first three times, and then maybe the fourth or fifth time she’ll say, ‘You know what’s wrong,’ and I’ll say, ‘No, I don’t, or I wouldn’t be asking! ’”
He smiles. It’s a huge smile. I try to work with the smile—anything to change his monologue into a dialogue and make contact with him.
“I’m curious about your smile just now,” I say. “Because you’re talking about being frustrated by many people, including Margo, and yet you’re smiling.”
His smile gets bigger. He has the whitest teeth I’ve ever seen. They’re gleaming like diamonds. “I’m smiling, Sherlock, because I know exactly what’s bothering my wife!”
“Ah!” I reply. “So—”
“Wait, wait. I’m getting to the best part,” he interrupts. “So, like I said, I really do know what’s wrong, but I’m not that interested in hearing another complaint. So this time, instead of asking, I decide I’m going to—”
He stops and peers at the clock on the bookshelf behind me.
I want to use this opportunity to help John slow down. I could comment on the glance at the clock (does he feel rushed in here?) or the fact that he just called me Sherlock (was he irritated with me?). Or I could stay more on the surface in what we call “the content”—the narrative he’s telling—and try to understand more about why he equates Margo’s feelings with a complaint. But if I stay in the content, we won’t connect at all this session, and John, I’m learning, is somebody who has trouble making contact with the people in his life.
“John,” I try again. “I wonder if we can go back to what just happened—”
“Oh, good,” he says, cutting me off. “I still have twenty minutes left.” And then he’s back to his story.
I sense a yawn coming on, a strong one, and it takes what feels like superhuman strength to keep my jaw clenched tight. I can feel my muscles resisting, twisting my face into odd expressions, but thankfully the yawn stays inside. Unfortunately, what comes out instead is a burp. A loud one. As though I’m drunk. (I’m not. I’m a lot of unpleasant things in this moment, but drunk isn’t one of them.)
Because of the burp, my mouth starts to pop open again. I squeeze my lips together so hard that my eyes begin to tear.
Of course, John doesn’t seem to notice. He’s still going on about Margo. Margo did this. Margo did that. I said this. She said that. So then I said—
During my training, a supervisor once told me, “There’s something likable in everyone,” and to my great surprise, I found that she was right. It’s impossible to get to know people deeply and not come to like them. We should take the world’s enemies, get them in a room to share their histories and formative experiences, their fears and their struggles, and global adversaries would suddenly get along. I’ve found something likable in literally everyone I’ve seen as a therapist, including the guy who attempted murder. (Beneath his rage, he turned out to be a real sweetheart.)
I didn’t even mind the week before, at our first session, when John explained that he’d come to me because I was a “nobody” here in Los Angeles, which meant that he wouldn’t run into any of his television-industry colleagues when coming for treatment. (His colleagues, he suspected, went to “well-known, experienced therapists.”) I simply tagged that for future use, when he’d be more open to engaging with me. Nor did I flinch at the end of that session when he handed me a wad of cash and explained that he preferred to pay this way because he didn’t want his wife to know he was seeing a therapist.
“You’ll be like my mistress,” he’d suggested. “Or, actually, more like my hooker. No offense, but you’re not the kind of woman I’d choose as a mistress . . . if you know what I mean.”
I didn’t know what he meant (someone blonder? Younger? With whiter, more sparkly teeth?), but I figured that this comment was just one of John’s defenses against getting close to anybody or acknowledging his need for another human being.
“Ha-ha, my hooker!” he said, pausing at the door. “I’ll just come here each week, release all my pent-up frustration, and nobody has to know! Isn’t that funny?”
Oh, yeah, I wanted to say, super-funny.
Still, as I heard him laugh his way down the hall, I felt confident that I could grow to like John. Underneath his off-putting presentation, something likable—even beautiful—was sure to emerge.
But that was last week.
Today he just seems like an asshole. An asshole with spectacular teeth.
Have compassion, have compassion, have compassion. I repeat my silent mantra then refocus on John. He’s talking about a mistake made by one of the crew members on his show (a man whose name, in John’s telling, is simply The Idiot) and just then, something occurs to me: John’s rant sounds eerily familiar. Not the situations he’s describing, but the feelings they evoke in him—and in me. I know how affirming it feels to blame the outside world for my frustrations, to deny ownership of whatever role I might have in the existential play called My Incredibly Important Life. I know what it’s like to bathe in self-righteous outrage, in the certainty that I’m completely right and have been terribly wronged, because that’s exactly how I’ve felt all day.
What John doesn’t know is that I’m reeling from last night, when the man I thought I was going to marry unexpectedly called it quits. Today I’m trying to focus on my patients (allowing myself to cry only in the ten-minute breaks between sessions, carefully wiping away my running mascara before the next person arrives). In other words, I’m dealing with my pain the way I suspect John has been dealing with his: by covering it up.
As a therapist, 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. To help John, I’m going to have to figure out what his loss would be, but first, I’m going to have to understand mine. Because right now, all I can think about is what my boyfriend did last night.
I look back at John and think: I hear you, brother.