Source
We recommend using this distillation as a supplemental resource to the source material.
Full Notes
Lori Gottlieb’s Journey
- Started working in the entertainment business after college
- Worked in film development, then moved to network television at NBC
- Worked on shows like ER and Friends
- Spent time in a real ER with a physician consultant for the show ER
- Realized she enjoyed the human stories and inflection points in people’s lives
- Decided to go to medical school at Stanford
- Wanted to guide people through their lives and have long-term relationships with patients
- Felt the new medical model with managed care was not conducive to her goals
- Began writing about her experiences in medical school
- Eventually left medical school to become a journalist and author
- Later became a psychotherapist, seeing individuals and couples in her practice in Los Angeles
- Wrote the book “Maybe You Should Talk to Someone”
- Writes the weekly “Dear Therapist” column for The Atlantic
- Has a podcast called “Dear Therapists” with co-host Guy Winch
- Gave a TED Talk about how changing our stories can help us change our lives
Lori Gottlieb’s journey to becoming a psychotherapist was non-linear, starting in the entertainment business and then going to medical school. She was drawn to the human stories and inflection points in people’s lives, which led her to eventually become a therapist. In addition to her practice, she writes, speaks, and hosts a podcast about helping people navigate their struggles and grow as individuals.
Lori Gottlieb’s Journey
- Left medical school to become a journalist
- Felt she could help people tell their stories through writing
- Worked as a journalist for 10 years
- After having a baby, desired more social interaction
- Called the Dean at Stanford Medical School about returning for psychiatry
- Dean suggested getting a graduate degree in clinical psychology instead
- Became a therapist, helping people change their stories
- Feels like an editor, helping people edit their faulty narratives
Medical School Experience
- Anatomy class with cadavers
- Emotional experience, humanizing the cadavers
- Respect for the cadavers and their families’ donations
- Ceremony at the end to express gratitude
Courage to Leave Medical School
- Less risk-averse at that point in life
- Felt she only had one life to live and wanted to make choices that wouldn’t impact others
- Believed in listening to the inner voice and trusting oneself
- Helps clients in therapy find their own answers
Career Changes
- Left a job at NBC to pursue medical school
- Left medical school to become a freelance journalist
- Left journalism to become a therapist with an infant
Pursuing Passions and Facing Mortality - Decisions to change career paths were not impulsive, but well-thought-out
- Sunk cost fallacy: people argue that time and effort invested in a career should not be abandoned
- Counterargument: focus on what you want to do for the rest of your life, not what you’ve done in the past
- Julie’s story: young woman diagnosed with treatable breast cancer
- Came to therapy for support as a newlywed going through cancer treatment
- Later diagnosed with a rare, aggressive, and incurable cancer
- Asked therapist to stay with her until she died, wanted to separate therapy from the “cancer world”
- Made unconventional choices in her life, despite others thinking she was crazy
- Emphasized living life intentionally and being aware of the gift of life
Trader Joe’s and Squeegeeing: Finding Joy in Simple Tasks
- Woman with terminal illness wanted to work at Trader Joe’s
- Enjoyed the energy and connection with customers
- Wanted to make people’s day better, even for a moment
- Doctor wished for time to squeegee windshields at a gas station
- Found satisfaction in the tangible, brief interaction with customers
- Both examples show the desire for simple, meaningful tasks in life
Therapy: Dealing with Difficult Patients
- John: abrasive, unlikable, insulting
- Kept people at a distance to avoid confronting his pain
- Grew the most in therapy as he learned to communicate and face his pain
- People often make judgments about others without knowing their full story
- John becomes a character that readers care about by the end of the book
Counseling vs. Therapy
- Counseling: short-term, focused on specific issues
- Therapy: deeper, long-term exploration of emotions and behaviors
- Not about instant gratification or providing answers
- Helps patients access their own knowledge and make informed decisions
- Therapists must resist the temptation to tell patients what to do
Lori Gottlieb’s Experience with a Patient Named John
- John came to therapy presenting with sleep disturbance and blaming “idiots” for making his life difficult
- John was initially resistant to opening up and being vulnerable in therapy
- Lori Gottlieb, the therapist, worked to build a relationship with John and create a safe environment for him to share his feelings
- John eventually broke open and revealed deep pain and vulnerability
- Lori noticed differences in how men and women approach therapy and vulnerability
- Men often struggle with mixed messages about emotional availability and vulnerability
- Women may have already shared their feelings with a few close people before therapy
- Lori emphasizes the importance of the relationship between therapist and patient for successful therapy
The Importance of the Therapist-Patient Relationship
- Studies show that the most important factor in the success of therapy is the relationship between the therapist and the patient
- This relationship matters more than the therapist’s training, modality, or years of experience
- Building trust and creating a safe space for vulnerability is crucial for therapeutic progress
Therapy and Personal Growth - Therapy can help individuals rewrite their personal stories
- Gain new perspectives and interpretations of events
- Manage remorse, regret, and self-forgiveness
- Change happens gradually, then suddenly
- Lasting change requires multiple steps and maintenance
- Understanding that setbacks are part of the process
- Therapeutic relationship is crucial for progress
- Goal is to have moments of connection in each session
- Develop trust and understanding between therapist and client
- Personal growth and transformation can happen at any age
- Never too late to seek help and make changes in one’s life
- Requires commitment and willingness to face challenges
Loneliness and Therapy
- Loneliness can lead to a false sense of self
- Therapy can provide a safe space for individuals to be themselves
- Building trust and connection with a therapist can take time
Therapists Learning from Each Other
- Therapists can learn from their own therapists and apply those lessons to their practice
- Example: Wendell’s metaphor of the open prison bars, encouraging patients to take responsibility for their lives
Discussing Suicide in Therapy
- Important to assess for suicide when a patient is depressed or mentions it
- Asking about suicide does not plant the idea in their head, but rather provides an opportunity for open discussion
- One of the biggest risk factors for suicide is feeling isolated
Common Issues in Therapy
- Relational issues (romantic, familial, work, etc.) and relationship to self
- Therapy can provide a second opinion on one’s life from an unbiased perspective
Humor and Self-Deprecation in Therapy
- Recognizing the ridiculousness of human behavior can be both humorous and relatable
- Therapists can acknowledge their own flaws and experiences to connect with patients
Change and Uncertainty
- Humans often resist change due to fear of uncertainty
- Moments of unwanted change can lead to transformative experiences
Rita’s Story
- Rita is an isolated individual with estranged adult children and failed marriages
- She gives the therapist an ultimatum to help her find a reason to live by her 70th birthday
- Rita’s story highlights the importance of human connection and physical touch
The Importance of Touch and Connection - People are routinely touched during the day in various ways
- Hugging, shaking hands, high fives, etc.
- Touch is important for connection and feeling a part of the human race
Rita’s Struggles
- Felt regret for mistakes as a parent and in relationships
- Lived with a sense of isolation and lack of connection
- Had a fear of joy (cherophobia) due to childhood experiences with an inconsistent mother
- Sabotaged potential connections in her adult life
Rita’s Letter to Myron
- Reveals her shame and past mistakes
- Shows her vulnerability and desire for connection
- Asks if Myron can tolerate and accept her despite her past actions
Choosing Patients for the Book
- Author chose patients she was no longer seeing in therapy
- Ensured patients gave permission for their stories to be included
- Avoided including patients who may feel pressured to please or be the “star patient”
- Patients’ reactions to the book showed they felt cared for and understood by the author
The Importance of Emotional Health - Emotional health is often undervalued compared to physical health
- People often ignore emotional discomfort until it becomes a crisis
- Emotional health issues can cause collateral damage to relationships
- Therapy is focused on the present and making changes for a better future
- Insight alone is not enough; changes must be made in the real world
- Investing in emotional health has a high return on investment (ROI) for improving the quality of life
Misconceptions about Therapy
- Therapy is not just talking about childhood or past experiences
- It is not just downloading the problem of the week
- Insight is the first step, but real change must be made in the person’s life
- Therapy is like physical therapy; exercises must be done outside of sessions for improvement
- The ultimate goal of therapy is to improve the quality of a person’s life
Lori Gottlieb’s Work
- Author of “Maybe You Should Talk to Someone”
- Hosts the podcast “Dear Therapists”
- Writes the column “Dear Therapist” for The Atlantic
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