From the Archive: Lori Gottlieb — What Your Therapist Is Really Thinking

11:07Lori Gottlieb:Right, right. Well, in the book, one of the patients that I see is this very self-entitled Hollywood producer. And at our very first session, he tells me that he's gonna pay in cash because he doesn't want his at the door, because he doesn't want his wife to know that he's seeing a therapist. And he says, you'll be like my mistress. I'll just come here every week, dump all my problems on you and leave. Or actually not my mistress, more like my hooker, because you're not the kind of person I would choose as a mistress. that was hard to like.

11:36James Altucher:Yeah. Like, why would someone say that? Like, there's sort of a control thing there in someone saying that.

11:42Lori Gottlieb:There's a lot of cluelessness and a lot of, yeah, a lot of ways of kind of pushing people away, of not wanting to let people know that you need them, that you need their help.

11:53James Altucher:But someone who's like such a success in their field, it doesn't matter if he's a Hollywood producer or anything, but in this case, he's a Hollywood producer, so he's had success in, he's had to work well with people because to be a producer, you have to convince studios, directors, actors to all fit into your agenda. How could he be so clueless in this one case as to say something that's so tone deaf?

12:17Lori Gottlieb:Right, right. Well, I think he's tone deaf more generally. You know, he can fake it at work, but he's very impatient with people. He has a lot of trouble. You know, everybody's an idiot in his mind. You know, his whole thing is sort of like, how do you manage the idiots?

12:32James Altucher:So are we talking about Scott Rudin here? I don't know in person. I just read stories. Anyway, I'm just kidding.

12:38Lori Gottlieb:We're not talking about Scott Rudin.

12:41James Altucher:Yeah, so what do you do? How did you find the likable in him? I mean, A, okay, you could say that was a little bit funny, what he's saying, if he didn't really mean it.

12:49Lori Gottlieb:Well, he kind of delivered it as a joke, but, you know, not a joke. Right. Yeah.

12:56James Altucher:So how did you find your way through the maze there?

12:58Lori Gottlieb:Well, I think what you have to do is, you know, you have to really get to know somebody. I mean, what my supervisor was saying was, you know, once you get to know somebody deeply, it's very hard not to find something likable in them. And I think that's true. I think we would have world peace, actually, if, you know, you get the world leaders in a room together and you have them really get to know, you know, their hopes, their fears, their vulnerabilities. People become very human in that way.

13:19James Altucher:But clearly some people don't like other people. Like, that's why divorces happen. Like, in every relationship, for any two people, if they just knew each other deeply, would they always like each other or should some people?

13:31Lori Gottlieb:I think they would find things that were likable about the other person. It doesn't mean that they would be compatible, but it means that they would find something that they could connect with on a human level about the other person.

13:40James Altucher:What are some other things that I would not expect my therapist is thinking while I'm in therapy?

13:47Lori Gottlieb:Well, going back to the boring question, you know, I think a lot of people worry about whether they're boring their therapist. And the boring people are not the people who come in with, you know, quote unquote, trivial problems. The boring people are the people who don't let you get, they don't want to be known. And so they deflect, they smile through their session. You know, they go off on tangent after tangent after tangent when you try to kind of get in there with them. They're people who keep you at bay. Those are the most boring people, the people who keep you at bay. They won't let you in.

14:19James Altucher:And how do you break through?

14:22Lori Gottlieb:You point out what's going on in the room. You tell them about your experience. I wouldn't necessarily use the word boring, but I would talk about the fact that it's really hard for me to connect with them in the room. It's really hard to figure out sort of, you know, what they're trying to tell me. So I find what you just said in my head,

14:43James Altucher:I've been calling that type of thing labeling, where you're having an interaction with somebody where it's not going, you don't understand what's happening or it's not going the way you want or it's an argument or whatever. and I find it to be very useful to take a step back and label what's happening. Like, did they just change the subject instead of the original subject or are they not answering a question or they're answering a question with a question? Like, I find it's useful to label what's happening in the conversation. Is that sort of what you're doing there to break through?

15:12Lori Gottlieb:Yeah, it's sort of pointing out, you know, what's going on between us. Out in the world, people don't do that, right? It would be very stilted and odd. Okay, okay. But I think out in the world in general, Maybe in your relationships, you do it. But just when we're having conversations with people, you know, we don't tend to point out all the subtleties that are going on beneath the surface. But in the therapy room, that's really a place where people are at their most human. And so I think when they're at their most human, you can say, hey, we're going to talk on this level. And it's not weird.

15:42Lori Gottlieb:And in fact, it clears out a lot of the junk, right? It clears out a lot of the trash so that you guys can have a conversation about what you really need to be talking about.

15:50James Altucher:So like with this Hollywood producer, were you able to say when you got comfortable enough in therapy, were you able to say, hey, that way you introduced yourself was probably inappropriate? And do you do that with other people?

16:01Lori Gottlieb:Not in the first session, no. I mean, it was at the door. He was leaving. It made me curious. I sort of tagged that for the future, you know, in my head. And we do that a lot as therapists. We tag things, you know, it's like timing is really important in therapy. And so we work really hard to help people to struggle less, but we have to form a relationship with them first. And so if we can't form a relationship with them, nothing we say is going to sink in with them. They're not going to be receptive to it. So we do a lot in the beginning. We front load with establishing the relationship.

16:32James Altucher:And how do you do that considering most relationships are give and take, but you're never revealing about yourself? Like that's kind of taboo in therapy. Like how do you do that without being vulnerable yourself?

16:43Lori Gottlieb:You know, I think that people want to be understood. And so if a person feels heard and respected and understood, that's going to make them trust you more. And I think too that, you know, we do reveal things about ourselves in therapy. I don't mean that we reveal, you know, extremely personal things, but I think that, you know, there are times when we very strategically and very intentionally will reveal something if we think it will benefit the patient in that moment.

17:08James Altucher:Like what?

17:09Lori Gottlieb:Someone might want to know that I have a kid. If they're really struggling with something with their kid or that I've experienced that with my own kid. You know, somebody might want to know that I struggled with choosing the right career. I won't necessarily say that kind of thing often, but if it comes up and if it's really related to that, an example that's not me would be, I've had colleagues who a parent committed suicide and someone came in and that person's parent committed suicide and that person decided not to reveal that. But another person had a kid who had Tourette's and that therapist had a kid with Tourette's and she revealed it.

17:47Lori Gottlieb:And it ended up really, really being meaningful to the person who came to see her.

17:52James Altucher:Do you ever find yourself judging your patients? So if someone comes in and says something you find ethically horrifying, do you say it? Do you say, well, what do you do?

18:07Lori Gottlieb:I don't. I think in the beginning it was harder. I think when I was doing my internship and people were telling me all of these different things, I think that I wanted to put a lot of distance between my dark side and their dark sides. But I think that what you come to see is that, you know, they made these decisions for a reason and they're coming to you because they actually want help with it. And so I think that that's important to remember. And I think the other part of it is that, you know, more than judging people, people will do things that just, you know, basically ensure their own happiness.

18:38Lori Gottlieb:You know, they keep like doing the same thing over and over or they'll say, I'm about to do this or make this decision. And I want to say, no, don't do it. You know, because they just keep sort of screwing up their lives. And so you want to kind of step in there. And it's like, don't go in the basement again. It's dark down there. So it's less judgment and more kind of protectiveness, I think.

18:59James Altucher:And so are you able to say, you can't say don't do this, but what do you say? Do you remind them the last 10 times they did something?

19:07Lori Gottlieb:I might say, why in the world would you do that? you know I mean I have to have a relationship with them first I wouldn't say that early on but I would say that after I got to know them like you know what why in the world would you make that decision it sounds really judgmental when I'm saying it here but in the context of our relationship

19:25James Altucher:prior times when they've made similar decisions oh yeah so that you could back up that statement

19:30Lori Gottlieb:oh yeah yeah

19:34James Altucher:take a quick break if you like this episode I'd really really appreciate it it would mean so much to me Please share it with your friends and subscribe to the podcast. Email me at altitra at gmail.com and tell me why you subscribed. Thanks.

19:58James Altucher:So I'm always trying to hear, I feel like there's this great opportunity here where I could just figure out everything my therapists through the ages are thinking about me that I never knew about. So like what else would be something that a therapist might think that the patient's not expecting or suspecting?

20:15Lori Gottlieb:I think that people don't realize that we care too about what our patients think of us to some degree. So, you know, I have a chapter in the book called Embarrassing Public Encounters, where, you know, when people see their therapist outside of the office, nobody knows who they are except for the patients. We're like Z-list celebrities, Like nobody knows except for the person who goes to them. And so, you know, you don't want to be, you know, you want to present well outside of the office. And there are times that, you know, you'll run into your patients in these really kind of embarrassing situations.

20:49Lori Gottlieb:And I think that people forget that we're human too. And we're just, you know, people in the world. I think it's kind of like your teachers when you're a kid. You know, like you only imagine them in the classroom. And if you see them out in the world, it's a very, it's very discombobulating. I think it's the same thing that therapists are kind of thought of as, you know, they exist in the office, but they don't exist outside the office.

21:07James Altucher:So, okay. So therapists also care what their patients think of them. Like, how should the patient, how can the patient make use of that to have the best possible relationship with the therapist?

21:21Lori Gottlieb:I think that, you know, there's nothing.

21:23James Altucher:Like, should the patient say, hey, you helped me last week. That was really good.

21:26Lori Gottlieb:Yeah. I mean, you know, positive feedback is nice, but I think there are also people who do that a lot because they want to ingratiate themselves with the therapist. I don't think there's anything the patient should do. It's just a reality that, you know, we want to help people. And when people, you know, we want people to respect us just like we want, just like the people who come to us want to be respected by us.

21:49James Altucher:One thing I've noticed, there's like all these different kinds of therapy, And I mentioned earlier that I almost view therapy as like statistics. An example might be, oh, somebody I'm very close to is mentally ill. I've been in this caretaker role. What usually happens? And then they've seen that situation a thousand times, and they say, okay, well, you should be doing this, this, this, and this. And usually they're correct about what they suggest. Right. And so I find at least the therapists I've gone to and the ones that have been, I only go to a therapist when he or she's been recommended to me.

22:28James Altucher:Nobody really asks me about my past anymore. Or actually, I don't even know if it's ever happened. No one's asked me about my parents. I don't think I've ever spoken to a therapist about my parents. Is that like unusual? Because I would think normally that the cliche is, you know, tell me about your mother. Tell me about your father.

22:45Lori Gottlieb:Well, why are you going to therapy?

22:47James Altucher:I mean, it's different reasons. I mean, it's over the past 26 years, it's different reasons each time. This past set of years is because I was dealing with someone close to me who was mentally ill and it just kind of evolved out of that.

23:03Lori Gottlieb:Why do you keep switching therapists?

23:05James Altucher:Usually I would go until I felt like I either wasn't getting anything anymore out of the relationship with the therapist or I thought that the therapist was not that good or because like any profession, 80 % might be not that great and 20 % are good and it takes a while to realize. Or I might have moved and then when I moved, I didn't restart anything with anybody. So it's usually not me saying, oh, everything is totally solved and I don't need therapy anymore. It's usually some other, either they've demonstrated that they've given very bad advice and I couldn't follow it or...

23:52Lori Gottlieb:What kind of advice was bad advice that you got?

23:55James Altucher:I'll give you an example. One time I was, so I have two kids from my first marriage. And one time I was with somebody who didn't really get along with my kids or didn't want to be in the house at the same time as my kids. And so if I wasn't there and my kids were knocking on the door, even though they had their own bedroom in my house, she wouldn't answer the door. And we went to a couples therapist, and the couples therapist agreed with her that I had to be there. And they were very quiet, good kids, not disciplined problems in any way. They would just go into their bedroom and study. And I thought that was bad advice.

24:36James Altucher:And so I stopped going then.

24:39Lori Gottlieb:But you kind of knew your answer, right, before you went to the therapist? Like something felt wrong about that.

24:45James Altucher:Yeah.

24:46Lori Gottlieb:Yeah. Yeah. So what were you wanting from the therapist? Like corroboration or? Yeah, or maybe explaining to both of us how we could compromise on this issue

24:59James Altucher:instead of just saying, okay, James has to be in the house when they're there. You know, I didn't like being in the middle between this woman I was seeing and my kids.

25:10Lori Gottlieb:Right.

25:10James Altucher:So I kind of wanted a solution with that, and I felt we were very far. We were like 10 steps away from getting anything what I wanted in that conversation.

25:24Lori Gottlieb:What's so interesting to me about that, and it's so common, is that you were going to therapy because you wanted a solution, right? You wanted to kind of work that out. but I don't know what went on in your couples therapy but I would imagine that the real issue was between you and your girlfriend what's her deal with your kids?

25:44James Altucher:Yeah, I guess we didn't really get to any of that so maybe I could have pursued the conversation that way I just didn't know how

25:52Lori Gottlieb:Right, most people don't

25:54James Altucher:and I think I tend to be afraid I'm very non-confrontational So I'm hoping the therapist could kind of handle the confrontation part somehow.

26:05Lori Gottlieb:Right. Well, what you bring up is such an interesting point because it's the question of, you know, do people go to therapy to get a solution to a problem? Like a very concrete prescriptive advice, like in my advice column. Sometimes I do go for that. Right? So like if you had written that into my dear therapist column, I would give you an answer. But if you came into my therapy office, because with my column, I only have a letter. I don't have the context. I don't have the other person's side of the story. I have one person's side of a story, and we're all unreliable narrators. And what I mean by that is we're not lying.

26:36Lori Gottlieb:We're just telling the story through our particular lens. So it's always very interesting to me. Like, for example, if I'm treating a couple and a colleague of mine is treating one of the individuals, and if we have to confer about anything, and we have releases to do that. It's so interesting because the person seeing the individual only knows one side of the story. and I see the couple every week and I have a much fuller picture of what's going on. And so if you wrote that letter to Dear Therapist, you know, I'd have a very specific answer for you. If you came in with your girlfriend, I wouldn't have that specific answer.

27:09Lori Gottlieb:I'd want you guys to start talking about, well, how does she feel about kids in general? How does she feel about your kids? How do you feel about being with somebody who treats your kids that way?

27:19James Altucher:Right, well, it all ended up working out one way or the other, but you address something similar in one of your Dear Therapist letters where someone's spouse didn't like the husband's friend. Yes. So they couldn't spend a lot of time with his friends. And you make the point that when someone marries somebody, they're not just marrying the person, they're marrying the whole package of friends, family, and so on, which I felt was related to this issue I had. But then you offer various ways to compromise, which I thought was very fair. given that you didn't know the full story on both sides. So a lot of times with your columns, I sort of look at the column and try to figure out how it fits into my own life.

28:05James Altucher:Because after so many relationships and jobs and situations and decades of living, almost every situation can fit into some other situation that I relate to. So I think that's a big benefit of your, you should collect your columns into a book too.

28:22Lori Gottlieb:Maybe. I'm focused on the first one.

28:24James Altucher:That could be like a companion book too. Exactly.

28:26Lori Gottlieb:Exactly.

28:27James Altucher:So do therapists ever Google their patients? You're not supposed to, but do they ever do it?

28:47Lori Gottlieb:Do they Google their patients? That's such a great question because when I, my very first patient, so I was, the way that therapists train is that you go, it's like doctors in a teaching hospital, right? And I went to medical school before this. And in medical school, you know, there's this saying like, see one, do one, teach one. That's how you learn. Like you watch someone, you know, palpate an abdomen or start an IV. You do one yourself and then you teach one to the next medical student, right? It's just trial by fire. And it's the same thing with therapy is that you go into your first therapy room, you've watched a lot of hours of tape, you've done all your graduate work, but you've never been in a room by yourself and you can't have someone else in there with you.

29:27Lori Gottlieb:It's not like, can you bring my supervisor in with me? So the first person that I see is this woman who I know nothing about. There's like a little intake form that just name, address, you know, age, that kind of thing. And she comes in and she tells me that she's really depressed. and the next thing I know she is crying, but like crying like, you know, level four tsunami. It just, it's not anything that, there was no warmup. There was no like, you know, a little bit of tears in conversation leading to this. And I just, you know, didn't know what to do. And so, I'm sorry, back to your question was.

30:03James Altucher:Do Google.

30:04Lori Gottlieb:Oh, do Google. So this woman, and then the more I started talking to her, the more I found out that, you know, she was like very successful and she had a boyfriend and, you know, all these things about her life. And I was like, that's really interesting. She was really, really falling apart in the room. She was like unkempt. She hadn't showered in a while, you know, all that stuff. So I actually Googled her just to see, like, who is this person? And my supervisor said, never do that. And I never did it again. I didn't know. I thought it was like going to help me get some information about her.

30:38Lori Gottlieb:but it didn't. You want to just have the relationship in the room with them. You don't want to have any additional information because it kind of sits there, you know, between you.

30:47James Altucher:Why? Like, it seems like you would want as, like, information is power so you'd want to know as much about the person as possible.

30:53Lori Gottlieb:But I also think that what people choose to reveal to you is very important to getting to know them. So what they choose to reveal and when they choose to reveal it is all kind of grist for the mill.

31:04James Altucher:Let's take the example of the Hollywood producer again. because he's very Google-able.

31:08Lori Gottlieb:Did not Google him.

31:09James Altucher:Right. So one thing he told you in that communication, all I know is his communication to you when he's paying. And the first thing he said to you that stands out is not so much the hooker or the mistress, but the fact that he didn't want his wife to know that he was in therapy. So that seems like a real informative thing. And then, of course, how he behaved afterwards, that could indicate all sorts of things. But the critical thing, it seemed to me, was somehow he didn't have this open line of communication with his wife that he could say he was sharing his issues with a professional when that's a very common thing.

31:44James Altucher:Right. But then using Google, does this Hollywood producer just make X-rated movies or does he make cartoons for kids? It seems this would be useful information to know.

32:00Lori Gottlieb:Yes, but it would come out over time. and more than sort of what he does was sort of what I'm most interested in with any patient is how do they interact with me in the room? Because whatever people do in the room, they inevitably do outside. We all do. I do too. Whatever I did with my therapist and therapy, I do outside in the world. For example, going back to Google, I Googled my therapist. I've never Googled my therapist.

32:28James Altucher:Right.

32:28Lori Gottlieb:This was the first time I'd ever done that and it was in the context of he was, he was, it was something that he had said in the room and I was trying to do the thing that he said. And instead I was at my computer and I typed in his name and, and I'd been seeing him for a while at that point. This wasn't, I wasn't new to him. And I found out all of these things about him. One of them was that his father had died suddenly at a, you know, at a young age. And so another time I was in therapy and I was talking about my own father with whom I'm very close. And I was talking about how he was aging and I was having a hard time dealing with the fact that I'm worried that he's going to die.

33:08Lori Gottlieb:And I realized that my father is in his 80s and my therapist father died much younger and he never had a father in his 80s. And I edited myself because I was worried that it would be painful for him to talk about, for me to talk about.

33:22James Altucher:So it's almost just as bad for the patient to Google the therapist. Right, right, because you edit yourself.

33:27Lori Gottlieb:And also, it's really embarrassing that you Googled your therapist. And so, you know, I knew who his wife was because I Googled. You know, I didn't know her personally, but I mean, like, I knew lots of facts about him. I knew how old his kids were. I knew a lot of things because there's a lot of stuff on the internet. Even if you don't want to be found, you can find it. So, you know, there were times when, you know, like, I had to be careful not to drop in that I knew something. And eventually, I fessed up, and we had a conversation about that.

33:53James Altucher:so so whenever i enter a therapy session feels very awkward like you sit it's like come on in sit there how do you begin what's the best way to begin talking like i usually don't even know

34:05Lori Gottlieb:what to talk about right those are and you know sometimes also just sorry to interrupt but

34:10James Altucher:sometimes i feel like oh my gosh i have no problems this week or nothing's really come up like it's almost like homework like i think of some problem to talk about on the way there yeah

34:22Lori Gottlieb:Yeah, yeah. No, we've all had that experience. I think, you know, it's like, things are really good. I don't really want to go to therapy today. But I think those are actually the best sessions because if you come with an agenda, you end up talking about that thing the whole time. And if you come in and you just take a minute, and a lot of people have trouble kind of sitting in silence. And it feels like forever. If we say like three minutes of sitting in silence, it feels like 10. But if you just come in and you kind of, you know, you have to kind of make that adjustment from the outside world where you've got your mind going, those tend to be the sessions where you have no agenda, you have no preconceived topic, and wherever your mind wanders to is usually a really, really fruitful place.

35:06So sometimes I'll go in, I feel this is like a real personal podcast.

35:10James Altucher:Like I keep talking about, it feels very vulnerable to keep talking about the fact that I go to therapy. There's still, not that there's a stigma to it, but there is a little tiny bit. There is, I think. Yeah. But sometimes I'll go in and she'll say, so what's going on this week? How are you doing? And even though I might have something on my head that is a problem, I'm almost afraid to say it. Because I don't want to just go in and start, I usually don't see people and start complaining about my life. So I feel awkward.

35:36Lori Gottlieb:Right. Right. Yeah. Yeah.

35:39James Altucher:It's hard to break that initial ice each session.

35:42Lori Gottlieb:Yeah, and I think there is really just a big sort of just like mental transition from the way we interact in the outside world to walking into a room where there are no phones, nothing's beeping, there are no distractions, there's no screen anywhere, there aren't other people in the room, and you're sitting face-to-face with another person. We get that so rarely nowadays. Yeah, and I guess maybe that's why I use the metaphor of the statistician

36:10James Altucher:because it's almost like drying up the content of that interaction to being almost like a math equation feels a little easier. Like, okay, I'm dealing with, you know, one plus two plus three. What's the answer?

36:27Lori Gottlieb:Right. See, yeah, I think therapy really is so relational. It's sort of the opposite of the statistician. It's incredibly relational. It's very intimate. And I think that, you know, there are things that it's not really so much what I know about people, but experiences that I've had in the room with people that are incredibly powerful and moving.

36:52James Altucher:Like what?

36:53Lori Gottlieb:You know.

36:54James Altucher:That difference between knowing and experiencing.

36:57Lori Gottlieb:Dealing with the woman who was dying of cancer, right? You know, she was going through her death, processing her dying with me. And I had never done that before with someone young. I'd done that with older people, but I'd never done that with someone in her 30s.

37:11James Altucher:Did you feel self-doubt? Did you feel unqualified?

37:14Lori Gottlieb:I did. I actually didn't want to take her on, and I told her that. But she wanted to come to me because she didn't want to be with what she called the cancer team. She didn't want all the sort of pink ribbons and sugarcoating and optimism. She knew she was dying, and she wanted to be with someone who would see her as a person first and a cancer patient second. and she felt like with the kind of, with the cancer specialist that, and true or not, because this was just her perception, she felt that it was just cancer all the time and she wanted to talk about her life. And we went through, you know, an incredibly moving experience together.

37:50Lori Gottlieb:So I think that, you know, you have that experience and she was married and I think, you know, she had an experience with her husband too, but I had a different experience with her that was, I think, in some ways, you know, maybe just as intimate. it.

38:03James Altucher:Do you ever get situations where someone sees you and then someone they've spoken about starts seeing you, but they each don't know that they're both seeing you?

38:12Lori Gottlieb:Actually, a colleague of mine had two people who were getting divorced. The first, the husband came to see him, and then he didn't know, because they had different last names, that then the wife came to see him, but he didn't know that they were the same people until he started hearing the same story from different sides, and then he had to stop seeing both of them.

38:34James Altucher:Did he explain to both of them?

38:35Lori Gottlieb:Oh, of course. Of course, yeah.

38:36James Altucher:That must have been awkward for both of them, though.

38:38Lori Gottlieb:Well, they were referred by the same friend.

38:40James Altucher:Oh, okay.

38:41Lori Gottlieb:The friend didn't realize that that would maybe be a conflict of interest. But I do see people who know each other in the outside world. Friends will refer friends. And sometimes, you know, it depends how close they are. It depends, you know, what the relationship is. I had a situation where somebody referred her friend, and it was my impression that they were friendly but not close friends, and they later became roommates. And that, you know, I think presented some awkwardness.

39:10James Altucher:you know do you ever like like earlier you were saying how maybe in some cases like this the woman with cancer you felt unqualified but do you ever get emotionally affected so that you can't you can't just leave it in the office you go home and you're and you've had you've heard 10 horrible stories that day from 10 different people or however many people and you're home now and And how do you kind of distance yourself from things that might be just emotionally very trying?

39:43Lori Gottlieb:Yeah. I think that people think of therapy as this sort of place of pain, where people bring their pain. But there's also a lot of joy in therapy, right? Because you see people make changes. You see people doing things outside of their comfort zones. You see people changing their lives in these really substantial ways. And so interspersed with some of the more painful sessions, and there are many of those, are these other ones that are incredibly inspiring and uplifting. And so I think it's a mix. But yeah, you know, the things I think that affect me the most are the ones that are about the way people are treated as children.

40:19Lori Gottlieb:Because I think children are so vulnerable. And so either I'll hear something from a parent talking about how they treated their child, and those are sometimes hard for me. and I think hearing about how my adult patient was treated as a child, some of those stories can be really intense.

40:37James Altucher:Yeah, so how do you, and particularly if you hadn't been treated that way as a child so you don't have the direct experience of it, how do you, A, deal with that and B, then move on to the next patient or move on to your home life or whatever?

40:53Lori Gottlieb:Right. Well, I think it affects me because I'm a mom And when I hear what's happened to some of these people, you know, I couldn't imagine that happening to my son. And so I get, I feel very, you know, I feel a lot of empathy or a lot of compassion for them. And it's hard to hear, but I think that you, you know, you deal with sort of what's in front of you the way they do. If you can't imagine a different future for them, if you can't hold the hope for a better future for them, then I don't know how they can. And so really you're a container for the hope for something different to happen. And I've seen it happen so many times that I know it's there.

41:32James Altucher:Is it a myth that if someone tells you they're thinking of committing suicide, you've got to call the police or the authorities or something?

41:39Lori Gottlieb:It's not a myth. I think what you do is you have to assess the situation. So we do have a duty to protect, which means that if somebody says we also have a duty to protect others, if they say I'm going to go murder my wife, well, we have to take action, right? but, you know, people talk about suicide a lot, but there's a difference between suicidal ideation, which is just the concept of, you know, like I'm feeling suicidal versus I have a plan and here's how I'm going to do it. And, you know, I have nothing holding me here.

42:09James Altucher:So what do you do then?

42:11Lori Gottlieb:You mean if they really are going to commit suicide, then we have to take action and we have to, you know, get them in a place where they can be protected. Usually we hospitalize them.

42:19James Altucher:You know, but people could, you know, So I've dealt with that with a family member where I had to contact their therapist, and the therapist was willing to send police or an ambulance over to where they were.

42:35Lori Gottlieb:We try not to do it that way. I think that's really, you know, like if we have to, we will. I mean, usually we want the person to, we want to help the person find a way to be safe. And so we will say to the person, you know, can you stay with someone? Is there someone you can stay with? and we talk to those people so they're aware of the situation, so they're with them 24-7. Can you and whoever, whatever family member or friend, go to the hospital and stay there for 72 hours so we can kind of keep you safe for right now and figure out what's going on? Usually it's temporary, meaning that usually people are feeling suicidal because in that moment, in those hours, in that day, they feel like there's no hope.

43:16Lori Gottlieb:But if we can get them past that, then they're very, very glad that they are here and that they are able to be here and move on.

43:24James Altucher:And so do you see a therapist now?

43:27Lori Gottlieb:Not right now, no.

43:28James Altucher:How come?

43:30Lori Gottlieb:I went and the book is sort of about my experience with this therapist. I feel like we worked through what we needed to work through. I don't think therapy is sort of this thing where it's like you put it in the oven, it's baked and it's done. I feel like you get to a place where I'm good now. I'm good now.

43:48James Altucher:I guess it's hard to know though. Like, I guess I've been seeing my current therapist for exactly three years. You know, I've had my ups and downs and usually when I have my downs, not even downs like I'm depressed, but downs where I'm dealing with a complicated situation and I need help solving it and my friends can't help me solve it. I need sort of an outside expert who's seen a thousand similar situations to help me solve it. You never know when those are going to come up. So I just sort of keep going.

44:18Lori Gottlieb:Right, right. You know, therapy is just, it's a weird business model, right? Because it's like the goal from day one when someone comes to see you is to have them leave. Because that's what we want for our patients. We want them to be independent. We don't want them to be dependent on us.

44:34James Altucher:But sometimes I see therapists where they're always trying to leave a cliffhanger so they never lose the patient. What does that mean? Like, okay, it's enough this hour, but next time we have to talk about this. And there's always the next thing that they want to talk about. Some therapists, you asked before, like, why would I stop seeing a therapist? Sometimes I would sense that a therapist is trying to keep me a patient forever.

45:03Lori Gottlieb:And did you bring it up?

45:05James Altucher:No.

45:06Lori Gottlieb:No. I think it's hard to bring up with your therapist.

45:08James Altucher:Yeah.

45:08Lori Gottlieb:I like to talk about termination with my patients. You know, I like to check in and see, you know, how are things going? And, you know, what do we think is happening here? And how long do you think we need? Because, you know, I want people to be thinking about leaving. Not at the very beginning. At the very beginning, they come in, they came in for a reason. Something is troubling them. But once we've been going for a while, right, whether that's six months or a year, I'll start talking about it. You know, just see where things are. I want an open line of communication about leaving so that people don't have to feel like, they're staying even though they don't want to, or they're not getting anything out of it, or they feel guilty bringing it up, or they just disappear, right?

45:50Lori Gottlieb:Because I think those are sad endings, I think, for the patient, and for me too, but I think for the patient, I think having the experience of being able to say goodbye is really powerful. And usually people, just in the world in general, we don't have the experience of having a really fulfilling, satisfying goodbye. So I agree.

46:09James Altucher:Like sometimes I'll disappear from a therapist. But then a year later, I realize I need a therapist again. And then you're embarrassed to go back. And I'm embarrassed to go back. Is it embarrassing? Because it's not like a friendship. Like it's more like a lawyer.

46:24Lori Gottlieb:Right. But see, I might say if that person came back, I might talk about sort of how it ended and why it was hard for them to tell me that they wanted to leave.

46:34James Altucher:or similarly, I might not mention something important to a therapist because I'm embarrassed about it.

46:41Lori Gottlieb:Right.

46:42James Altucher:Now that's the more - And it'll come up later because then it'll become too important later.

46:46Lori Gottlieb:Right, right. And that's actually in my book. That's what happens with me. And that's what happens with a lot of my patients is we all have these secrets. And sometimes we're aware that it's a secret and we're not mentioning it. Other times we're not so aware of it. But it's like, we'll come in with one thing and we want to be well thought of. And so we don't really, we're not really ready to talk about this other thing. So, so many times I'll find out, you know, months in something that was really, really important, but the person didn't tell me because, you know, they were afraid to, they didn't know how to talk about it, they were embarrassed.

47:24James Altucher:And do you address the fact that, hey, why didn't you tell me about that?

47:28Lori Gottlieb:Yeah, not like that. Really fucking important. Like, what the fuck? You left that out? What were you thinking? Yeah, no, I mean, I might say, you know, I'm really surprised to hear that. You know, was it hard for you to bring that up? Or how long had you been thinking about telling me about that?

47:44James Altucher:You know. What do they say?

47:46Lori Gottlieb:Well, then we'll talk about it. You know, like, oh, I thought I should have told you, but then it was too late. And then I didn't know if it was too late to bring it up. But now I have to bring it up. And we'll talk about what they thought would happen if they brought it up or what I might think of them if they brought it up. Or sometimes people don't bring things up, not because they're embarrassed, but because they know that if they bring it up, now they'll have to address it. So if they don't talk about it, it's kind of like they can just keep doing, like they're drinking too much. They don't really have to bring that up because if they bring it up, now they're going to have to talk about it.

48:17Lori Gottlieb:They're cheating. They don't really want to bring that up because it's kind of just an emotional affair and it's not really anything. So they don't really need to bring that up and they're focusing the whole time on my girlfriend this, my girlfriend that, my girlfriend this, but they've never mentioned they're having this thing on the side.

48:31James Altucher:And then once they bring it up, Like that changes the whole conversation.

48:35Lori Gottlieb:Well, right, yeah.

48:37James Altucher:And they say, listen, I should have told you this, but...

48:41Lori Gottlieb:Sometimes they don't even say it. Sometimes they're like, oh, by the way, there's this thing we have called a doorknob disclosure, which means that often people will tell you something that's very hard for them to talk about when there's like a minute left in the session, you know, or even at the door. It's like, I found my biological mother on Facebook. See you next week. You're like, what? You know, so often there'll be like this disclosure at the very end when there's, and they do that on purpose, you know, because then you can't really talk about it. And then I have to sit with, you know, whatever feelings about it for the whole week and they feel relieved.

49:18James Altucher:Well, but they have to sit with it too, but it's easier for them. They feel like, okay, I revealed it. Now a week's gone by. It's old news. Right, right. So what's like one more thing? I might not be suspecting my therapist is thinking, not bad or good, but just something I should know about how my therapist is thinking when I'm in a therapy session.

49:41Lori Gottlieb:You might not be thinking about everything we're noticing. You might be thinking that we're really focused on the content of the conversation, but I might be noticing where you're looking in the room. I might be noticing your leg that's going up and down. I might be noticing...

49:57James Altucher:What do you derive from that? from all of that?

49:59Lori Gottlieb:Well, you know, like, is it hard for you to, if you're looking away a lot, do you do that with other people? Is it hard for you to maintain eye contact? Are you talking about something where maybe you're not being truthful or maybe you're embarrassed?

50:12James Altucher:What do you think is a sign when someone's not being fully truthful about what's going on in their life?

50:18Lori Gottlieb:I think it's hard to know. I think it's different for every person. I mean, I think people who, again, who like talk a lot about content that seems really irrelevant, those sometimes are people who are not really telling you what they need to be talking about.

50:33James Altucher:And I think that's probably true in general in life.

50:36Lori Gottlieb:Yeah.

50:37James Altucher:So what else is in your book? I want to, your book's coming out in April. So hopefully, will you come on again before your book comes out? Because it's only October. Yeah, yeah, I'd love to. I have a thousand more questions. We didn't even get to marry him, the case for settling for Mr. Goodenough.

50:52Lori Gottlieb:Right, which I have to say is not about settling. I lost that title battle.

50:56James Altucher:I think so many women got upset and men after that.

51:01Lori Gottlieb:I think they did until the people who read it. I mean, I still get mail all the time from people. Every week, I get several letters from people who have said it saved their relationship. It helped them meet their partner, whether it's a man or a woman.

51:14James Altucher:Because you think we expect perfection, and if there's one thing wrong, we flip out?

51:18Lori Gottlieb:I think that people actually don't have high enough standards in a lot of ways, which is funny because people think the book is about lowering your standards. But I think that people don't have high enough standards about the things that matter. The book is a very extensively researched book. It's not my opinion. It's actually, as a journalist, I was talking to experts in various fields about, you know, from behavioral economics, sociologists, to historians, to divorce experts, to psychologists. And, you know, a lot of people, they don't put enough value on things like responsibility or generosity, and I mean by generosity, emotional generosity.

51:59Lori Gottlieb:You know, do you have the same values? Do you want the same things in life? Kindness, respect. So many times people will be like, I'm so obsessed with this person, and the person treats them horribly. And they keep going after those kinds of people. And so it's really about having higher standards about what you want in a partner. And yes, letting go of some of the things that don't matter. And I think that, you know, the whole book kind of unravels all of the research on what are some of the ways that people end up picking partners that aren't right for them and for all kinds of reasons. And I think that's the same thing we do in the therapy room and even in the Dear Therapist column, right?

52:34Lori Gottlieb:That's something that people write in about all the time. Or I'm with this guy, I'm with this girl, and this is so confusing to me. And it's like very clear from the outside. And I'll bet if they ran it by their friends, it would be very clear too.

52:47James Altucher:So Laurie Gottlieb, author of Marry Him, The Case for Settling for Mr. Good Enough, and your upcoming book, Maybe You Should Talk to Someone, which I can't wait to read one of the early drafts and we'll have you on the podcast again to talk about it. You've been kind enough to answer so many questions I've had about my own therapy sessions. You asked me earlier, why would I stop or what makes for me not such a good therapist? I've had all kinds of therapists. So sometimes therapists will be talking on the phone for half my session. Sometimes therapists will be telling me about their vacation for half the session.

53:25James Altucher:Sometimes I would get the sense therapists were just trying to make me feel good about myself, and it wasn't necessarily solving my issues. Other times therapists would look around their room to find samples of drugs that pharmaceutical companies had sent them and say to me, here, try this. So there's lots of reasons. That's why I say 80%. Not every therapist, but 80 % I've usually found is not so good for whatever reason. But the 20 % that's great. It's really changed my life and done well for me. But I look so much forward to maybe you should talk to someone and for you to come back on the podcast.

54:03James Altucher:Thank you for coming.

54:04Lori Gottlieb:Well, it's been really fun. Thanks for having me. Thank you.

54:06James Altucher:That was fun.

54:07Lori Gottlieb:Yeah, yeah. Wow. I can't believe people were talking on the phone in your therapy.

54:14James Altucher:Yeah, he would get phone calls and he would be arguing, like, you have to pay this bill. And meanwhile— I was surprised at that, too, actually. Meanwhile, he would, like, pick up some pill that was on the floor and, like, throw it over me and, like, yell out, like, here, try this. It would be, like, Seroquel, like some kind of major, you know—

54:31Lori Gottlieb:Mood stabilizer.

54:32James Altucher:Yeah, not only mood stabilizer, I would sleep for 27 hours.

54:35Lori Gottlieb:Yeah.

54:36James Altucher:So it's just, I had some crazy therapists.