Maybe You Should Talk to Someone_A Therapist, HER Therapist, and Our Lives Revealed

by Lori Gottlieb

  “Then Margo wanted another baby, and I said, fuck it, okay. I mean, Jesus, I was in no shape to be a new father, but Margo was adamant that she didn’t want Gracie to grow up alone. It wasn’t just that we had lost a child. Gracie had lost her only sibling. And the house did seem different than it had when we had two kids running around. It didn’t feel like a kid house anymore. The stillness was a reminder of what was missing.”

  John sits forward, puts the cover on his salad, tosses it across the room into the trash bin. Swish. It always goes right in. “Anyway,” he says, “the pregnancy seemed to be good for Margo. It brought her back to life. But not me. I kept thinking that nobody could replace Gabe. Besides, what if I killed this one too?”

  John told me that when he first heard that his mother had died, he was sure he had killed her. Before she’d left to go to rehearsal that night, he’d begged her to rush home so she’d be there in time to tuck him in. She must have died rushing home in her car, he thought. Of course, his father told him that she died while trying to push one of her students out of harm’s way, but John was certain this was a cover story to protect his feelings. It wasn’t until he saw the headline in the local paper—he had just learned to read—that he knew it was true, he hadn’t killed his mother. But he also knew that she would have died for him in a heartbeat, just like he would have done for Gabe or Gracie and just as he would now for Ruby. But would he do it for Margo? He’s not so sure. Would she do it for him? He’s not sure either.

  John pauses, then quips to break the tension. “Wow, this is getting heavy. I think I’ll lie down.” He stretches out on the couch, tries to fluff a pillow behind his head, and makes a disgruntled sound. (“What’s this filled with, cardboard?” he once complained.)

  “In a weird way,” he continues, “I was worried I might love the new baby too much. Like I’d be betraying Gabe. I was so glad it wasn’t another boy. I didn’t think I could handle a baby boy without him reminding me of Gabe—what if he liked the same fire trucks that Gabe did? Everything would be an agonizing memory, and that would be unfair to the kid. I was so worried about this that I did research on when to have sex so you had the best chance of a girl—it was on the show.”

  I nod. It was in a subplot with a couple who were later written out, season three, I think. They were always having sex at the wrong time because one or the other of them couldn’t control themselves and wait. I remember how funny it was. I had no sense of the pain that inspired it.

  “The point,” John says, “is that I didn’t tell Margo. I just made sure to have sex only on the day that we’d have the best chance of a girl. Then I sweated it out until the ultrasound. When the OB said it looked like a girl, Margo and I both said, ‘Are you sure?’ Margo wanted a boy because she loved raising a boy and we already had a girl, so she was disappointed that first night. ‘I’ll never get to raise a boy again,’ she said. But I was fucking ecstatic! I felt like I could be a better father to a girl, under the circumstances. And then, when Ruby was born, I thought I’d shit my pants. The second I saw her, I fell madly in love.”

  John’s voice catches and he stops.

  “What happened to your grief then?” I ask.

  “Well, it got better at first—which, in a strange way, made me feel worse.”

  “Because the grief had connected you to Gabe?”

  John looks surprised. “Not bad, Sherlock. Yeah. It was almost like my pain was evidence of my love for Gabe, and if it let up, it meant I was forgetting about him. That he didn’t matter as much to me.”

  “That if you were happy, you couldn’t also be sad.”

  “Exactly.” He looks away. “I still feel that way.”

  “What if it’s both?” I say. “What if your sadness—your grief—is what allowed you to love Ruby with so much joy when you first saw her?”

  I remember a woman I treated whose husband had died. When she fell in love a year later—a love all the more sweet because of the loss of her husband—she worried that others would judge her. (So soon? Didn’t you love your husband of thirty years?) In fact, her friends and family were excited for her. It wasn’t their judgment she was hearing—it was her own. What if her happiness was an insult to her husband’s memory? It took her a while to see that her happiness didn’t diminish her love for her husband—it honored it.

  John tells me he finds it ironic that Margo used to be the one who wanted to talk about Gabe and John couldn’t; later, if John made a rare reference to Gabe, Margo would get upset. Would their family always be haunted by this tragedy? Would his marriage? “Maybe we remind each other of what happened—like our mere presence is some kind of sick memento,” John says.

  “What we need,” he adds, looking up at me, “is some kind of closure.”

  Ah, closure. I know what John means, and yet I’ve always thought that “closure” was an illusion of sorts. Many people don’t know that Elisabeth Kübler-Ross’s familiar stages of grieving—denial, anger, bargaining, depression, acceptance—were conceived in the context of terminally ill patients learning to accept their own deaths. It wasn’t until decades later that the model came to be used for the grieving process more generally. It’s one thing to “accept” the end of your own life, as Julie is struggling to do. But for those who keep on living, the idea that they should be getting to acceptance might make them feel worse (“I should be past this by now”; “I don’t know why I still cry at random times all these years later”). Besides, how can there be an endpoint to love and loss? Do we even want there to be? The price of loving so deeply is feeling so deeply—but it’s also a gift, the gift of being alive. If we no longer feel, we should be grieving our own deaths.

  The grief psychologist William Worden takes into account these questions by replacing stages with tasks of mourning. In his fourth task, the goal is to integrate the loss into your life and create an ongoing connection with the person who died while also finding a way to continue living.

  But many people come to therapy seeking closure. Help me not to feel. What they eventually discover is that you can’t mute one emotion without muting the others. You want to mute the pain? You’ll also mute the joy.

  “You’re both so alone in your grief,” I say. “And in your joy.”

  In our sessions, John had dropped occasional hints of his joy: his two girls; his dog, Rosie; writing a killer show; winning another Emmy; a boys’ trip with his brothers. Sometimes, John says, he can’t believe that he’s capable of feeling joy. After Gabe died, he thought he’d never live through it. He’d go on, he figured, but like a ghost. And yet, just a week after Gabe’s death, he and Gracie were playing together, and for a second—maybe two—he felt okay. He smiled and laughed with her, and the fact that he laughed amazed him. Just one week ago his son had died. Was that sound really coming from him?

  I tell John about what’s known as the psychological immune system. Just as your physiological immune system helps your body recover from physical attack, your brain helps you recover from psychological attack. A series of studies by the 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. John’s reaction while playing with Grace wasn’t unusual; it was the norm.

  There’s another related concept that I share with John: impermanence. Sometimes in their pain, people believe that the agony will last forever. But 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. Everything you feel—anxiety, elation, anguish—blows in and out again. For John,
on Gabe’s birthday, on certain holidays, or simply running in the background, there will always be pain. Hearing a certain song in the car or having a fleeting memory might even plunge him into momentary despair. But another song, or another memory, might minutes or hours later bring intense joy.

  Where, I wonder, is John’s shared joy with Margo? I ask him what he imagines would have happened with Margo had the car crash not happened. What would their marriage be like today?

  “Oh, for God’s sake,” he says, “now you think I can rewrite history?” He looks out the window, at the clock, at his sneakers, which he had slipped off when he lay down on the couch. Finally he looks at me.

  “Actually, I think about that a lot lately,” he says. “Sometimes I think about how we were a young family and my career was taking off and Margo was taking care of the kids and trying to run a business, and how we’d lost touch with each other, the way people do at that stage of life. I think about how things might have changed once both kids were in school and we were farther ahead in our careers. You know, life would normalize. But maybe it wouldn’t have. I used to be so sure that she was the right person for me and I was the right person for her, but we make each other so unhappy, and I don’t even remember when that started. Everything I do is wrong in her eyes. Maybe we would have been divorced by now. People say that marriages fall apart after a child’s death, but maybe we stayed together because of what happened to Gabe.” He laughs. “Maybe Gabe saved our marriage.”

  “Maybe,” I say. “Or maybe you stayed together because you both want to rediscover the parts of yourselves that seemed to have died along with Gabe. Maybe you both believe you can find each other again—or for the first time.”

  I think about the family of the drowned toddler in the ER. What are they doing right now? Did they have another child? Their baby, the one whose diaper was being changed while their three-year-old ran outside and drowned, would now be in college. Maybe that couple is long divorced and living with their new spouses. Or maybe they’re still together, stronger than ever, perhaps taking a hike on the scenic trails near their home on a peninsula south of San Francisco, reminiscing about the past, remembering their beloved daughter.

  “It’s funny,” John says. “I guess we’re finally both ready to talk about Gabe at the same time. And now that we are, I feel better. I mean, I also feel like shit, but it’s okay, if you know what I mean. It’s not as bad as I thought it would be.”

  “It’s not as bad as it was not talking about Gabe,” I suggest.

  “Like I said, you’re good, Sher—” We share a smile. He’s stopped himself from calling me Sherlock, from using the caricature as a space keeper between us. Letting Gabe become more real in his life is allowing him to let others be more real too.

  John sits up and starts fidgeting; our session is about to end. As he slips on his sneakers and stands to retrieve his phone, I think back to his earlier comment about telling Margo he came to therapy due to stress and how often he’s told me the same thing.

  “John,” I say, “do you really think you came here because of stress?”

  “What are you, an idiot?” he says, a twinkle in his eye. “I came here to talk about Margo and Gabe. Boy, are you dim sometimes.”

  When he leaves, there’s no wad of cash at the door for his “hooker.” “You can bill me,” he says. “No more skulking around. We’re legit now.”

  49

  Counseling Versus Therapy

  “Are you asking for counseling or therapy?” Wendell says at today’s session after I tell him that I have a professional question. He knows I’ll understand the distinction because he’s offered professional guidance twice before. Do I want advice (counseling) or self-understanding (therapy)?

  The first time I asked Wendell such a question, I’d been talking about my frustration with people choosing the quick fix over the deeper work of psychotherapy. As a relatively new therapist, I was curious how someone more seasoned—specifically Wendell—dealt with this. It was one thing to hear what older colleagues had to say, but from time to time, I couldn’t help but wonder how Wendell handled the frustrations of the profession.

  I doubted he would answer my question directly—he would more likely express empathy for my predicament. In fact, I knew I was putting him in the classic Catch-22 position in which therapists often find themselves: I want empathy, but if you give it to me, I’ll feel angry and hopeless, because empathy alone won’t solve my very real problem, so what good are you anyway? I was thinking that he might even say something about this Catch-22 (because the best way to defuse an emotional land mine is to expose it).

  Instead, he looked at me and asked, “Would you like a practical suggestion?”

  I wasn’t sure I’d heard him correctly. A practical suggestion? Are you kidding me? My therapist was going to give me a concrete piece of advice?

  I moved closer.

  “My father was a businessman,” Wendell began quietly. At that time, I hadn’t yet fessed up to my Google-binge, so I nodded, pretending this information was new. He told me that when he was starting out, his father suggested that he make an offer to prospective patients: They could try a session, and if they chose not to continue to work with Wendell after that, the session would be free. Since many people were nervous about starting therapy, this risk-free session would give them the opportunity to see what therapy was about and how Wendell might help them.

  I tried to picture Wendell having this conversation with his father. I imagined the pleasure his father might have gotten from finally giving professional advice to his gentler son. His suggestion wasn’t groundbreaking in the world of business, but therapists don’t often think of what we do as a business. And yet we do run small businesses, and Wendell’s father must have realized that his son, despite leaving the family’s company, had actually become a businessman after all. Maybe he took great joy in having that connection with his son. And maybe it meant a lot to Wendell, which is why he was willing to pass this wisdom along to other therapists like me.

  In any event, his father was smart. As soon as I implemented this offer, my practice filled up.

  But his second piece of counseling—which I not only asked for, but pushed for—flopped. While I was grappling with my happiness-book dilemma, I kept agitating for Wendell to tell me what to do. I pushed so hard and so often that finally, Wendell (who, of course, had no knowledge of the publishing business) gave in near the end of one session. “Well, I don’t know what else there is to say about this,” he replied to my eighty-seventh query on that topic. “It sounds like you’ll just have to find a way to write this so that you can write what you want next time.” Then he patted his legs twice and stood, signaling our time was up.

  Sometimes a therapist will deliberately “prescribe the problem” or symptom that the patient wants to resolve. A young man who keeps putting off finding a job might be told in therapy that he can’t look for a job; a woman who won’t initiate sex with her partner might be told not to initiate it for a month. 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).

  But Wendell hadn’t been doing that. He was just reacting to my endless complaints. If I came in upset because my agent once more insisted that nothing could be done and that I had to write this book or I’d never get another book contract, Wendell would question why I couldn’t get a second opinion—or another agent—and I would explain that I couldn’t approach other agents because I had nothing to offer them other than
the mess I was currently in. Wendell and I had some version of this conversation often, and finally I convinced both of us that there was just one way out: to keep writing. So I trudged on, now blaming not just myself but also him for my predicament. Of course, I didn’t realize I was blaming Wendell, but my resentment surfaced the week after I emailed my editor and told her I wouldn’t be finishing the book. I’d been edgy all session, unable to share this milestone with him.

  “Are you angry with me?” Wendell asked, picking up on my vibe, and suddenly it hit me: Yes! I was furious with him, I replied. And, I added, guess what—I had canceled my book contract, finances and consequences be damned! I was walking around those prison bars! Especially given my mysterious medical condition and its debilitating fatigue, I wanted to be sure that I was using the “good” time I had in a meaningful way. Julie had once said that she finally understood the meaning of the phrase “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. Like Julie, I told Wendell, I was starting to strip my life down to its essentials rather than sleepwalking my way through it, so who was he to tell me to hunker down and write this book? All therapists make mistakes, but when it happened with Wendell, I felt irrationally betrayed.

  When I finished talking, he looked at me thoughtfully. He didn’t get defensive, though he could have. He simply apologized. He’d failed, he said, to see something important that was going on between us. In trying to convince him how trapped I was, I left him feeling trapped as well, imprisoned by my perceived imprisonment. And in his frustration, like me in mine, he’d taken the easiest way out: Fine, you’re screwed—write the damn book.

  “The counseling I want today is about a patient,” I say now.

  I tell Wendell that I have a patient whose wife sees him, Wendell, and that every time I come here, I think about whether she’s the woman I’ve seen leaving his office. I tell him that I know he can’t say anything about a patient to me, but still I wonder if she’s mentioned the name of her husband’s therapist—me—to him. And how should we handle this coincidence? As a patient, I can say whatever I want about any aspect of my life, but I don’t want to cloud his patient’s therapy with my private knowledge of her husband.