Maybe You Should Talk to Someon - Lori Gottlieb Page 0,52

she told me about an argument they’d had. Wade had noticed that Becca seemed to complain about her friends quite a bit. “If you’re so unhappy with them,” he said, “why do you keep them as friends?”

Becca “couldn’t believe” Wade’s response. Didn’t he understand that she was just venting? That she wanted to talk it through with him and not be “shut down”?

The parallels here seemed obvious. I asked Becca if she was just trying to vent with me and that, as with her friends, she found some value in our relationship, even though sometimes she also felt frustrated. No, Becca said, I’d gotten it wrong again. She was here to talk about Wade. She couldn’t see that she had shut Wade down just as she had shut me down, which left her feeling shut down herself. She wasn’t willing to look at what she was doing that made it difficult for people to give her what she wanted. Though Becca came to me wanting aspects of her life to change, she didn’t seem open to actually changing. She was stuck in a “historical argument,” one that predated therapy. And just as Becca had her limitations, so did I. Every therapist I know has come up against theirs.

Maxine asks again why I’m still seeing Becca. She points out that I’ve tried everything I know from my training and experience, everything I’ve gleaned from the therapists in my consultation group, and Becca is making no progress.

“I don’t want her to feel emotionally stranded,” I say.

“She already feels emotionally stranded,” Maxine says. “By everyone in her life, including you.”

“Right,” I say. “But I’m afraid that if I end therapy with her, it’s going to further cement her belief that nobody can help her.”

Andrea raises her eyebrows.

“What?” I say.

“You don’t need to prove your competence to Becca,” she says.

“I know that. It’s Becca I’m worried about.”

Ian coughs loudly, then pretends to gag. The entire group bursts out laughing.

“Okay, maybe I do.” I put some cheese on a cracker. “It’s like this other patient I have who’s in a relationship with a guy who doesn’t treat her very well, and she won’t leave because on some level, she wants to prove to him that she deserves to be treated better. She’s never going to prove it to him, but she won’t stop trying.”

“You need to concede the fight,” Andrea says.

“I’ve never broken up with a patient before,” I say.

“Breakups are awful,” Claire says, popping some grapes in her mouth. “But we’d be negligent if we didn’t do them.”

A collective Mm-hmm fills the room.

Ian watches, shaking his head. “You’re all going to jump down my throat over this”—Ian’s famous in our group for making generalizations about men and women—“but here’s the thing. Women put up with more crap than men do. If a girlfriend’s not treating a guy well, he has an easier time leaving. If a patient isn’t benefiting from what I have to offer, and I’ve made sure I’m doing my very best but nothing’s working, I’ll break it off.”

We give him our familiar stare-down: Women are just as good at letting go as men are. But we also know there might be a grain of truth here.

“To breaking it off,” Maxine says, raising her glass. We clink glasses but not in a joyful way.

It’s heartbreaking when a patient invests hope in you and, in the end, you know you’ve let her down. In those cases, a question stays with you: If I’d done something differently, if I’d found the key in time, could I have helped? The answer you give yourself: Probably. No matter what my consultation group says, I wasn’t able to reach Becca in just the right way, and in that sense, I failed her.

Therapy is hard work—and not just for the therapist. That’s because the responsibility for change lies squarely with the patient.

If you expect an hour of sympathetic head-nodding, you’ve come to the wrong place. Therapists will be supportive, but our support is for your growth, not for your low opinion of your partner. (Our role is to understand your perspective but not necessarily to endorse it.) In therapy, you’ll be asked to be both accountable and vulnerable. Rather than steering people straight to the heart of the problem, we nudge them to arrive there on their own, because the most powerful truths—the ones people take the most seriously—are those they come to, little by little, on their own. Implicit in the therapeutic contract is the patient’s willingness