The Couch and the Screen: ”Maybe You Should Talk to Someone” – Podcast

Welcome to the fourth episode of “The Couch and the Screen” series, where we dive into mental health topics in TV, movies, books, and popular culture. 

In this episode, we delve the book “Maybe You Should Talk to Someone” by Lori Gottlieb, exploring its portrayal of mental health issues and therapeutic relationships. The book follows a therapist, who faces her own crisis, leading her to seek help from another therapist, Wendell. 

Podcast Intro:

Welcome to Convos from the Couch By LifeStance Health, where leading mental health professionals help guide you on your journey to a healthier, more fulfilling life.

Nicholette Leanza:

Hello everyone, and welcome to our fourth episode of The Couch and the Screen, where we explore our mental health topics and TV, movies, books, and popular culture. I’m Nicholette Leanza and I’m joined by my LifeStance colleagues, Angel Kramer.

Angel Kramer:

Hello.

Nicholette Leanza:

And Laura McClure.

Laura McClure:

Hello.

Nicholette Leanza:

And on today’s episode, we’ll be talking with LifeStance Maryland Clinician, Meridith Braden-MacMullan about the book, Maybe You Should Talk to Someone by Lori Gottlieb. So welcome Meridith. Good to have you on today. The fun factor, when I was researching the book more, I came across that she did a TED Talk. The name of the TED Talk was How Changing Your Story Can Change Your Life, which she did back in 2019. So yeah, it was a really good TED Talk, but we’ll get into more about the book as well. So Meridith, glad you’re here to talk with us about it. Let me give a little bit of a book cover synopsis. One day, Lori Gottlieb is a therapist who helps patients in her Los Angeles practice, the next a crisis causes her world to come crashing down.

Enter Wendell, the quirky but seasoned therapist in whose office she suddenly lands as Gottlieb explores the inner chambers of her patient’s lives. A self-absorbed Hollywood producer, a young newlywed diagnosed with a terminal illness, a senior citizen threatening to end her life on her birthday if nothing gets better and a 20 something who can’t stop hooking up with the wrong guys, she finds that the questions they are struggling with are the very ones she is now bringing to window. So definitely an interesting book. We’ll see what our different thoughts about it was. Meridith, let’s start with you. What did we all think about the book? So what did you think, Meridith?

Meridith Braden-MacMullan:

I really enjoyed the book. I obviously love reading and watching things about therapy. I found her writing to be really easy and engaging. I think it’s pretty obvious that she’s worked in television or other mediums. So I just found it very easy to read and digest and I appreciated that. And I think I also really liked how it made therapy so approachable. It normalizes it and helps to maybe get rid of some of the stigma and make it okay for folks to spend some time on their mental health and make that a nice normal thing like going to the doctor.

Laura McClure:

Meridith, I totally agree with you, especially on her writing style. I think it’s very evident that writing is a passion of hers. I also found her sense of humor to relate. I almost felt, “Oh, you’re writing my inner dialogue that goes through my brain.” That sense of humor was on brand for me. I loved the book, but I love to read. I read about a book a week. Thought it was great. I love anything that portrays therapists as real people and shows that we are fallible people just like our clients and that we have the exact same issues, because as I told my clients, “Life happens to me just like it happens to you.” I loved that. The only criticism I might have as a therapist would be, sharing her inner dialogue about her clients could be off-putting in that, “Does my therapist really think that way about me when I say this or when I say that.” The things that we say in our head are never-

Nicholette Leanza:

Right.

Laura McClure:

So that was my only thing, is that I just don’t know if I would’ve been that open about my inner dialogue that happens while I’m in session with my clients, because I think that could be really off putting to people. But other than that, I’d give this book an A. I loved it.

Nicholette Leanza:

Angel, what do you think?

Angel Kramer:

I knew I was going to be next, just by the look on Nicki’s face. For the most part, I enjoyed the book. I thought it was really well written. You can tell that she loves to write. She has a passion for it. It was easy to read. I thought there was some… We’ll get into that part later. I’ll leave that out. But at the end of it, I felt a little dissatisfied. I felt like something was missing. I felt like there needed to be more. It was already a pretty long book, but I felt like there should have been a little bit more there.

I almost couldn’t help getting to the end of the book and being like, “How come I read this? But what was the culminating point?” So that I struggled with, I don’t tend to read a whole lot of self-help books, but I don’t think this really falls into the self-help category too much, other than maybe to help someone understand therapy. I agreed with Laura and I was a little uncomfortable by the internal dialogue. Not saying that we don’t think that way sometimes because sure, we do.

Nicholette Leanza:

We do.

Angel Kramer:

We’re human. But I’ve actually had two or three of my own clients recommend this book to me.

Nicholette Leanza:

Oh, really?

Angel Kramer:

So it was already on my reading list when it was brought up for our podcast, and at least two of them have said, “This book helped me understand what I was getting out of therapy.” When I would leave sessions and be like, “Why am I having these sessions?” So it helped them see the progress they were making, what we were doing, the point of what I was doing for them. But at least one of them was like, “I have a question though. Do you think this about us? Do you criticize us during sessions?” And I was like, “Ah, repair work. Repair work.”

Nicholette Leanza:

But I mean, I would be put on the spot with that too, Angel, because it’s true, we’re human as well, but the way she depicted it in here does feel like, Ooh. And I can see someone who was a client meeting this would really be looking at their own therapist, “Wait a second here, that would feel awful if this is some of the stuff my own therapist was thinking about me.” I generally like the book. It’s very long. At the end, probably the last 50 to a hundred pages, I was just like, “Okay, time to wind it down.” I was ready for it to wind down. I liked how it was written because it was written to me more like fiction. My understanding, it looks like she was actually one of the writers for Friends. And then I’m forgetting the other show, it sounds like she used to write for.

Meridith Braden-MacMullan:

ER.

Nicholette Leanza:

Oh, yeah. ER. Yeah.

Laura McClure:

Yeah, I was going to say it was a big one.

Nicholette Leanza:

Yeah. So I loved her writing style because it felt like I wasn’t necessarily reading self-help, I’m putting that in air quotes, but I was actually reading a fiction book. So I loved how it was written. I think too, just another random thought as I was reading it, as a therapist, I don’t think I can remember all the specific dialogue that she did. But then I had to step back and realize, I think these… I almost called them characters. These patients were maybe hodgepodge of a culmination of different clients and that a lot of the dialogue maybe was created per se. Because the level of detail, what she remembers, I’m like, I would not be able to ever remember at that level. So just a random thought with that. What mental health issues did we see portrayed in the book?

Meridith Braden-MacMullan:

I think it started with clients presenting as having relationship problems or maybe lack of relationship. But then you come to find out that there’s underlying, there’s anxiety, there’s depression, there’s grief and loss, there’s terminal illness, substance issues, and also not just childhood trauma, but trauma as well. So it really covered a lot of issues that we work on. Definitely.

Angel Kramer:

One of the things I did like about the book was that it wasn’t diagnosis based.

Nicholette Leanza:

True.

Angel Kramer:

So then whenever I was prepping for my answer for this part of our discussion, I was like, “Ooh, should I focus my answer on diagnosis?” Because the book was all about presenting issue. It was a big deal that this is her presenting issue. She has found it. But nonetheless, those presenting issues, we can morph into our diagnosis if we were doing this as a session, diagnosing treatment planning and whatnot. We see an intimate partner of violence. We see parenting struggles. We see self-doubt and defense mechanisms, and we see how our traumas, big T, little T, anything in between have impacted us and how those have brought about those defense mechanisms. And I can appreciate that she approached that as a presenting issue and not as, let’s put you on to a diagnosis.

Nicholette Leanza:

Yeah, definitely. Yeah.

Laura McClure:

Angel, I would say I really agreed with that. I actually really appreciated the fact that there were no diagnoses in there because I think it’s become, and I’m going to blame TikTok because I just despise social media, but it’s become very trendy to have a diagnosis. And I think people in the long run don’t understand how a diagnosis stays with them and impacts things such as your ability to get healthcare or life insurance and things like that when you’re older. So I really appreciated not talking about people or clients as a diagnosis.

And also what you said about that presenting issue, I tell my clients all the time, once I’ve built up rapport, I’m like, “Yeah, you’re presenting issue is usually just a symptom of what’s actually going on. It is never the actual diagnosis. It’s usually just a symptom of something larger. And I’m here to help us discover what the thing larger is.” And so I appreciate that because otherwise if you don’t stay curious about everything, you’re missing big chunks of what’s really impacting our clients. I’m probably going to just talk about John because I really loved that client and that because I think I could resonate so much with that, because I do. There is something lovable about every person, but I’ve also had those clients that you come in and you’re like, “You’re just a jerk.” What do you-

Nicholette Leanza:

So to give context to the listeners, John is… I keep wanting to say a character because that’s how I felt the book was written.

Laura McClure:

Yes.

Nicholette Leanza:

Is one of her patients who happens to be a TV writer, comes across very self-absorbed and things like that.

Laura McClure:

Yeah. But what I’m really saw there were attachment cluster B personality tendencies in him. And I think I focused on that and really got involved in that story because that’s something that I’m really passionate about and I really enjoy working with cluster B personality disorders. I know that makes me a very strange clinician, but I do. So I think that was really cool the way she presented that about how people with that personality disorder can come off very arrogant, but really showed her process of digging to see where that originated from, because that’s where the empathy, creating that room for empathy. So I loved that part of the book. John.

Meridith Braden-MacMullan:

I really love that too with his character because it shows how therapists as humans, how we understand how hard it is to be alive. And then that helps us connect to our clients and to really appreciate what they’re going through and to not judge them as we would have maybe thought with that internal dialogue. That was a little bit cringe worthy, but maybe that we really identify with that. And even someone who is as harsh as John appears in the beginning, you really start to see his humanity and just appreciate and love a part of that client story. Yeah.

Nicholette Leanza:

One of the things I found myself doing as she was talking about the patients and things she was doing with them is, “What would I do if I was their therapist?” Did you guys find yourself doing that as well? Maybe taking things, maybe with John, maybe something a different angle or whatever. But did you guys each find yourself doing that too, if you were that patient’s therapist?

Angel Kramer:

Yeah, and I also caught myself thinking, would this be the clientele that I would work with? Would they be on my caseload? And then comparing if they were, and this is up in my scope, what do I do with them? John was one of the people in the book, I was like, they would definitely be on my caseload.

Laura McClure:

Me too.

Angel Kramer:

Because very [inaudible 00:12:16] Laura, those challenges are the ones that I appreciate. And I also felt like his story really showed her as a therapist and how she presented, and it felt very authentic. And then with Charlotte, I appreciated her talking about the transference that was happening and being aware of her trying to pull back. I can’t treat Charlotte like my younger self, even though two peas in a pod, kind of situation happening.

Nicholette Leanza:

And just to jump in, Charlotte was the patient who would often hook up, right? Different men who maybe weren’t the best for her.

Meridith Braden-MacMullan:

Got you.

Nicholette Leanza:

And you bring up another point, Angel, that I’m thinking of, even jumping it back to John, just our boundary as clinicians in that it’s about the client, where they’re at and making sure we’re not projecting onto them. If that’s the younger, that was me back in the day or whatever, but specifically with John, he’s this successful TV writer for a show that it sounds like Lori actually would watch. Right? And so part of me is, if I was John’s therapist, I would have to really make sure I was checking my wanting to know more about the process and his work, because the therapy’s not about that, but there’d be this natural curiosity is, the human Nicki watching the show to want to know more about that? Because I just love books and movies and hence why we’re doing this podcast. But to really make sure that I was checking myself that this is about John’s treatment and what John is navigating and not my desire to know more about the nooks and crannies, how he develops the show.

Angel Kramer:

Nicki, even while reading the book, I was like, “What show could this be on?”

Nicholette Leanza:

Yeah.

Angel Kramer:

How can I track this?

Nicholette Leanza:

Yeah. What could this be? Definitely. No, I was thinking that too. So what did you all think about the book’s format? Where it’s alternated between Gottliebs own therapy sessions and then her work with her clients? Meridith, what you think?

Meridith Braden-MacMullan:

I was happy with the format. I thought it just brought everything together and again, really showed her as a person, because you’re looking at her individual sessions and how she shows up and how she struggles and how she’s not really seeing the big picture that her therapist, Wendell is eventually able to help her get to. And I think that’s a nice example of why it’s sometimes a good time to give time to therapy. Things don’t always happen fast, fast, but over the course of time you can figure out what’s going on in your life, what you want to change about your own story, and then start to see some of those patterns and things that you want to change.

Nicholette Leanza:

Laura, thoughts?

Laura McClure:

I loved the format because I thought that you could see her progression as an individual human being in therapy, and you saw the progression and growth within her therapy sessions. And so I thought that was just really neat to watch the process unfold and how it is such a parallel process. And also highlights the importance that, even if you don’t have big life happening to you, if you’re a therapist, you should have your own therapist and just be checking in. Even if you only go once every two months, you still should be having your own therapist because that growth that you do in that room helps the growth of your clients and yourself as a therapist.

Angel Kramer:

Yeah, I thought the format was engaging. It kept me interested, but there were a couple times I caught myself being like, “Wait, when does this happen in the timeline? Have we gone forward? Have we gone backwards? Where are we at?” So some of it felt a little out of place, but once I got past that, I thought it was okay in the layout. And actually we keep referring to people as characters. It reminded me of episodes of a show. Oh, we’re back to the John episode. We’re on the Rita [inaudible 00:15:58]

Nicholette Leanza:

Oh, interesting.

Laura McClure:

Yes, I see that. I see that very much.

Nicholette Leanza:

Oh, I didn’t pick up on, that’s actually really good, huh?

Meridith Braden-MacMullan:

That was my experience when you all first were asking about books and… Or not books, I think you were talking about shows. I’m like, “I know a show. No, it’s a book. It’s a book.” And then I remembered that this was that book that just was very vivid. It felt like maybe because it’s written closer to a show.

Nicholette Leanza:

She was a TV writer. She knows how to write.

Laura McClure:

I think she wrote to television. So that could also be why it read to us so much like that, because that’s her writing background.

Angel Kramer:

Yeah, it didn’t read like a case study.

Nicholette Leanza:

No, no. It wasn’t stuffy at all. This was not stuffy.

Angel Kramer:

Yeah. No [inaudible 00:16:39].

Nicholette Leanza:

It was very readable.

Angel Kramer:

[inaudible 00:16:39] it sometimes.

Laura McClure:

At certain points it was comedy gold, I thought.

Nicholette Leanza:

I very much like the format too, going back and forth and looking at the parallels. There were times too that I thought if Wendell was my therapist, would his style match with how I am and my personality, if I was doing work with him and stuff like that. So it was more just a comment of just, when it comes to matches between therapists and clients and what works and what doesn’t, and stuff like that. So it just got me pondering that a bit too. And how their therapeutic approaches, Lori’s and Wendell’s were different approaches separately in their own work, but they worked together, they worked well as a match in their own therapies. So overall, just the relationship that Lori had with Wendell seems like it’s pretty positive, pretty appropriate, nothing that seemed to be a good match for other. Thoughts on that?

Laura McClure:

I don’t know if I have thoughts on the actual match between Wendell and Lori, but I would like to talk about, it’s at the very start of the book and she talks about the issues of a therapist finding their therapist. And I just want to say thank you for discussing that and add a couple of bullet points to that list because it’s really hard.

Nicholette Leanza:

Yeah, fair point. Yeah.

Laura McClure:

The next bullet point I would like to add is that it is incredibly difficult as a therapist to sit in a room with another therapist who’s trying to therapize you and all you can think about is, “Oh, I wouldn’t have said that to me.”

Nicholette Leanza:

Yeah, very true.

Laura McClure:

And all I can do is critique their therapy of me because I can’t get out that brain. So I really love that she talked about that struggle because it is real.

Nicholette Leanza:

Yeah. Angel, you’re nodding quite a bit. Did you have-

Meridith Braden-MacMullan:

No, I was just going to say, especially if you’re in a smaller area, it’s hard to find someone who’s not connected to one of your colleagues or maybe friend. I’ve been very lucky somehow in that search.

Angel Kramer:

Yeah. I belong to some of the local therapist groups online and the amount of people posting anonymously saying, “I’m looking for my own therapist.” And then in parentheses, they’re like, “No judgment, please don’t judge me.” I’m like, “Why would we judge?” You [inaudible 00:18:50] therapist. But it is such a struggle, whether we’re getting over our own imposter syndrome of, “Oh, am I a bad therapist because I wouldn’t have said what Wendell just said,” Or whatever the circumstances might be. And then like Laura was saying, getting out of our own heads about it, whether we’re critiquing or trying to control the therapy, like Lori said in her book, those are all struggles, but just like our patients need us, we also need someone to talk to, to get out of our own way.

Nicholette Leanza:

Yes. I love that. Get out of our own way. Right.

Laura McClure:

Beautifully said, Angel.

Nicholette Leanza:

Any criticisms or concerns with how the book portrays mental health or even therapeutic relationships?

Laura McClure:

I think, again, for me, it’s just that inner dialogue. I think there’s a point where we can say a little bit of what those thoughts might be, but we still need to remember that clients are reading this book and that it irked me, it bothered me. But that would just be my only complaint, is that I thought that was a little too honest of our thoughts.

Nicholette Leanza:

Got you.

Meridith Braden-MacMullan:

I think I really liked how the book showed progress over time. Sometimes as a therapist, it’s hard to know week to week, are things going well? Am I helping a client to make positive change? And even though sometimes the change wasn’t always linear, but it was nice to see positive change over time with this selection of clients. I mean, maybe you can’t expect a book to do everything, but I was wondering about the backgrounds of all these clients. Are we lacking in diversity all from the same socioeconomic background? And on the West Coast, it would be nice to maybe have more there.

Angel Kramer:

Having those characters fleshed out a little bit. What’s the background? What are we working with? Is there ethnicity, racial things to be considered? Socioeconomics, gender identity, things like that. Where’s that intersectionality happening to give us a little bit more scope, because it could be read as pretty cis heteronormative in the approach of the stories. A couple of concerns that I had with it, one of the things that made me super uncomfortable was when she was talking about Google stalking-

Nicholette Leanza:

Oh, gosh.

Angel Kramer:

… Wendell and all the information that she had going into session. I was like, “Oh, no.”

Nicholette Leanza:

Just to give context, everyone. So Lori, when she started seeing Wendell, her therapist, Google stalked him, where she just went down a rabbit hole of just trying to find information about her own therapist. So yeah, I forgot about that cringing there.

Laura McClure:

Yeah. It’s creepy on both sides. Whether [inaudible 00:21:37] Yeah.

Angel Kramer:

Were we saying the same thing, Laura?

Laura McClure:

I don’t know. I was going to say that it’s creepy on both sides. It’s creepy if you’re the client stalking your therapist, and it’s creepy if you’re the therapist stalking your client.

Nicholette Leanza:

Oh, yeah.

Laura McClure:

But it’s also the reason I know that stuff happens, it’s why I have zero internet presence. I don’t even have LinkedIn because I want there to be out no record of me online.

Angel Kramer:

Yeah, exactly. It’s an incredibly human thing to be curious about the person you’re meeting with and to want to have that background information that we were just talking about with the clients depicted in the book. But ooh, the door that opens with people reading this book and being like, [inaudible 00:22:18]

Nicholette Leanza:

Yeah. Because she found a lot of information and then she had to withhold, even if he would share little bits and pieces of himself, she had to withhold that she already knew that. And then she finally fessed up saying it, and he seemed to take it in stride. But yeah, I never thought that could give people ideas to do that. I’m sure there are some people who already do it, but those who didn’t think about it, I’m sure that would be something they would consider. Meridith, other thoughts on this?

Meridith Braden-MacMullan:

Oh, I was just thinking that it really brings up the point of authenticity because she wasn’t able to be real with him while she was moving onto that information. So then if the real therapy couldn’t happen, and then same way goes for therapists, we can’t BS our clients. We have to be authentic in the room with them. And I think the book did that well.

Nicholette Leanza:

One other thought, just maybe a little minor criticism/concern is that patient John would come in and they would eat lunch together, which that’s fine, but it sounds like he would buy it for her, and that they’re just like… I was just like, “Is that allowed? Can he just buy the food and they eat it week after week or whatever?” I did have that, is that a thing or not? What are your thoughts on that part? Did you guys think any more about that? Was that anything that stood out to you guys?

Laura McClure:

I… Go on, Angel.

Angel Kramer:

Okay. So I think as my initial read of that was, “Oh man, what a great moment of rapport building and just letting him be in that moment.”

Nicholette Leanza:

Okay, okay.

Angel Kramer:

I’m taking you to lunch break. Bring that food in. Let’s try to bond over food.

Nicholette Leanza:

I could see it from that point.

Angel Kramer:

And that’s where some cultural things might come from.

Nicholette Leanza:

True, true.

Angel Kramer:

I have some clients who culturally speaking, if we met during lunch hour, food would be part of it, but as an ongoing thing, the food was delivered even when John didn’t come in. That’s where it started to feel a little weird, when it was referenced as an ongoing part of session.

Meridith Braden-MacMullan:

I think at the end, they’d talked about how maybe the food wasn’t there after John had finally opened up, and then that was taking that icebreaker away. They didn’t need the food anymore.

Angel Kramer:

Yeah. I see that.

Nicholette Leanza:

I think it serves the purpose of helping them deepen their connection with one another. Because I can totally understand that I’m all for that. It was just more that he was consistently paying for it, and then that was the part that I was just like, “Eh.” But nonetheless, I think this has been a great conversation about this book, and I hope we inspire some people to pick it up and check it out. It’s Lori Gottliebs, Maybe You Should Talk to Someone. And I think overall, we were all thinking it was a pretty good book, showing some things very accurately, and we all have some minor concerns, but it was good overall. So thank you, Laura. Thank you, Meridith. Thank you, Angel.

Meridith Braden-MacMullan:

Thank you.

Laura McClure:

Thanks very much.

Nicholette Leanza:

For our next Couch and the Screen episode, we’ll be covering the HBO show Succession. I’d like to thank the team behind the podcast, Jason Clayden, Juliana Whidden, and Chris Kelman. With a special thanks to Jason Clayden for editing our episodes. Take care, everyone.