Maybe You Should Talk to Someon - Lori Gottlieb
Nothing is more desirable than to be released from
an affliction, but nothing is more frightening
than to be divested of a crutch.
Chart note, John:
Patient reports feeling “stressed out” and states that he is having difficulty sleeping and getting along with his wife. Expresses annoyance with others and seeks help “managing the idiots.”
Have compassion, have compassion, have compassion . . .
I’m repeating this phrase in my head like a mantra as the forty-year-old man sitting across from me is telling me about all of the people in his life who are “idiots.” Why, he wants to know, is the world filled with so many idiots? Are they born this way? Do they become this way? Maybe, he muses, it has something to do with all the artificial chemicals that are added to the food we eat nowadays.
“That’s why I try to eat organic,” he says. “So I don’t become an idiot like everyone else.”
I’m losing track of which idiot he’s talking about: the dental hygienist who asks too many questions (“None of them rhetorical”), the coworker who only asks questions (“He never makes statements, because that would imply that he had something to say”), the driver in front of him who stopped at a yellow light (“No sense of urgency!”), the Apple technician at the Genius Bar who couldn’t fix his laptop (“Some genius!”).
“John,” I begin, but he’s starting to tell a rambling story about his wife. I can’t get a word in edgewise, even though he has come to me for help.
I, by the way, am his new therapist. (His previous therapist, who lasted just three sessions, was “nice, but an idiot.”)
“And then Margo gets angry—can you believe it?” he’s saying. “But she doesn’t tell me she’s angry. She just acts angry, and I’m supposed to ask her what’s wrong. But I know if I ask, she’ll say, ‘Nothing,’ the first three times, and then maybe the fourth or fifth time she’ll say, ‘You know what’s wrong,’ and I’ll say, ‘No, I don’t, or I wouldn’t be asking! ’”
He smiles. It’s a huge smile. I try to work with the smile—anything to change his monologue into a dialogue and make contact with him.
“I’m curious about your smile just now,” I say. “Because you’re talking about being frustrated by many people, including Margo, and yet you’re smiling.”
His smile gets bigger. He has the whitest teeth I’ve ever seen. They’re gleaming like diamonds. “I’m smiling, Sherlock, because I know exactly what’s bothering my wife!”
“Ah!” I reply. “So—”
“Wait, wait. I’m getting to the best part,” he interrupts. “So, like I said, I really do know what’s wrong, but I’m not that interested in hearing another complaint. So this time, instead of asking, I decide I’m going to—”
He stops and peers at the clock on the bookshelf behind me.
I want to use this opportunity to help John slow down. I could comment on the glance at the clock (does he feel rushed in here?) or the fact that he just called me Sherlock (was he irritated with me?). Or I could stay more on the surface in what we call “the content”—the narrative he’s telling—and try to understand more about why he equates Margo’s feelings with a complaint. But if I stay in the content, we won’t connect at all this session, and John, I’m learning, is somebody who has trouble making contact with the people in his life.
“John,” I try again. “I wonder if we can go back to what just happened—”
“Oh, good,” he says, cutting me off. “I still have twenty minutes left.” And then he’s back to his story.
I sense a yawn coming on, a strong one, and it takes what feels like superhuman strength to keep my jaw clenched tight. I can feel my muscles resisting, twisting my face into odd expressions, but thankfully the yawn stays inside. Unfortunately, what comes out instead is a burp. A loud one. As though I’m drunk. (I’m not. I’m a lot of unpleasant things in this moment, but drunk isn’t one of them.)
Because of the burp, my mouth starts to pop open again. I squeeze my lips together so hard that my eyes begin to tear.
Of course, John doesn’t seem to notice. He’s still going on about Margo. Margo did this. Margo did that. I said this. She said that. So then I said—
During my training, a supervisor once told me, “There’s something likable in everyone,” and to my great surprise, I found that she was right. It’s impossible to get to