I couldn’t be more thrilled to be able to share this testimonial. This client provided her feedback with consent for it to be publicly shared. If you would like to begin working with me, drop me an email to get started.
“I started working with Kirsty at the end of 2022. I had moved abroad but it hadn’t worked out, and I was under a lot of pressure from people close to me to “figure out what I was doing with my life”, which led to me having panic attacks and high levels of anxiety that I’d previously had completely under control.
I tried a few therapists before Kirsty, two that I just did a single session with but one who I saw for a twelve-week block, but I found it frustrating, grounded too much in the past and I felt like words were being put in my mouth.
Kirsty’s approach was a complete breath of fresh air.
I feel heard and understood in every session, and she doesn’t tell me what to do or how I’m feeling, instead guiding me towards making decisions for myself and highlighting things I’ve said by repeating them back to me and prompting me to think about why I’ve said that.
The reason why I’ve loved working with Kirsty is because she is very focussed on the future. We’ve jumped back in time in the early days and spoken about the root causes behind my anxiety, but all with the objective of moving forwards and making progress in my life now.
Once my anxiety was more under control, we moved to a session every two weeks and now have ad hoc sessions if I have a challenging situation to deal with or I just feel like clearing my head. Kirsty creates a safe space to talk, and I always leave her sessions feeling better equipped to deal with whatever comes my way.
We can have a lot of light-hearted moments in our sessions, and she is very easy to get along with and relate to, which I think helped build a relationship of trust very quickly.
Kirsty’s sessions don’t feel clinical, but instead warm, like you’re getting advice from an older sister rather than sitting in a therapist’s office.
I look forward to our sessions and even when I’m in a good place with my anxiety issues, Kirsty has helped me with relationships, travel, my career and supported me as I moved to another different country (but I’ve been here for 10 months now, so this time it’s working out!)
I couldn’t recommend her more.
She’s supported me in turning my whole life around and has helped me regain my confidence and self-esteem. I continue to work with her because I think her sessions make me more self-aware, compassionate and confident, and she is helping me to understand and empathise with myself in a way I never could before, which has led to me being a happier person.”
If you want to become more self-aware, compassionate, confident, and happier like this client, drop me an email to get started.
Anxiety is unpleasant and distressing with symptoms including:
Feeling light-headed
Feeling nauseous
Sweaty face, armpits, and palms
Knot in the stomach
Racing heart
Tight chest
Anxiety comes along when the amygdala (a small almond-shaped part of the brain) interprets a “threat” and begins preparing the mind and body for “fight-or-flight” in order to survive.
We need this system to function so that we can keep ourselves safe if there is an emergency.
However, in modern-day living, this system gets activated in non-life-threatening situations when we get anxious about daily life, so our fight-flight reaction is kicking in when it’s not really needed.
The issue is that when this reaction kicks in, the behavioural elements of fight or flight can become problematic for our work, relationships, and lifestyle.
The consequences of “flight”
Flight is when we escape the situation, we leave, we don’t turn up, we don’t face the problem. The amygdala threat alarm rings, the brain goes “get me out of here!”, and we flee.
This is an understandable reaction because the brain is interpreting the situation as threatening and is doing what it can in that moment to return you to “safety”.
So, we can say that, very short-term, avoidance works for dealing with anxiety.
But this isn’t the whole picture because as adults in modern day, that situation we avoided hasn’t gone away or been resolved; the problem is still there waiting to be dealt with.
We can sum up the problem with avoidance in the image below:
This is a vicious cycle.
Over the longer-term, as we go round and round this vicious cycle, we’re restricting our life, becoming more anxious, confidence is dipping, and our comfort zone becomes smaller and smaller while our anxiety increases and confidence falls.
What a pickle!
Know that it doesn’t need to be this way.
The first step is awareness. Become aware of what situations you’re avoiding and become aware of what you think about the situation. Common anxious thoughts relate to the problem being too big, you don’t know how to solve it or cope, you’re all alone and nobody else will help you.
Secondly, begin to talk back to those thoughts to give yourself some reassurance and encouragement. Remind yourself that things often aren’t as bad as the anxiety leads us to believe, that you can do it even if you need to break problems down into smaller manageable chunks or ask for help.
Thirdly, rip the band-aid! Ok, I know this is scary but biting the bullet is short-term “pain” for long-term gain. You can do this.
Top tip – remember to slow down and breathe to help regulate your nervous system as you take these steps.
If this feels too overwhelming to go alone, I’d be happy to help you. We can work out what the problems are, reframe unhelpful thoughts and beliefs, and create manageable steps to get you back out there with confidence.
I offer one-one therapy online and face-face in Edinburgh.
CBT – Cognitive Behaviour Therapy – is a highly effective form of therapy that focuses on the link between what we think, what we do, and how we feel as shown in the diagram below:
Our thoughts influence our feelings, our feelings inform our behaviour, and our behaviour can reinforce our thoughts and beliefs. As such, we can find ourselves in “vicious cycles” of unhelpful thoughts, uncomfortable or distressing feelings, and unhelpful behaviours that keep us stuck in the cycle.
Note that I’m saying unhelpful thoughts and behaviours. In therapy, it’s important to step back from judgement as this creates a barrier to effective change. Rather than criticise ourselves as being wrong, silly, or stupid, we can simply notice that what we’re thinking and doing is unhelpful for the outcome we’re seeking.
CBT aims to help the client develop self-awareness and tools to be more present in daily situations and to be able to identify and adjust unhelpful thoughts and behaviours in order to feel better.
CBT is evidence-based and recommended by NICE guidelines (National Institute of Clinical Excellence) which is the government standards and recommendations for the best practice of health and care treatments and technologies.
What to expect
CBT sessions tend to last 50 minutes and take place on a weekly basis.
The sessions are quite structured with an agenda set at the beginning of each session so that both client and therapist know what will be worked on. The therapist will typically lead on this in the beginning sessions as the client becomes familiar with therapy but there is always scope for the client to add items to the agenda, perhaps particular situations that have been on the client’s mind that week.
CBT is usually more time-limited than other forms of therapy – typically 6-20 sessions – to work on a specific problem. For example, if you have a problem with anxiety in social situations, the first few sessions are about understanding what happens for you in social settings in terms of your thoughts, feelings, and behaviours and considering where this problem has originated from. The next few sessions might work on adjusting your thoughts and testing new behaviours. The remaining sessions are used to create a plan to maintain your progress before moving towards an end.
CBT involves out-of-session work which may involve things like reading over some information, reflecting on your experience, practicing CBT tools and models, or trying out new ways of doing things. The purpose of this is to build forward momentum for the change you’re working on and create new pathways in your brain to turn these new strategies into habits.
We’re only together for 50 minutes each week, do you think that alone is enough to change your life? Like with most things, you’ll get out what you put in! If you’re struggling to do the agreed work, let your therapist know so a solution can be found.
CBT with me
I am calm, friendly, and organised and I make it my mission to help clients make meaningful, sustainable change. As my client, I want you to understand yourself more fully, to get to the root of the problem, and to feel empowered to make choices and decisions.
I encourage you to turn up as yourself – no need to worry about getting things right or wrong, or oversharing, or swearing. The time and space we have together is safe for you to say what needs said and I’ll be here to guide you forward.
I’m big on holistic health so I’ll likely check in with your hydration, nutrition, exercise, sleep, and caffeine consumption as these factors all interlink with our mental health and wellbeing.
Language is also a key point of interest for me – language says a lot about the meaning we give to ourselves, other people, and the world. Don’t be surprised if I ask you what you mean by certain things or pick up on words, phrases, or images – I’m not quizzing you, I’m genuinely keen to hear more about your perspective!
My biggest aim is for you to feel better within yourself and about yourself, I’m here for you.
If you work with me through an insurance provider, we’ll have allocated session numbers to help you work on resolving a particular problem. I’ll draw out a research-based treatment plan and we’ll work methodically towards reaching your hopes within our timeframe.
If you work privately with me, sessions can be a little more flexible if needed, and you may wish to continue seeing me over a longer period of time. This can be for various reasons – perhaps a life event occurs that you’d like some support navigating; perhaps you’d benefit from regular accountability, or perhaps you like knowing you have someone impartial to speak to.
Ways to work with me
I provide online therapy sessions via Zoom on Mondays, Wednesdays, and Thursdays.
I provide face-face therapy sessions in Edinburgh on Tuesdays.
How to get started
Drop me an email with your name, your preference for remote or face-face sessions, and your availability and we can arrange an initial call to get started!
Sleep and mental health have a reciprocal relationship; our mental health can impact our sleep quality and poor sleep can impact our mental health and wellbeing as illustrated in the vicious cycle below:
Read on for my Top Ten Tips for improving your chances of a better sleep!
Environment Make your room somewhere you want to relax and sleep.
Do this by tidying your room and keeping the bedroom for sleep and sex only. Avoid eating, drinking, or watching tv in your sleep space.
Routine Try to stick to a bedtime and a wake time and avoid snoozing through the day.
This can feel tricky but sticking with it can help regulate your circadian rhythm meaning your mind and body are programmed for sleep.
Caffeine and sugar Avoid caffeine or high sugar food or drinks prior to bed.
Usual caffeine suspects are coffee, tea, energy drinks, and chocolate. I’m not necessarily asking you to give them up forever, just while we’re sorting your sleep out!
Swap the screens Reduce or avoid screen time where possible before bed. The blue lights from the screens keep our brains awake and sometimes the content puts our brains on high alert, particularly watching the news or high action movies.
Pick up a book instead – our eyes moving left to right across the page helps induce sleep.
Too many to-dos or should-have-dones? Write down those thoughts that swim round and round in your mind.
Getting them out of your mind and onto the page means that you can go to sleep safe in the knowledge that your thoughts won’t be forgotten.
2-4 Breathing Inhale for the count of 2, and exhale for the count of 4. Extending the exhale relaxes the mind and body, taking our nervous system to the “rest and digest” state.
It’s normal for the mind to wander off, return your focus to your breath.
Avoid the countdown “If I fall asleep now I’ll get 7 hours… oh no, now I’ll only get 6 hours…”
Instead remind yourself that sleep is a fundamental need of the body, you will manage to sleep, and even simply resting the body, mind, and eyes is worthwhile.
Block out the light Eye masks can be helpful for blocking out light and signalling to the brain that it’s time to sleep – no more staring at the ceiling!
Eye masks are inexpensive and come in a range of colours and materials so you can find what works for you.
Relaxing sounds Listening to ocean sounds, forest sounds, rain drops, or guided sleep meditations can be a helpful distraction if thoughts are still circulating in your mind.
There’s loads to choose from on youtube, so if one doesn’t work either try it again or try a different audio.
Natural remedies Drinking “Sleepy Tea” or “Night Time Tea” can be helpful as they typically contain ingredients like lavender and camomile which promote a calm state.
Avoid drinking too close to bed time as you’ll likely be up through the night for the toilet! I’d recommend at least an hour prior to bed.
There you have it! Have a go at incorporating these tips into your routine for a couple of weeks to see how it impacts your sleep ability and quality and let me know how you get on.
If you’re struggling to establish a sleep routine or those pesky racing thoughts stick around, I could help you in 1-1 therapy by processing your stress, worry, or anxiety and tailoring the information specifically to you and your circumstances. Drop me an email to get started.
Dweck calls this belief a “mindset” and categorises into “fixed mindset” and “growth mindset”.
In this review of Mindset by Carol Dweck, I’ll cover:
An intro to the author
What is a fixed mindset
What is a growth mindset
My key takeaways
How this book relates to the work done in therapy
And whether you should grab yourself a copy
Let’s get into it.
The Author
Carol Dweck is a professor at Stanford University and is one of the world’s leading researchers in personality, social psychology, and developmental psychology.
She uses her own research, anecdotes from her own life experience, and her work with her students, to illustrate how our mindset can have a big say in how we behave and interact with the world across various settings – arts and science, sport, business, education, and relationships.
You can expect to find out how mindsets change:
What people strive for and what they see as success.
The definition, significance, and impact of failure.
The deepest meaning of effort.
So what are these mindsets?
In essence, the mindsets are what we believe about ourselves in terms of our intelligence, competence, and talent.
The fixed mindset is rigid and black-and-white. In this mindset we might think we can either do something or we can’t.
Whereas the growth mindset is more flexible. In this mindset we’d be more inclined to believe that we can learn and improve.
The fixed and the growth mindsets interact with key life components including how we view challenges, obstacles, effort, criticism, and the success of others, as shown in Carol Dweck’s diagram below:
Mindset by Carol Dweck, Two Mindsets
Dweck explores these topics in the eight chapters and each chapter ends with “Grow Your Mindset,” which includes tips on how to apply the lessons from that chapter. The final chapter is dedicated to helping the reader cultivate a growth mindset.
My Key Takeaways
The fixed mindset is a barrier to change, development, and progress. The growth mindset is a starting point for change, but the work doesn’t stop here – “skills and achievement come through commitment and effort”.
In the chapter on Parents, teachers, and coaches, Dweck describes growth teachers who convey the message that there are no shortcuts, no magic, and no miracle workers.
These two takeaways really chime with my approach to therapy – while I understand why clients would like to magically feel better, it will take time, effort, and commitment to gain traction and momentum.
According to the research, “normal young children misbehave every three minutes”. Although this might bring a big sigh of relief to parents out there, there’s another message that comes with this: children pick up messages very early on about whether their behaviour and mistakes are “worthy of judgement and punishment or an occasion for suggestions and teaching”. It might be worth considering which message you’re conveying and how this could be tailored to, not just your children, but anyone you have a relationship with.
Although children love receiving praise about intelligence and talent, Dweck cautions that, “Praising children’s intelligence harms their motivation, and it harms their performance”. This is because if success equals intelligence, then failure equals stupidity, and this is the fixed mindset. Instead, praising the effort, process, and learning leads to longer-term confidence and a growth mindset.
On the other side of the coin is criticism. Children require honest, constructive criticism to learn and grow. Dweck tells us that even though we often just want to protect our children from criticism, not providing effective constructive criticism can lead to a lack of confidence, which can have far-reaching repercussions into their future. Constructive criticism should not be conflated with judgement. Constructive criticism involves helping people to become better.
“Change can be tough, but I’ve never heard anyone say it wasn’t worth it.”
Mindset, Carol Dweck
The biggest takeaway for me was stated in the first chapter, “The message is: you can change your mindset” which resonated fully with me in the four-step process in the final chapter which Dweck calls “the journey to a growth mindset”. The four steps involve acceptance, trigger-awareness, persona creation, and testing, with a fifth step being maintenance. Dweck expertly navigates any resistance in the reader by explaining that we all have a fixed mindset in some areas of our lives and that it’s just part of being human.
The aim of the book aligns with the principles of Cognitive Behavioural Therapy because the premise of CBT is that we hold beliefs about ourselves, other people, and the world which shape our thoughts and actions.
Having negative beliefs leads to unhelpful thoughts and behaviours, meaning that we can find ourselves stuck in vicious cycles that take us away from our desired outcome and can even inadvertently confirm our negative beliefs.
Below is one of Dweck’s descriptions of the growth and fixed mindsets responding to an academic failure, which I have transferred into a CBT model:
We can see that although the feeling of disappointment is present in both mindsets, the growth mindset leads to helpful thoughts and more effort, whereas the fixed mindset leads to unhelpful thoughts and avoidant behaviour.
Our interpretations inform our behaviour. If we can get our mindset in check, more productive and effective behaviours will follow.
In therapy we explore what the beliefs are, where they came from, as well as how to create new beliefs, thoughts, and actions that serve us better.
Should you read it?
I would absolutely recommend you read Mindset by Carol Dweck for yourself and use the four-step process in the final chapter to work on your own mindset.
After reading this book, I felt motivated and inspired to view challenges as learning opportunities, it’s already made a big difference in some key areas of my own life.
For anyone interested in continuing their learning, Dweck has provided a list of recommended books at the end which I reckon I’ll be working my way through because after reading her work, I truly trust her judgement.
Psychotherapist Esther Perel explores eroticism, lust, love, desire, security, and commitment in her book, “Mating in Captivity, Unlocking Erotic Intelligence” in which she challenges surrendering to the doomed fate of a sexless marriage.
Through the book, Perel hopes to encourage the reader to “question yourself, speak the unspoken, and be unafraid to challenge sexual and emotional correctness” by presenting several client case studies which explore fantasies, fidelity, monogamy, and sex after children.
A compassionate and non-judgemental acknowledgement that spice and sizzling passion isn’t the thing for everyone, that some relationships are centred on “warmth, tenderness, and nurturance” and that there is “no one way, and no right way”, creates an emotional safety to begin broaching topics that are often taboo and enveloped by shame.
Perel provides a widely accepted therapeutic framework that “the first place we learn about love and relationships is in our original family” which means that the environment in which we are raised – the messages we receive and perceive from those around us – shapes our understanding of how to relate to ourselves and to others:
How was love expressed at home?
Was there discussion or avoidance around sex?
How did gender dynamics play out?
These messages set our expectation for how relationships work in life, a blueprint. This blueprint becomes more relevant when a change occurs when we go from more spontaneous-style sex on the dating scene to entering a family dynamic, even a family of two after saying “I do” as we often begin seeking to replicate or correct past experiences, known as the “repetition compulsion” (thank you Sigmund Freud). It’s important to note that the other person in the relationship is also bringing their blueprint into the equation which is why effective communication is fundamental to healthy relationships.
This dynamic is further complicated when kids come on the scene and there are multiple titles attached to your “former lover” – partner, wife, mother – as well as different priorities and time commitments, which Perel’s case study summarises with, “I knew we were in trouble when I couldn’t even think about sex until all the toys were put away”, a statement which I imagine resonates with many a parent who is struggling to rekindle the spark with their partner.
“Love and desire are not the same. Cosy is not the same as sexy”.
While the above statements may not be ground-breaking, in therapy, often the simple messages stated clearly by a professional land in a meaningful way with clients. As we now seek the heat of desire, lust, and eroticism as well as the warm love and tenderness in the same person, it’s helpful to have these statements in mind when thinking about what mode you and your partner are in and when and how to change from cosy to sexy.
When discussing fantasises, Perel astutely navigates the shame barrier by informing us that “sexual fantasies don’t reflect reality”, when you close the bedroom door, you close the door on reality too. Perel highlights that typically women struggle to own their fantasies and often “she makes him, and his desire for her, the centrepiece of her sexual identity”. So, we’re not only bringing our thoughts and beliefs from our origin family, but also internalised gender-norms from society; tough stuff!
Eroticism can seem like a minefield, as Perel describes it as being “fuelled by a host of feelings that are far from proper: aggression, raw lust, infantile neediness, power, revenge, selfishness, and jealousy (only to name a few)” and can be rife with fear, anxiety, and insecurity.
However, she also describes eroticism as an “act of generosity and self-centredness, of giving and taking” and highlights the importance of cultivating erotic play which by definition is “carefree and unself-conscious…a fundamental feature of play is that it serves no purpose”.
What strikes me from these contrasting concepts is that there needs to be love and emotional safety within the relationship if each partner is to let their guard down to explore creativity and play in the bedroom while also allowing the other to see our “improper” thoughts and feelings. Perel creates a beacon of hope by saying that “love is a vessel that contains both security and adventure, and commitment offers one of the great luxuries of life: time”, if love is at the heart of your marriage then let’s do the work.
“Marriage is not the end of their romance, it’s the beginning.”
Through her case studies’ stories, Perel conveys some key aspects of therapy: challenge, disclosure, strategies, beliefs, and returning to therapy.
A common trope is that therapists listen, nod their head, and ask “how do you feel about that”. But a key function of the therapist is to offer challenge. Perel light-heartedly captures this concept through one of her case study examples, when a client says, “The laundry won’t just do itself you know.” To which she responds, “And sex will?”. Challenge doesn’t have to be scary or aggressive, as a therapist the intention is to provoke thought and open conversation.
Perel takes the pressure off her clients by reassuring them that, when working with fantasy, “disclosure is not a necessary part”, a concept that can be applied more broadly too – you don’t have to tell everyone everything, and you don’t need to tell your partner everything. Your mind, your thoughts, your feelings, and your desires are all yours and you get to decide what you share and what you hold for yourself. This is your power.
Perel provides some insight into how to open discussions about sex by asking her clients to reflect on their connotations of sex, desire, and marriage and inviting clients to talk to each other about, “what does sex mean for you?”, “how was sex treated in your family?”, “what are the important events that shaped your sexuality?”, “what would you most like to experience with me sexually, and what are you most afraid of?” to enable shared understanding, find common ground, and navigate any differences.
We all hold unhelpful beliefs that are often started in childhood and morph over time through our experiences. Perel’s simple statement that, “often, therapy is a process of dismantling these beliefs”, reassures the reader and potential clients that is a common feature of therapy, dismantling beliefs that no longer serve.
Through Perel’s understated line, “I’ve worked with Jackie and Philip on and off for years”, she normalises the idea of returning regularly to therapy. At times, folk can think they’ve “failed therapy” if they need or want to return for more sessions, but this couldn’t be further from the truth! New life circumstances can throw up different problems, it can be helpful to revisit previously learned coping strategies, and it can be useful at any point to have an impartial person listen and guide. A common analogy is that if you were physically ill, you probably wouldn’t decide not to see the doctor because you saw a doctor once before. Come back to therapy at any time, the door is open.
The biggest flaw in this book for me is the language and tone which almost became a barrier to completion. Perel flags in the acknowledgements that she’s not a native English speaker, however it’s a pity the book wasn’t edited more effectively to create a smoother read.
My problem with the language begins where Perel refers to “eros” (physical love, sexual desire; Greek god of erotic love) in her introduction. No definition is provided but the word is repeated throughout. Whether or not readers know the intended meaning upon reading the word, my argument is to take the reader with you by providing a definition.
The hopping from colloquial phrases like “what happens in Vegas” to Latin phrases such as, “sine qua non” disrupts the reading flow and creates an inconsistent rhythm. And this broken flow is exacerbated through a mix of French and English language. In one relationship case study, Perel says that the male is “avoiding her démarches”, a statement which is quickly followed by the male finding it increasingly difficult to “fuck her”. For me the use of French elevates the tone, then the colloquial swearing brings it back down in a way that feels really disjointed.
There are words used in both English and French that I didn’t fully understand, despite being a psychotherapist who studied languages (in a past life). I imagine that this book would leave many readers reaching for Google at the mention of “contretemps”, “quixotic”, or “mensch” to name but a few. As a therapist, I speak with the intention of being understood. This of course doesn’t mean dumbing down or patronising my clients, but there’s an intentionality behind my language to ensure understanding and the formation of a strong therapeutic connection. I appreciate that in this case, Perel isn’t our therapist, she’s our author, but more considered language or more effective editing could have gone a long way.
Perel alienates her reader at times – referring to Americans she says, “nowhere is our profound discomfort with sex more apparent than in the way we approach teenage sexuality”. There are 341 million Americans, and her statement lacks nuance of the difference between different American states, religions, and cultures; the melting pot of America.
Perel goes on to contrast Americans with Europeans who “view adolescent sexuality as normal” and “not a problem”. Who are “Europeans”, and do they really share an approach to sex? I would argue that Brits don’t view sex as normal and not a problem; in fact, there appears to be a lot of embarrassment and shame when it comes to talking about bodies and their functions. I would contend that the various countries are influenced by their own cultural norms, history, and religion. Added to this, the UK has one of the highest rates of obesity in Europe, which for many people is often another influential factor in the bedroom. Is Perel really saying that countries like Germany, Ireland, Italy, Luxembourg, Serbia, the Ukraine, and the UK all share an approach to sex? Admittedly I’m not an expert in the field, but I find it hard to believe that this would be the case. I don’t believe that there is one shared European approach to sex.
Perel states in her introduction that her intention is for the book to be an “honest, enlightened, and provocative discussion” about sex in modern committed relationships, and I think she does meet that intention. Although I underlined several points of interest, I also wrote several question marks on the pages; I was unsure of the relevance of the statement or couldn’t even follow the meaning of the statement. This book lacks a bit of punch which I chalk down to the inconsistent tone and language that makes it hard for the reader to get on board and follow the author.
This was an interesting and thought provoking read but difficult to engage with and so I’ll only be giving this 3/5 recommendation.
How do you review something so layered, so insightful, so expertly created?
These are the questions I’m asking myself as I sit down to write this review of “Maybe you should talk to someone” by American psychotherapist Lori Gottlieb.
In this instant New York Times bestseller, Gottlieb tells her story of being a therapist, whilst also attending therapy as a client herself, the very same position I was in when my good friend gifted me this book.
Gottlieb begins by posing the question, “how do we change?” and through the pages of her book she responds, “in relation to others”. The therapeutic process is brought to life by Gottlieb sharing her clients’ stories, her own perspective of sessions and clients, and how she finds relating to her own therapist, Wendell. The latter of which she captures brilliantly in her line, “I both loved and hated Wendell for saying that”.
The strength and depth of the therapeutic relationship is the basis for effective work. But just like any other relationship, it can be complicated. It’s the process of turning up, sitting in discomfort, and doing the work from both client and therapist that creates safety for exploring and creating change.
This book is an expertly crafted interweaving of stories that exemplify the therapeutic arc taking us from what’s bringing clients to therapy now, laying it all out, editing the narrative, moving towards meaningful change, and coming to an end.
Gottlieb introduces us to four of her clients:
A twenty-something who is into bad guys and booze
A thirty-year-old newlywed with a terminal illness
A forty’s TV producer who calls everyone else an idiot
A 69-year-old contemplating suicide if things don’t get better
Through these tales we sit in ambivalence with the twenty’s client, face death with the thirty’s, learn about defence mechanisms with the forty’s, and seek forgiveness with the almost-septuagenarian. The craftsmanship of the writing absorbs you in each client making it easy to follow each client’s journey.
Just like therapy, as the stories unfold and we delve into the depths of learning with Gottlieb and her clients, there’s a somewhat sudden, yet also subtle, shift as the pace picks up as they all move through their change process, pictured below:
Stages of Change, James Prochaska, 1980s
Gottlieb describes this change process as happening “gradually and then all at once”.
This book is one to be highlighted and scribbled on as Gottlieb brings an abundance of knowledge to every page.
You’ll find out about:
Erikson’s psychosocial changes
Four ultimate concerns
Misery-seduction dynamic
Privacy vs. secrecy
Projection and projective identification
Reacting vs. responding
Ultracrepidarianism
Unconditional positive regard
And much, much more!
It’s not just the psychological context but also Gottlieb’s graceful articulation of tender moments of therapy that you’ll want to underline. A standout line for me was: “I watch her hear what she already knows” which for me called to mind so many of my wonderful clients, particular moments where we’ve sat in the reality of it all, where I’ve seen emotions appear before my eyes, where I’ve felt a physiological shift in my body and observed the shift in them as we arrive at and embody realisations.
Therapists are somewhat mysterious as our work is bound with confidentiality, meaning that people often struggle to grasp the nature of our day-to-day as we can’t elaborate or exemplify what we do. By bringing the four clients plus herself as a fifth client, Gottlieb provides a real insight into how clients present and how therapists work in session, and how therapists are in Gottlieb’s words, “a card-carrying member of the human race” which is not a flaw, it’s our biggest credential.
Gottlieb captures the sense of mystery when she addresses the question that we therapists often get asked “what kind of people do you see in your practice”, to which she responds, “just like any of us, which is to say, just like whoever is asking”.
You don’t need to be in crisis, you don’t need to have a diagnosis, therapy is for any of us.
Throughout writing this review, I caught myself being tempted to refer to the author as “Lori”. This speaks to the familiarity she creates through her writing. It feels deeply personal and vulnerable whilst also feeling very considered and expertly crafted. I also struggled to write this review because I didn’t want to say too much that would spoil the story unfolding for you!
I highly recommend this book – whether you’re interested in going to therapy, have already been, are a therapist yourself, you want to learn more about humans, or you just want a damn good read.
Expertly written, this book is an absolute gem that I’m sure I’ll be rereading for years to come.
* Bonus recommendation: If you read the book and enjoy it, I’d also recommend watching Couples Therapy on BBC iPlayer which is a similar behind-the-scenes look at therapy, facilitated by Dr. Orna Guralnik.