Written frankly, this book and Gottlieb’s approach to therapy do not pull punches.  She tackles small problems (how should she refer to those she counsels - patients or clients?) to large ones (how to “dump” patients that are not progressing in therapy and the ethics of maintaining confidentiality) with humor, candor, and a forthrightness that makes you feel like you’re listening in on her actual thoughts.  In one memorable juxtaposition between herself and a patient, she employs Carl Rogers’s approach of “unconditional positive regard” to a patient in a session, but admits that she doesn’t necessarily like him as a person.  Whereas in her own therapy with Wendell, she worries so much about making him like her and his opinion of her that she eventually asks him directly what he thinks about her.

Gottlieb’s writing is unique as she places a magnifying glass on herself and her own experiences in therapy just as much, if not more, than those of her patients.  Her entire backstory is presented, even parts which she did not share with Wendell.  Her insecurities, her fears, and anxiety about writing a book that she doesn’t care about (don’t worry - not this one) are presented and explored in parallel with similar feelings in her patients.  Her patients themselves are a varied group:  a seemingly self-absorbed TV writer, an artist who feels stuck and isolated in her own life, a professor finding her priorities after a terminal cancer diagnosis, and a younger woman struggling with alcohol addiction and finding the right romantic relationships.  Through them, Gottlieb’s devotion to the therapeutic relationship is laid bare.  Each patient’s story unfolds candidly and compassionately, providing the opportunity for Gottlieb to demonstrate the varied approaches therapists have to different “presenting problems” and how much thought goes into unlayering and understanding the patient and then preparing them to make changes in their own thought processes and behaviors.

But, there is another unspoken subject that she addresses:  you, the reader.  It is difficult  to read of Gottlieb’s tribulations or her patients’ emotional admissions without considering your own challenges communicating, the personal traumas you’ve experienced, and the relationships with friends and family that you’ve made, nurtured, damaged, or let fall by the wayside.  Regularly throughout, such as when we learn of Erik Erikson’s psychosocial stages or Carl Jung’s theory of the “collective unconscious,” Gottlieb presents different psychological concepts with each providing a moment to reflect back on your own life and thought processes.  In doing so, our lives, much like her own and those of her patients, are revealed.