Gottlieb has taken on a difficult task, that of taking the reader into the sessions and the relationship of therapist and patient (or client, depending on your school of thought.) Since the Diagnostic and Statistical Manual of Mental Disorders 5th edition, or DSM 5 is the source for diagnoses accepted by insurance companies for payment, characterizing therapy as medical treatment, then patient would be the correct term. Gottlieb describes various aspects of treatment, the core being that revelations and insights about the therapist-patient relationship is the catalyst for change in the patient. Difficulties are played out in the consultation room, hence the reason for no sharing on the therapist's part of their own selves, minimal outside-office contact, and complete protection of anonymity. Nothing must contaminate the relationship, to preserve the meaning and context of therapist for patient.

In general the author does a pretty good job of accurately rendering the nature of this artificial, yet powerful relationship. Her descriptions of her therapist, Wendell are entertaining and feel very real. Seeing Gottlieb experience both sides of the relationship, as therapist and patient is funny and humanizing, as she struggles with her own challenges, limitations, and circumstances, as well as trying her best to provide conditions of healing and progress for her patients. Her struggles are all too human, from maintaining anonymity when encountering patients out and about when with her son or boyfriend, to her natural curiosity about her therapist's personal life.

I can't help but wonder about how successful her mode of therapy is with the type of patients she sees. She describes patients with "problems of daily living", not handling clinical depression, acute anxiety disorders, or the intractable difficulties of the personality disordered (those who make it into therapy). In general, it felt like a light, insubstantial treatment of the very real suffering most bring into a therapist's office. With this mode of treatment, patients can be seen for years on end, with a therapist observing trends up and down in patient's mental health, improved functioning, or happiness and satisfaction in life. Is that due to the passage of time, or does this form of therapy actually work? Or is the therapist an objective sounding board, providing a safe place to speak out loud about one's miseries? I don't know how Gottlieb can attribute any success to the relationship she provides the patient--how does she measure success?

This book will give the novice a window into one form of psychotherapy, and make them question the usefulness, the efficacy of such treatment. Maybe that is all this form of therapy provides--a place where you can safely talk to someone, outside of your sphere of relationships. If it helps to air difficulties out loud, you may feel relief. Will the relationship over years provide healing? I have my doubts.