"It’s not like everyone in LA is in therapy,” sighs Lori Gottlieb. “That’s a stereotype. I think it’s a big misconception.” And having worked as a psychotherapist in the city for the past decade – and recently published Maybe You Should Talk to Someone, a New York Times bestselling book on the matter – she should know.

“A lot of people have strange notions and misconceptions about what therapy is,” Gottlieb continues. “We’re not wizards; there are no tricks. When we look at the clock, we’re not bored; we’re looking at the rhythm of the session. We want to make sure that if [the patient] is talking about something very intense, we’re putting them back together before they leave.”

[Explainer: pursuing a career in neuropsychology]

Gottlieb’s latest book follows her infamous 2010 bestseller Marry Him: The Case for Settling for Mr Good Enough, which caused a storm on both sides of the Atlantic.

The successful but highly divisive self-help book seemed to encourage women to settle for second best. Based on a magazine article Gottlieb wrote in 2008, it sparked multiple think pieces accusing Gottlieb of everything from being anti-feminist to provoking anxiety. With her new book, she is arguably on safer ground. It is so rich with insight into the secretive and misunderstood world of therapy that it could have been called, “What Your Therapist is Really Thinking”. That, however, would be selling it short. At the heart of it is something else entirely.

Five years ago, Gottlieb, a single mother (to a then eight-year-old son) was blindsided when the man she thought she was going to marry – referred to in the book only as Boyfriend – ended their relationship. He had grown-up children; he didn’t want to raise someone else’s. It just took him two years to figure that out. Struggling to cope with the demands of her day-to-day life and the complexities of her patients’ lives, Gottlieb, then in her late-40s, decided to get a therapist of her own. “I was in so much shock that my whole reason for going to therapy was to have my therapist agree with me that Boyfriend was a jerk, then I would feel better,” she explains.

Lori Gottlieb's new book proves that sometimes therapists need the couch too
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What starts out as a couple of sessions evolves into a difficult but transformative journey towards self-understanding. “Boyfriend starts off as the villain, but it becomes clear that I knew a lot more than I let on,” reflects Gottlieb. “We were both ignoring the elephant in the room.”

Gottlieb effectively becomes the fifth patient in a book that goes behind the closed doors of her sessions with clients; from the thirtysomething newly-wed diagnosed with a terminal illness, to the self-important Hollywood producer with anger issues. But, she explains, she chose them based on issues we can all relate to: “How can I love and be loved? What do I do with regret? How do I manage what I can’t change?”

How did it feel to expose herself – especially given the furore around her previous work?

“I wasn’t concerned about [the world of therapy]; in fact, a lot of clinicians I’ve spoken to are very glad I’ve put it out there. Me? That’s a different story!” she laughs. “It wasn’t as if I woke up one day and said, ‘I want to write a book about myself in therapy,’ but I didn’t want to write a book about my patients being vulnerable while I was going through an upheaval in my own life. There was something almost fraudulent about hiding what I was going through.”

The most common reasons people come to see her are rooted in emptiness or loneliness. “We’ve lost the organic way we used to connect,” she explains. “People have a lot of Facebook friends but in real life you wouldn’t be able to manage that many. We’ve lost the ability to be alone with ourselves and with each other, and that’s detrimental to our mental health. I’m not anti-technology but I think it’s got out of hand. We need to be more intentional in putting limits on social media, and putting our phones away. In therapy, I make it clear it’s a phone-free 50 minutes.”

It might seem more of an American phenomenon, but Gottlieb is convinced therapy is as commonplace in the western world. “People don’t talk about it, but they are doing it,” she says. And then, of course, there are those who are avoiding it, “partly because they think therapy is only for people who are falling apart, or they [feel] shame, or they know they’re going to have to make changes.

“We don’t like change because with it comes loss and uncertainty. So even if the familiar is unpleasant, we cling to it because it’s comfortable,” she explains. “But when you try to push feelings down, they get stronger. It comes out in short-temperedness or insomnia; it will come out in different ways if you try to ignore it.”

Sage advice aside, it’s Gottlieb’s personal story – from leaving a Hollywood career as a film and television executive to pursue medical school to having a baby with a sperm donor – that’s impossible not to invest in. She gave birth to her son, now a teenager, when she was 38.

“When a friend suggested I look at sperm donor sites, I hadn’t even heard of such a thing. But it was the best decision of my life.”

How did she find embarking on romantic relationships as a single mother?

“It’s very hard,” she says. “The romantic part of a relationship is challenging enough when you have a young child.”

Gottlieb is reluctant to elaborate on her split from Boyfriend (“This is not about a break-up, this is about facing the fact that we have a limited time on this earth”) and on whether, at 52, she has a new partner (“I don’t talk about that”).

It’s now 10 years since she wrote Marry Him. Does she stand by it?

“My advice in that book was excellent,” she says, firmly. “The article had a lot of hyperbole in it – people did not understand the humour – but the book is a reported piece of journalism where I talk to behavioural economists, historians and psychologists about what makes a happy, lasting marriage. It asks people to raise their standards, not lower them.”

What did she make of the criticism?

“People who wrote those articles didn’t read the book! I never wanted the word ‘settling’ in the title; we lost that battle with the publisher.”

It’s no surprise, then, that one of the requirements of her new book was getting to choose what it was called. “They wanted to use a title that I found so misrepresentative I put my foot down,” she says, declining to say what it was. “Honestly, if I hadn’t had the therapy I’ve had, I don’t think I would have.

“It really helps.”

The Daily Telegraph