Lorna Martin, the author of the memoir Girl on the Couch, had a reasonably “good” life. She worked as a writer for the Observor. She had a loving family and a group of girlfriends. But when she found herself involved in a love triangle that was threatening to become a love square, she decided to begin psychotherapy in order to get down to the bottom of things.

While I tend to think we are just about one block away from the end of Memoir Street, another one always pops up that catches my eye. I wonder, “Is there anything new to tell?” And in this case in particular, “Is there anything new to tell us about therapy?” As mentioned before, this is not a book about what we would refer to as “mental illness” but more about the feeling and position in life of being blocked. Or maybe it could be better described as feeling as if you are forever waking up in the middle of the woods with no idea how you got there and even less of an idea about how to get out. It’s confusion wrapped up with lack of perspective, ingrained habits, runaway emotions and bad memories. And yes, it’s very real, even if it lacks a name like manic depression (perhaps Martin defines it best through the use of the term “normal neurotic”).

All around Martin, people she were settling down, making choices about their lives and, essentially, getting on with their lives. Meanwhile, she felt “out of gear.” To be “out of gear,” as I interpret it, can be to experience depression, anxiety or a mixture of both. It’s a feeling that can cause one to feel desperate for alone time only to be unable to relax once finally alone. Or to feel lonely while in a big group of friends. Or to be “held captive” by two wildly conflicting fears. It could cause one to weep over having to attend a boring business lunch or to sleep for 12 hours and not feel rested.

And, for many reasons, I think this “out of gear” feeling is well-known to women, probably because it isn’t OK for us to be angry or jealous when instead we should be smiling as we attend yet another bridal shower, work full-time jobs and take care of children. But of course anyone can experience this – the question becomes how much  is tolerable for any one person? How much can feelings like this be attributed to being human and how much means you need help to pull yourself out of it?

The catalyst that finally gets Martin to admit she needs help is the aforementioned love affair; she’s been having an affair with a married man who sort of/kind of stops seeing her to take up with yet another woman. This leaves Martin feeling betrayed, angry and jealous. Even though she is aware of just how ironic and sad her relationship with this man is, she can’t stop herself from calling to blackmail him while alternately trying to get back together with him.

But what she discovers throughout her year of three-times-a-week sessions (an ambitious schedule, to be sure) is that this latest debacle is only another page in her book. For over a year before entering therapy she’d experienced crying jags, chronic lateness, misplaced items and the constant worry about not being good enough in her job. She was a member of what I call the Cult of Perfectionism; meaning she didn’t want to do something once she realized she wasn’t going to be fabulous at it. At one point, her sister and friends point out all the things she quit because she realized she’d never be amazing at them: running, playing the cello, tennis, Pilates, yoga, French, German, Italian, meditation, creative writing, surfing, painting, snowboarding… It does tend to start to limit your options. Her sister counsels her to, “Dare to be average. Wake up to the fact that you’re not that important.” I find this advice to be very attractive indeed. It seems to hold the promise of taking joy in things like grocery shopping, nights of deep sleep and buying birthday gifts without spending hours agonizing over everything in a store.

The rub was that all the while she was striving for perfection, she experienced feelings and emotions that told her she was anything but good enough, smart enough, attractive enough or funny enough. It set her up for exhaustion. It set her up in a game she could never win: “You have to be absolutely perfect at everything you do, but since you are deeply, deeply flawed… Good luck with that.”

Martin’s doctor, whom she refers to as Dr. J, is not a feel-good, comforting person who invites Martin in for a cup of tea and a snuggle. When Martin complains and says, “I wish you’d say something nice to me; something that would make me feel better about this mess I’m in,” Dr. J simply replies, “That’s not my job,” which doesn’t stop Martin from trying to make it so, always asking Dr. J what she thinks might be possible for her in the future. When Martin describes running into an old boyfriend who is now happily involved with someone else, she explains that he had just returned from a mini-break (Martin is Scottish) in Amsterdam with his new girlfriend. “Do you think I’ll ever be able to go on mini-breaks with someone special?” she asks Dr. J. “I mean, after all this treatment is finished?” Dr. J is predictably silent in response. But it’s through this relationship, where she’s not getting hugs, seeking approval or trying to be better than someone else, that Martin finally gets back to herself; the self that’s there no matter what’s happening in the world around her.

A lot of people don’t believe in unearthing the past and Martin points out that this is particularly true in Scottish culture. There’s nothing to feel so bad about, is there? Suck it up. Work harder. Take up a hobby. Move on, already. But if this worked, if going to the movies, shopping or decorating our houses really worked, wouldn’t everyone who was feeling lost, depressed or anxious take part in these activities and be “cured?” At one point, Martin says to Dr. J, “You can’t undo something that’s already happened, so what’s the point in getting hung up on it?” and Dr. J replies, “Who said anything about trying to undo the past? We can be hung up on things we’re not even aware of. When we become aware of them, we often stop being so affected by them.”

In the end, we each have our own experience of “mental health.” We each could write our own memoir detailing how we dealt with this problem, that crisis or a really tough time in our life. But some of us would tell it better and more honestly and Martin has accomplished that here. She maintains her sense of humor and keeps plugging away at her story even when her words make her reader cringe in horror at how very embarrassing her actions could be. And yes, there is a bit of a love story here (what memoir worth anything doesn’t contain at least one sexy, young doctor?) but things don’t end up in a predictable place, which is refreshing and is, when you get all the way down into it, the way life often goes.