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And How Does That Make You Feel?: Everything You Never Wanted to Know About Therapy

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Have you ever wondered what goes on behind the closed door of the therapist's office? Psychotherapist Josh Fletcher takes us on a candid and human journey into the individual sessions of four patients, sharing their self-discovery and recovery as they engage in therapy for the first time. He invites us in to the inner thoughts of a therapist, from shock and sympathy to how it feels to bump into a former client on a messy night out.

Interspersed with straight-talking advice on common issues such as anxiety, obsessive-compulsive disorder, and panic attacks, as well as a therapist's guide to how to find the right therapist, And How Does That Make You Feel? is darkly funny, illuminating, and full of promise that a better future is always possible. It's everything you wanted to know about therapy (and a few things you probably didn't).

309 pages, Kindle Edition

First published February 27, 2024

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Joshua Fletcher

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Displaying 1 - 30 of 392 reviews
Profile Image for K.J. Charles.
Author 65 books12k followers
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August 23, 2024
Interesting and candid account of a therapist's life touching on five heavily fictionalised patients. I found it very readable and it felt honest, plus he's a good and entertaining storyteller. Although there has to be a point where constantly analysing your own thoughts must drive you crackers.
Profile Image for Jason Pettus.
Author 17 books1,446 followers
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March 20, 2024
2024 reads, #19. DID NOT FINISH. I’ve been a big fan of the psychotherapy process ever since starting my own sessions back in 2015, so much so that I’ve spent a lot of time vaguely thinking about what it would be like to become a therapist myself (which, to be clear, I’m not planning on doing, because I’m already in my mid-fifties and wouldn’t want to yet again start all over in my career like that). That’s had me reading and really enjoying a number of books over the years by therapists specifically about the therapy process, mostly by the brilliant Irvin Yalom (but for more, see my reviews of Love’s Executioner , Creatures of a Day , and Staring at the Sun ), as well as that contemporary book that got so much traction several years ago, Lori Gottlieb’s Maybe You Should Talk to Someone .

That made me think that Joshua Fletcher’s brand-new And How Does That Make You Feel? would be right up my alley, a book that promises to be a similar behind-the-scenes look at what an actual therapist is going through in their own head as they go through the process of analyzing and helping their clients, which I had especially high hopes for because it took forever for my name to finally come to the top of the reserve list at the Chicago Public Library, and typically books that popular tend to be pretty good as well. But alas, this turned out to be almost worthless, because Fletcher doesn’t actually provide any insights whatsoever here, but instead presents his inner voice as a series of “little people who live inside him” -- yes, just like the Disney children’s movie -- then doesn’t give these little people anything more insightful to say than such facile, obvious, kneejerk reactions like, “I’m scared of this guy!”, “I’m proud of her!”, and “I really have to pee!”

Jesus Christ, bro, are you telling me that a professional full-time therapist has absolutely nothing more interesting to share about their profession than childish little quips about his clients’ physical attributes and whether or not they stammer while they talk? Then again, I suppose this is partly my fault for not actually reading Fletcher’s bio before picking up the book, where I would’ve seen him proudly talking about his popular TikTok account; and that’s all a grown-up needs to hear to now know that they’re dealing with a glorified man-child and not an actual grown-up, which is exactly what this book feels like, like a little child trying to explain psychotherapy in ten-second snippets while doing his cutesy little cheerleader dance or whatever the hell those TikTok children are into these days. This is now the third contemporary book in a single week I’ve been forced to give up on before even making it 25 pages in, which makes me want to never pick up a book published after 2020 again the entire rest of my life; and while I know already that I won’t actually stick to that threat, certainly it’s just more evidence to me of how completely and totally contemporary literature has now permanently fallen into a disastrous pit of unreadable schlock, as we now all just become inured to a world where the marketing sociopaths are now the ones making all the book acquisition decisions anymore, and they aren’t greenlighting anyone who doesn’t have a TikTok account and writes at a third-grade level. Avoid, avoid, avoid; for the love of all that is holy, avoid.
Profile Image for Alan.
716 reviews288 followers
December 8, 2024
Compulsively readable. Loved Fletcher breaking down his inner thoughts into “inner voices” instead. I felt it was profound at times, too on the nose at others, and an overall faithful and human depiction of the therapeutic hour.
Profile Image for kbreads.
219 reviews7 followers
January 22, 2024
"We’re in a global mental health crisis, and unfortunately many people feel disillusioned after their first attempt at therapy. To me, saying this is the equivalent of saying “I tried sports and I didn’t like it” when all you played was lawn bowling, once." Have you ever wondered what goes on behind the closed door of the therapist's office? What's revealed there may surprise you.

Similar to Maybe You Should Talk to Someone, this book delves into what goes on behind the doors of psychotherapist Joshua Fletcher's doors. This includes his personal thoughts, feelings and behaviors towards clients as well as these stories from his highly regarded clients. Structured around four client case studies, Joshua Fletcher lifts the veil of secrecy around an often-misunderstood profession. He details, with care and compassion, his clients’ nonlinear path to health and healing, as he works with them to overcome their anxiety. Along the way, Joshua chronicles the voices in his own head that act both as a hindrance and a guide in his treatments. He also educates his audience on anxiety and psychotherapy, explaining the origins of anxiety and the different modalities of therapy, in the hopes of normalizing the conversation around mental health.

"It’s important to remember that therapists are as human as everybody else. It’s okay to see them like any other human inside or outside the therapy room. Therapists don’t have everything worked out. We are flawed, we have our vices, and we constantly work on our own personal stuff." As a therapist, I couldn't have said it better myself. This book offers a glimpse into the not-so-scary side of therapy. "I promise that there is no omnipotent know-it-all waiting for you on the other side of the therapy-room door, ready to pounce at the first chance to judge or shame you. Instead, the person who awaits you is, ideally, someone who wants to listen and is willing to be a conscientious, nonjudgmental guest in your world for a short while."

Fletcher does an excellent job of portraying the often misinterpreted field of therapy. He honestly and vulnerably portrays himself as a human doing his best while trying to maintain positive human regard, professionalism, and hope for each of his clients. Throughout four client stories, we see what it's like to be in the intimate of rooms: the therapy office.

"Good therapy—beautiful therapy—is a life-enhancing experience as much as it is a remedial or mitigating experience. Good therapy is a gift." Highly recommend this book if you are at all interested in therapy, mental health, self help, anxiety...I. could go on and on.

Thanks to NetGalley, Harper Collins & Joshua Fletcher for the ARC in exchange for my honest review. Out 3/14/24 - def pick this up!
Profile Image for Sammie Reads.
1,109 reviews182 followers
April 19, 2024
Oh my goodness, I absolutely LOVED this book! Such a helpful guide for therapy, ins and outs of what to look for in a good therapist relationship, such helpful tidbits about anxiety, OCD, grief, etc…and the cherry on top is that it was absolutely fucking hilarious! ADORED
Profile Image for Farrah.
920 reviews
July 11, 2024
Kim, I really should’ve listened to your review and not read this book! I found it so irritating, basic, and boring. I hated how he constantly named every voice in his head. I didn’t find any of his client’s stories interesting and I didn’t really care for him personally. Also, I didn’t need a 101 level primer on every different type of diagnosis like anxiety, OCD, etc.

i felt bad about his brother, but the way in which he told the story made it simply feel like a gimmicky construct for this book. I never felt interested or emotionally connected.

If you want to read a fantastic book by a therapist, read, Maybe you should talk to someone by Lori Gottleib.
Profile Image for Randal White.
1,008 reviews96 followers
February 13, 2024
I thoroughly enjoyed this book! Having been to a few therapists myself over the years (PTSD, anxiety, depression), I always wondered what they were thinking as I spilled my feelings. Did they think I was weird? Am I an anomaly? How do they know what to say/do?
Thankfully, Fletcher has written this book to explain it all. How therapy works (or doesn't), how there's not a one size fits all category of therapist, what they are trying to do to help us. And, lo and behold, they're not invincible to the same feelings./disorders as us.
He does this through telling about several case studies. ALL of them were fascinating! And his methods of trying to pull out of us what the problem's roots are.
And he discusses his own problems too! His own personal demons and foibles. How he tries to work through them. And all with a sense of humor that I found to be appreciated.
All in all, the book left me with the confidence that, if I ever needed therapy again, I would be much more secure and less apprehensive about it.
I encourage people to read this. You'll feel better about yourself!
Profile Image for Victoria White.
223 reviews1 follower
October 20, 2024
What a beautiful book.
I didn’t want it to end!
It was so heartfelt, I could feel every word and every story.
A brilliant mix of client stories, personal stories and fact and theory - and very well-written.
A good book is where the sentences just flow, it felt like he was chatting to me.
He absolutely captured the beauty and importance of his role and therapy in general. I teared up a few times and found it so comforting to read how he captured many of my own views in words.
Also, it was a bit like ‘Inside Out’ for adults!!! And how can that be anything but great?! I liked reading all the different thoughts and emotions in his head as a script.
Profile Image for Joana da Silva.
447 reviews784 followers
September 15, 2024
I'm just a girl who goes to therapy and loves to read about it to learn more about the process of it all. Although I already knew about most of the matters covered by this book, Joshua Fletcher has a beautiful and funny way to show you more about it. It's always interesting to think about the other person in the room as therapy is supposed to be a one-sided thing developed by two people. And I'm nosy, so I loved reading about the therapeutic process of a few strangers.
Profile Image for Bettemay.
26 reviews2 followers
May 31, 2024
Vond dit echt heel leuk om te lezen. Heb gelachen om de herkenbaarheid van dingen in gesprekken met cliënten en neem ook zeker dingen eruit mee. De omschrijvingen waren niet voor mij nieuwe info, maar het was interessant om zijn perspectief te lezen. Overall dus een fijn boek
Profile Image for Ashley.
518 reviews88 followers
June 13, 2024
(4.5/5 ⭐ , rounded up)

You'll either love this book, or hate this book; I'm confident that will be based on:
1 If you've tried therapy
2 If you've enjoyed it/felt it "worked" for you
3 If you "believe in" therapy
4 If you are willing to accept therapists are also human
5 If you have a sense of humor

If any of those are a no, you'll prob not enjoy this and end up with a bad taste in your mouth when it comes to "talking to someone".

I'd highly recommend onlyyyyy if you're willing/able to be open minded, take this with a grain of salt, and accept docs are just like us regular folk.
Profile Image for Hally.
281 reviews113 followers
April 7, 2024
Maybe a little harsh, as I was often moved by Josh's clients' struggles and by his own personal story. This just wasn't for me, I think because I've had more experience with therapy than the intended audience. I mainly hoped to learn rather than feel sad and there was nothing here that expanded my knowledge. I also felt uncomfortably unsure about the clients' confidentiality despite their names having been changed.
Profile Image for Daryl MacDonald.
133 reviews3 followers
July 4, 2024
Surprised by how much I disliked this one. I think it just wasn't my style. Being a therapist myself I thought Fletcher was far too unprofessional and cavalier about the profession. That's just my personal opinion, of course.

I wanted more insight and detail into how he works. The "voices" mechanic he uses (straight out of an RPG video game like Disco Elysium) were cute and novel for a while and then quickly got boring with how little they contributed to the actual therapeutic process. It was simply a series of pointless comments about how he feels compassion for a client, or that he shouldn't have had that second coffee after lunch. It reads more like an attempt at a comedy rather than an insight into the therapeutic process. Indeed, much of what Fletcher does here sort of feels like bragging or overinflating his contribution to his clients' journeys without actually detailing *what he did to help them*.

I'd say my biggest issue with this is how little Fletcher actually has to say about...well, anything. He details his client stories in simple dialogue without any interjection as to what his clients might mean when they say this, or his analytical insight into how they might have come to believe their own schemas. He does pepper in little bits of psychoeducation (more on that in a second) but they are apart from the clients themselves and don't refer to the clients in a way that could be helpful to the reader understanding the link. It's maddening.

Again, this is all just a personal take. I felt for Fletcher, his backstory is indeed compelling, but this felt far too surface level for me to be able to engage with it. The chapters detailing therapeutic theory felt superfluous to me (I've trained in these theories in much more detail than Fletcher gives in these pages) but I'll concede he was probably writing for those who don't know much about it.

In the end I think it was a personality thing with me. Fletcher just isn't the kind of therapist I would want to see, nor did I get much of a sense of how he works in his practice to change my mind.

I feel like this review has been quite harsh and maybe it has, but it's likely because I keep hoping I'll find another Love's Executioner and this definitely wasn't it.
Profile Image for Claudia Greenway.
14 reviews1 follower
December 16, 2024
I’m saying that was a 4.5 stars, and I think that was the first book to make me cry…?! Loved his inner voices they added a light-heartedness to the book. Would recommend to a friend!!
Profile Image for Leigh Freda.
21 reviews3 followers
April 23, 2024
I want to give a fair review to this because while it is not terrible, I dont think it is outstanding either. Overall, it is a quick and easy read, which might be great for those who've not yet encountered therapy or have only had negative experiences with therapy in the past. I agree with other reviews that state a trigger warning might be beneficial.

This book reminded me slightly of The Devil You Know by Dr Gwen Adshed and Eileen Horne, though admittedly, it didn't hit the mark in the same way.

While I find some other reviews I've read quite harsh, upon reflection, I do personally feel there was a lot missing from this book - chunks of time specifically, which made some client journeys seem quick and simple. Maybe Fletcher wanted to leave out the mundane/less intense sessions, but sometimes, it's the less intense sessions that are the most helpful to the client's self-discovery. I think more detail on the therapy process wouldn't have been a bad thing, in my opinion.
I also think a dedicated slot about transference (and not just a snippet) would have been beneficial, as this would have fully explained certain feelings Fletcher was feeling towards certain clients.

One thing I cannot leave unsaid is that I'm unsure how ethical it is to get in a car with a client, even if it is to try and help them with their driver anxiety. It seems like a safeguarding issue to me. Something to consider a lesson in boundaries for the future, perhaps.

Fletcher has undoubtedly been through a lot in his own life, and will undeniably learn a lot from publishing this book. I appreciate him acknowledging his own triggers and still trying to stay in his client's frame of reference.
This entire review has been hidden because of spoilers.
Profile Image for Maisie.
129 reviews
July 5, 2024
My favourite kind of book. Real life stories that have taken a LOT to share to the world!!! Received with so much gratitude. READ this everyone!!!!!!
Profile Image for alicebme.
1,161 reviews3 followers
June 2, 2024
Highly recommend, although the very end is a little sappy. Enjoyed the inner voices a lot.
Profile Image for Marinna.
219 reviews11 followers
January 7, 2024
'And How Does That Make You Feel?' made me love Joshua Fletcher! I didn't realize he had an internet presence and is a bit Instagram famous. As a therapist, my interest is always piqued when hearing of a book about therapy. Josh does such a lovely job in not only explaining and describing therapy, but also in humanizing therapists. Oh how accurate his inner dialogue is! I loved the way there were different internal voices for the critical, compassionate, irreverent, etc. It was very relatable in how the mind tends to see situations - multifaceted.

The different client vignettes are highly entertaining. Not only are heavy topics addressed, but there is education behind them. Since Fletcher is known as 'AnxietyJosh' on social platforms, it makes sense that there is anxiety at the core of all his clients, but it's so much more. I especially appreciated his explanation and exploration of intrusive thoughts and OCD. This is HIGHLY misunderstood by many, and I am grateful he was able to share more about this. Also, the grief that is explored is so very powerful. I found myself tearful in learning about Josh's experience with his own brother.

This book is for everyone! I couldn't put it down. I love the short chapters that keep you wanting to learn more about Josh and the clients he works with. A vulnerable and honest look at a therapist and the clients he cares about.

Thank you so much to NetGalley and William Morrow for this ARC!
Profile Image for Marketa.
41 reviews2 followers
April 24, 2024
Not sure yet how do I feel about this book. I honestly enjoyed reading it and felt deeply for all its characters. However, the writing style of using a lot of script made me somewhat uncomfortable for knowing too much about author’s clients, despite their characters being anonymised. I hope that all characters of clients are mosaics of many people - fictional / anonymised to the extent of not being able to recognise their own stories.
Profile Image for Alexandra Caggiano.
41 reviews1 follower
April 17, 2024
This was an absolutely amazing read! I saw so much of myself in Josh’s clients and learned so much about myself through his explainations of each of diagnosis. MUST READ!!!!

I’m excited to discuss this book with my therapist! ☺️
Profile Image for deja.
81 reviews
July 9, 2025
4.5 ⭐️ As a newly emerging therapist, this book was super validating and reassuring. The author does a great job of explaining what it’s actually like to be a therapist sometimes (chaotic thoughts, self-doubt, ethical dilemmas, etc). I also liked that the book felt conversational, rather than feeling dense.

I appreciated seeing that even experienced therapists can struggle with their inner dialogue and don’t always get it right the first time. It made the work feel more human, and less like something you have to do perfectly. Definitely recommend if you’re in the mental health field or just curious about the real BTS of therapy.
Profile Image for Laura Jonakova.
21 reviews
May 23, 2025
This has been an amazing read, I haven't felt this immersed in a book for a long time. A big part of it for me was the fact that several of the topics discussed in the book hit very close to home. (I even got inspired by one of the exercises mentioned in the book and it turned out to be a very positive experience.)
Apart from that, the book stirs up emotions, some devastating, some very funny. The structure of the book is very good, going from conversations to a more informative text.
It will stay on my 'read again at some point' list.
Profile Image for Tilak.
10 reviews
June 20, 2025
3.5 would be ideal here. It isn’t a bad book but after reading Maybe You Should Talk to Someone it falls flat. A ‘there are levels to this’ type of thing. An easy and interesting read but it’s held up more by the client stories themselves rather than leaving with a deeper understanding of the human experience / therapy which my goat Lori Gottlieb does so well.
Profile Image for Filipa Nogueira.
36 reviews1 follower
September 10, 2024
“até que você torne consciente o inconsciente, ele vai comandar sua vida, e você vai chamar isso de destino” 🔮
Profile Image for Patrycja.
100 reviews
April 29, 2025
4,5 ⭐

Ciekawy koncept na książkę - z chęcią przeczytałabym kolejny podobny format. Natomiast czegoś mi w niej zabrakło, żeby uznać ją za 5-gwiazdkową pozycję.
30 reviews3 followers
August 9, 2024
ATE. So friggin fascinating. I finished in three days I could not stop listening to it. Highly recommend. Being a therapist is so crazy ?!?!
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