Author and narrator Gottlieb introduces the main intention of the book (to show that we change in relation to others), and explains that the case histories given are real and shared with permission, with some details changed or omitted. The point of the book is “to reveal our shared humanity so that we can see ourselves more clearly” (8). She also explains that she has opted to use the word patient instead of client, because that word best captures the relationship that develops during therapy.

The narrator, Lori, is a therapist whose first patient is John, who “expresses annoyance with others and seeks help ‘managing the idiots’” (11). The narrator finds it difficult to focus on John’s finding faults in everyone, and especially his wife, because the therapist’s fiancé has just broken off their engagement and she is feeling sad and hurt. She is having trouble connecting to John, which makes her reflect on how therapists need to find something likeable in all their patients, and have compassion for them.

John is brusque and insulting, comparing the therapist with a prostitute he pays to “release all my pent-up frustration, and nobody has to know! Isn’t that funny?” (17).