Jun 20

Irvin Yalom, Existential Psychiatrist

This encounter, the very heart of psychotherapy, is a caring, deeply human meeting between two people, one (generally, but not always, the patient) more troubled than the other. Therapists have a dual role: they must both observe and participate in the lives of their patients. As observer, one must be sufficiently objective to provide necessary rudimentary guidance to the patient. As participant, one enters into the life of the patient and is affected and sometimes changed by the encounter. Irvin Yalom, Love’s Executioner and Other Tales of Psychotherapy 

Now in his late 80’s, therapist Irvin Yalom has influenced many less experienced mental health providers through his books. The most recent by the author is personal, Becoming Myself: A Psychiatrist’s Memoir (2017).

Following are selected quotes from a few other notable books by Irvin Yalom about the practice of psychotherapy:

From Creatures of a Day: And Other Tales of Psychotherapy  

All I can do in one session is to be real, to leap into the patient’s life, to offer observations in the hope that he’ll be able to open doors and explore some new parts of himself in his ongoing therapy.

From Love’s Executioner and Other Tales of Psychotherapy 

Four givens are particularly relevant for psycho-therapy: the inevitability of death for each of us and for those we love; the freedom to make our lives as we will; our ultimate aloneness; and, finally, the absence of any obvious meaning or sense to life.

Even the most liberal system of psychiatric nomenclature does violence to the being of another. If we relate to people believing we can categorize them, we will neither identify nor nurture the parts, the vital parts, of the other that transcend category. The enabling relationship always assumes that the other is never fully knowable.

From The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients 

Life as a therapist is a life of service in which we daily transcend our personal wishes and turn our gaze toward the needs and growth of the other. We take pleasure not only in the growth of our patient but also in the ripple effect—the salutary influence our patients have upon those whom they touch in life.

Sometimes I simply remind patients that sooner or later they will have to relinquish the goal of having a better past.

The establishment of an authentic relationship with patients, by its very nature, demands that we forego the power of the triumvirate of magic, mystery, and authority.

Look out the other’s window. Try to see the world as your patient sees it.

Psychotherapy is a demanding vocation, and the successful therapist must be able to tolerate the isolation, anxiety, and frustration that are inevitable in the work.

The therapist’s worldview is in itself isolating. Seasoned therapists view relationships differently, they sometimes lose patience with social ritual and bureaucracy, they cannot abide the fleeting shallow encounters and small talk of many social gatherings.

A great many of our patients have conflicts in the realm of intimacy, and obtain help in therapy sheerly through experiencing an intimate relationship with the therapist. Some fear intimacy because they believe there is something basically unacceptable about them, something repugnant and unforgivable. Given this, the act of revealing oneself fully to another and still being accepted may be the major vehicle of therapeutic help.