Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients by Irvin Yalom

From Barnes & Noble

An unorthodox thinker and professor emeritus of psychiatry at Stanford University, Irvin D. Yalom, M.D., reflects upon the practical, philosophical, and emotional dynamics of therapy through the lenses of both patient and therapist. This thought-provoking collection of essays covers topics that include self-disclosure, occupational privileges and hazards of the therapist, dream interpretation, talking about death, and the existential components of therapy. Described by the author as "a nuts-and-bolts collection of [my] favorite interventions or statements," The Gift of Therapy is a welcome and well-deserved addition to the library of anyone seeking excellence and a deeper understanding of the therapeutic process.

From the Publisher

Anyone interested in psychotherapy or personal growth will rejoice at The Gift of Therapy, a masterwork from one of the most accomplished psychological thinkers of our day. As an award-winning author of both nonfiction and fiction, and a psychiatrist in practice for 35 years, Yalom imparts his unique wisdom in this remarkable guidebook for successful therapy.

At once startlingly profound and irresistibly practical, Yalom's insights—let the patient matter to you; create a n ew kind of therapy for each patient; how and how not to use self-disclosure—will help enrich the therapeutic process for both patient and counselor.

Publishers Weekly

If the future of psychotherapy lies in psychopharmaceuticals and the short-term therapies stipulated by HMOs, argues Yalom, then the profession is in trouble. Yalom, the recipient of both major awards given by the American Psychiatric Association, professor emeritus of psychiatry at Stanford and the author of both fiction and nonfiction volumes about psychotherapy, writes this book in response to that crisis. Based on knowledge gained from his 35 years of practice, the resulting book of tips (a "gift" for the next generation of therapists) is an enlightening refutation of "brief, superficial, and insubstantial" forms of therapy. Yalom, who references Rilke and Nietzsche as well as Freud's protege Karen Horney and the founder of client-centered therapy, Carl Rogers, describes therapy as "a genuine encounter with another person." He suggests that therapists avoid making DSM IV diagnoses (except for insurance purposes), since these "threaten the human, the spontaneous, the creative and uncertain nature of the therapeutic venture." He also encourages psychotherapists to use dream analysis, group therapy and, when appropriate, wholly inventive forms of treatment. Traditionalists will probably squirm at some of his suggestions (particularly "Revealing the Therapist's Personal Life" and "Don't Be Afraid of Touching Your Patient"). Other tips, though, such as "Never Be Sexual with Patients" are no-brainers. Although the book dies somewhat in the second half, and not much here is new, the wise ideas are perfectly accessible. (Jan.) Forecast: Yalom has explored many of these ideas before. His followers will certainly be charmed, and newcomers patients as much as therapists may be won over by his openness and tender tone. Copyright 2001 Cahners Business Information.

Library Journal

These two books defend the professional treatment of psychological problems by listening and responding in the Freudian manner, and they deplore the current dominance of neuroscience, pharmacology, and behaviorism. In Why Psychoanalysis?, French psychoanalyst, historian, and critic Roudinesco refers to our "depressive society" and our loss of subjectivity in the era of individuality. She fiercely defends Freud against "fanatical" opponents, even claiming that he was not antifeminist. Roudinesco will appeal to scholars of Freud and Jacques Lacan, of whom some knowledge is assumed. Unfortunately, though Roudinesco wants psychoanalysis to be a science, she often waxes polemical when a clear, objective evaluation of Freud is needed. For that, a general audience will be better served by Elio Frattaroli's Healing the Soul in the Age of the Brain (LJ 8/01). For a more readable presentation of the cultural nexus of psychiatry, Julian Leff's The Unbalanced Mind (LJ 11/15/01) is outstanding. In The Gift of Therapy, Yalom (psychiatry, emeritus, Stanford) writes for both the professional and the lay reader a good idea, since educated consumers help bring professionals into the real world. He favors some self-disclosure by therapists, home visits, meeting with significant others, nonsexual touching, and time for reflection on each session. In 85 short chapters, he presents little pearls of ideas shaped from 35 years in practice. Yalom's view that the therapist is also healed in the process reminds this reviewer of James P. Carse's philosophy. Yalom's latest is essential for therapy trainers and fine for general libraries with psychology and self-help collections. For a general selection of this respected psychiatrist's earlier work, including fiction, consider The Yalom Reader (Basic Bks: Perseus, 1998). E. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, DC Copyright 2001 Cahners Business Information.

Booknews

Having reached his 70th year, Yalom (psychiatry, Stanford U.) worries about where the next generation of effective psychotherapists will be trained, noting that the big medical corporations are primarily interested in pushing medicine. He advises students against sectarianism and suggests a therapeutic pluralism in which effective interventions are drawn from several different therapy approaches. He does not include an index. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Product Details

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Table of Contents

Read an Excerpt

Chapter One

Remove the Obstacles to Growth

When I was finding my way as a young psychotherapy student, the most useful book I read was Karen Horney's Neurosis and Human Growth. And the single most useful concept in that book was the notion that the human being has an inbuilt propensity toward self-realization. If obstacles are removed, Horney believed, the individual will develop into a mature, fully realized adult, just as an acorn will develop into an oak tree.

"Just as an acorn develops into an oak..." What a wonderfully liberating and clarifying image! It forever changed my approach to psychotherapy by offering me a new vision of my work: My task was to remove obstacles blocking my patient's path. I did not have to do the entire job; I did not have to inspirit the patient with the desire to grow, with curiosity, will, zest for life, caring, loyalty, or any of the myriad of characteristics that make us fully human. No, what I had to do was to identify and remove obstacles. The rest would follow automatically, fueled by the self-actualizing forces within the patient.

I remember a young widow with, as she put it, a "failed heart" -- an inability ever to love again. It felt daunting to address the inability to love. I didn't know how to do that. But dedicating myself to identifying and uprooting her many blocks to loving? I could do that.

I soon learned that love felt treasonous to her. To love another was to betray her dead husband; it felt to her like pounding the final nails in her husband's coffin. To love another asdeeply as she did her husband (and she would settle for nothing less) meant that her love for her husband had been in some way insufficient or flawed. To love another would be self-destructive because loss, and the searing pain of loss, was inevitable. To love again felt irresponsible: she was evil and jinxed, and her kiss was the kiss of death.

We worked hard for many months to identify all these obstacles to her loving another man. For months we wrestled with each irrational obstacle in turn. But once that was done, the patient's internal processes took over: she met a man, she fell in love, she married again. I didn't have to teach her to search, to give, to cherish, to love -- I wouldn't have known how to do that.

A few words about Karen Horney: Her name is unfamiliar to most young therapists. Because the shelf life of eminent theorists in our field has grown so short, I shall, from time to time, lapse into reminiscence -- not merely for the sake of paying homage but to emphasize the point that our field has a long history of remarkably able contributors who have laid deep foundations for our therapy work today.

One uniquely American addition to psychodynamic theory is embodied in the "neo- Freudian" movement -- a group of clinicians and theorists who reacted against Freud's original focus on drive theory, that is, the notion that the developing individual is largely controlled by the unfolding and expression of inbuilt drives.

Instead, the neo-Freudians emphasized that we consider the vast influence of the interpersonal environment that envelops the individual and that, throughout life, shapes character structure. The best-known interpersonal theorists, Harry Stack Sullivan, Erich Fromm, and Karen Horney, have been so deeply integrated and assimilated into our therapy language and practice that we are all, without knowing it, neo-Freudians. One is reminded of Monsieur Jourdain in Molière's Le Bourgeois Gentilhomme, who, upon learning the definition of "prose," exclaims with wonderment, "To think that all my life I've been speaking prose without knowing it."

Read a Sample Chapter

When I was finding my way as a young psychotherapy student, the most useful book I read was Karen Horney's Neurosis and Human Growth. And the single most useful concept in that book was the notion that the human being has an inbuilt propensity toward self-realization. If obstacles are removed, Horney believed, the individual will develop into a mature, fully realized adult, just as an acorn will develop into an oak tree.

"Just as an acorn develops into an oak..." What a wonderfully liberating and clarifying image! It forever changed my approach to psychotherapy by offering me a new vision of my work: My task was to remove obstacles blocking my patient's path. I did not have to do the entire job; I did not have to inspirit the patient with the desire to grow, with curiosity, will, zest for life, caring, loyalty, or any of the myriad of characteristics that make us fully human. No, what I had to do was to identify and remove obstacles. The rest would follow automatically, fueled by the self-actualizing forces within the patient.

I remember a young widow with, as she put it, a "failed heart" -- an inability ever to love again. It felt daunting to address the inability to love. I didn't know how to do that. But dedicating myself to identifying and uprooting her many blocks to loving? I could do that.

I soon learned that love felt treasonous to her. To love another was to betray her dead husband; it felt to her like pounding the final nails in her husband's coffin. To love another as deeply as she did her husband (and she would settle for nothing less) meant that her lovefor her husband had been in some way insufficient or flawed. To love another would be self-destructive because loss, and the searing pain of loss, was inevitable. To love again felt irresponsible: she was evil and jinxed, and her kiss was the kiss of death.

We worked hard for many months to identify all these obstacles to her loving another man. For months we wrestled with each irrational obstacle in turn. But once that was done, the patient's internal processes took over: she met a man, she fell in love, she married again. I didn't have to teach her to search, to give, to cherish, to love -- I wouldn't have known how to do that.

A few words about Karen Horney: Her name is unfamiliar to most young therapists. Because the shelf life of eminent theorists in our field has grown so short, I shall, from time to time, lapse into reminiscence -- not merely for the sake of paying homage but to emphasize the point that our field has a long history of remarkably able contributors who have laid deep foundations for our therapy work today.

One uniquely American addition to psychodynamic theory is embodied in the "neo- Freudian" movement -- a group of clinicians and theorists who reacted against Freud's original focus on drive theory, that is, the notion that the developing individual is largely controlled by the unfolding and expression of inbuilt drives.

Instead, the neo-Freudians emphasized that we consider the vast influence of the interpersonal environment that envelops the individual and that, throughout life, shapes character structure. The best-known interpersonal theorists, Harry Stack Sullivan, Erich Fromm, and Karen Horney, have been so deeply integrated and assimilated into our therapy language and practice that we are all, without knowing it, neo-Freudians. One is reminded of Monsieur Jourdain in Molière's Le Bourgeois Gentilhomme, who, upon learning the definition of "prose," exclaims with wonderment, "To think that all my life I've been speaking prose without knowing it."