The Gift of Therapy – A Book Review

Reading any Irvin D. Yalom book is therapeutic in itself. He writes boldly yet gently and fills every page with the insights of past philosophers and those of his own. Yalom founded existential psychotherapy, a stance holding that unconscious anxieties–most notably the “Four Ultimate Concerns” of death, isolation, meaninglessness, and freedom–impair our conscious thoughts and actions. This is not a standalone therapy, he claims, but a supplemental stance intending to make therapists and patients privy to existential issues. However, The Gift of Therapy‘s pages are not colored only with existential ideologies. No, this is a dynamic and broad guidebook for therapists and prospective therapists written by a wise, meritorious figure, covering anything from dealing with death-anxieties to how far apart one should schedule his patients.

It reads like an inspired university lecture sounds–authoritative yet passionate. There are a few eye-opening sentiments I’d like to share (many of which are relevant outside of the practice):

INTERESTING POINTS

(1) therapy is not the process of solving a client’s problems, but the process of uprooting obstacles to their growth.  Find and dismantle the dam, as it were, and let the river finds its way through.

(2) Avoid diagnosis–it’s counterproductive in common sessions with less-impaired clients. The goal of therapy is to know a client as wholly as possible; diagnoses and biases can mislead the therapist, restricting his understanding. Could any DSM item fully describe you? It’s unlikely!

(3) Don’t get hung up on your brilliant interpretations of the patient’s issue–the clients seldom care. It’s far more important to be endlessly supportive and non-judgmental. In the end, that’s what they remember and need most.

(4) Let clients matter to you; let them change you; grow together.

(5Create a new therapy for each patient (Yalom takes on a fascinating stance here, reminiscent of Jung’s in his “therapist’s dilemma“).

(6) Be mindful of dangerous silent anxieties–remember, you have many clients, yet the clients but one therapist. They will fight for your attention and feel insignificant. Ensure them that they are not.

(7) Be mindful of the here-and-now–once comfortable, how the patient acts in front of you is likely how they act in front of others. Any annoyance, distance, and so on that you feel others likely feel as well. This is an invaluable tool lessening the need to trust their renditions of past occurrences. You can be an observer.

(8) Do not be a “blank screen”; the days of emotionless, indifferent therapist belong in the past.

(9) Avoid generalized feedback. Keep it useful and innovative, and “strike when the iron is cold.” That is, if the patient said or did something highly emotional or out of character, wait until they have calmed down before asking what caused it for optimal reflection.

(10) Do not make decisions for your patients. If you do, you overlook a via Regia into existential bedrock. The client’s refusal to make a decision is a decision which can reveal more about their fears of freedom, responsibility, et cetera.

(11) Express dilemmas openly. “Irvin, I’m afraid I’m stuck: on one hand I feel that A, but on the other, that B. A may undermine your trust, but B may undermine my credibility. What are your thoughts on this?”

I understand that this one may not be appealing to a wide audience–patients or students of therapy and therapists themselves may get the most out of it–but any curious individual will be sated, given much food for thought and much information. What more can one ask for? I certainly recommend this one.

 

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