My client’s memories more often trigger my own, my work on their future calls upon and disturbs my past, and I find myself reconsidering my own story.
Irvin Yalom’s lifetime professional achievements, his published books and his collection of important accolades received from both the psychiatric and literary societies speak for themselves: the praise is well deserved and hard-earned. How come his biography turned into such a slog for me? This was one of the most unappealing books I read in recent times. After almost every chapter, I put the book aside in order to read something else and, if not for this being a group read project, I would have abandoned the lecture after the opening chapters.
In the interest of full disclosure, these problems can probably be blamed on my ingrained skepticism about psychotherapy, as I became familiar with it through literature and cinema. So I was willing to expand my horizons and do a more in-depth exploration, but this memoir turned out to be not the best material about the profession. As the title should have warned me, the book is a biography of the author, with heavy emphasis on childhood, years of study, career projects, novels published and many, many holidays in exotic locations. The actual information about psychotherapy and the interpretation of new trends from the author’s perspective is mentioned mostly as a recommendation to read the other manuals and novels published by the author, with only a brief synopsis provided here.
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Me and Mr. Yalom started on the wrong foot right from the very first chapter, recounting a childhood dream from the perspective of the 85 years old narrator. As a person who has extreme difficulty remembering what he dreamt about five minutes after waking, I found the clarity of the childhood memories presented suspect. I do agree with the need to stress the importance of ‘empathy’ in a professional caregiver and felt it was the right way to start the lecture, but it made me doubly suspicious of the author’s candour.
The following pages reinforced this first impression of carefully rearranged facts to fit a narrative drive, and I know by the last page that Mr. Yalom is well aware of what he is doing. Almost every time I made a note of something fishy, it turns out a few chapters later or even in the closing remarks that he comes clean about his little ‘teaching tales’ and how useful they are to underline an idea. Here’s an example:
Looking back now, I feel tenderness for that lonely, frightened, determined young boy, and awe that he somehow made his way through his self-education, albeit haphazardly, without encouragement, models, or guidance.
A lot of his childhood memories are used to reinforce an image of hardship and loneliness, the myth of the self-made man that has risen above the squalor of roaches, rats, drunks, racists, bullies, etc. to the highest peaks of his chosen field. These details often clash with the actual biographical details that slip through the narrative [his father was a successful business man, his mother loved him, he went to some of the best schools in the country, he married his highschool sweetheart and they had an uneventful, beautiful relationship with career success and many children and grandchildren]. Later in the memoir the author admits:
I know it’s time to discard my notion that I am entirely self-created.
and, In many ways I have been insulated from hardship.
and, This all sounds plausible and makes for a satisfying narrative. How powerful is our drive to fill gestalts and to fashion neatly composed stories! But was it true?
The pattern is repeated throughout his illustrious career, something that I feel the need to repeat is the result of hard work, dedication, ambition and a talent for communicating clearly and effectively. The closest approximation I have for Mr. Yalom, after checking out at the end of the book some of the references to existential psychotherapy he made [Alex Comfort, Viktor Frankl, Rollo May, Oliver Sacks] is that his main merit in not so much in breaking new ground in the field as in the successful promotion and application of the principles defined by his peers. Something along the lines of Isaac Asimov for hard science or David Attenborough for ecology. Which is high praise when you consider how well known these motivational speakers are. Mr. Yalom has excelled in early studies in group therapy, in changing the perception of the doctor as a cold, analytic observer and in writing teaching manuals and literary novels about psychotherapy. Based on his own account, he also seems to spend more time on the conference circuit than in his cabinet. He himself, towards the end of his career, sees his literary efforts as more, or at least equally important, as his work with patients.
... my experience in leading therapy groups turned out to be therapeutic, not only for my patients but for me as well: it greatly increased my comfort in group situations.
Learning more about group therapy was a primary interest in picking up the memoir. I did have some already made ideas about the importance of social interactions and probably looked only for confirmation bias in the account. I don’t think you need a degree in psychotherapy or years of research to discover that most of our modern problems are driven by loneliness and that the solution is often to rely on your circle of friends.
In general, though, his work helped me understand that most of our patients fall into despair because of their inability to establish and maintain nurturing interpersonal relationships.
or, ... the group offers comradeship, supervision, postgraduate learning, personal growth, and, occasionally, crisis intervention. I strongly encourage other therapists to create a group such as ours.
Ultimately, what is such a leaderless therapy group other than the close friends that you gather in a lifetime and that you can rely upon in your time of need? I know not all of us are lucky in this matter, and even if I do not consider psychotherapy to be major science, I do believe the guidelines established for group therapy and the many studies performed in a controlled ecosystem are useful to those who really need help.
Yalom himself considered throughout his career that he was as much in need of therapy as some of his patients (although I have my own suspicions that this was more in the nature of research than actual anxiety). Starting with his residency years until the time he wrote this memoir Mr Yalom has chosen to undergo therapy in an effort to grow as a person and to receive unbiased feedback about his life choices. Which sort of explains the title of the memoir and the choice of a lapidary image on the cover: becoming ourselves, being comfortable in our own skins is an effort of a lifetime, and you really need to know yourself before starting to advise others about the meaning of life.
Slowly I began to understand that, since the therapist’s chief professional tool is his or her own person, self-disclosure of personal shortcomings felt doubly risky: not only might one’s character be judged, but one’s professional competence as well.
or, I felt so isolated, unappreciated, and uneasy in my skin that year that I decided to find a therapist for myself, as I’ve done at various difficult points throughout my life.
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The second major breakthrough in Mr. Yalom’s career has to do with existentialism. The author sort of claims he introduced this concept into mainstream therapy, although I believe his friends and mentors Rollo May or Viktor Frankl would beg to differ. Mr. Yalom still has a valid claim on the most widely used manual in North America on the subject, whose succesful and multiple revised editions speak volumes about his erudition.
More and more I grasped that many of the issues my patients struggled with – aging, loss, death, major life choices such as what profession to pursue or whom to marry – were often more cogently addressed by novelists and philosophers than by members of my own field.
I could have pointed out to the relevance of fiction in presenting and solving the problems in our daily lives before discovering Yalom. Once again, I feel common sense and an inquisitive mind are more important than a degree in psychotherapy, but I sort of enjoyed the numerous references the author makes to the books and the stories that shaped his life and informed his treatment decisions. These philosophers and storytellers are most probably the driving force in his career shift towards becoming a novelist, a field that has been as rewarding to him as his medical practice.
Through narrative, these writers had plumbed depths of existence in a way that psychiatric writing never seemed to have achieved.
and, All my life I have been a lover of narrative, and I have often smuggled therapy stories, some only a few lines long, some lasting a few pages, into my professional writing.
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Unfortunately, the last half of the memoir is dedicated to trivialities and self-congratulatory passages. Mr Yalom holiday recollections and his assortment of funny anecdotes from his travels hold little interest for me: Vespa adventures, hunting for ancient coins in Cyprus, experiments with drugs in Chiang Mai, meditation in an Indian ashram – funny party pieces that have been polished to a sparkle by repeated renderings in front of nephews or around the conference circuit until the line between fact and fiction disappears.
Similarly the details of how he came to write his novels, instead of discussing their substance I found less appealing than an in-depth discussion on psychoanalysis in modern times. By far the most annoying aspect of the memoir is the self promotion, a little aspect of the author’s pride that would have been more palatable coming from other people who knew him (and he doesn’t lack for groupies]. Even here, there is an acknowledgement that mr. Yalom is aware of the pitfalls of self-delusion in a passage where he describes a commentary that he made to Frankl in a review of a book by that celebrated analyst.
I replied, as gently as possible, that such heavy focus on applause deterred from his presentation and might lead some readers to conclude that he was overinvested in the applause. He wrote back immediately, saying, “Irv, you just won’t understand – you weren’t there: they DID rise and applaud five times.” Even the best of us are sometimes blinded by our wounds and our need for praise.
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In conclusion, I do not regret getting to know this eminent analyst, even as I struggled to get the end of his rambling memoir. My particular interest would have been better served by one of his other books, either one of his fictional novels or one of his collection of clinical tales.