How
are we supposed to grapple with the knowledge that soon we will be
nothing? How do we live a meaningful life with the always-looming threat
of death? That’s what
Dr. Irvin Yalom
of Stanford University — and the field of existential psychotherapy
that he pioneered — strive to address. (To learn more about existential
psychotherapy, click
here.)
Yalom, who is now in his mid-eighties, recently published his 14th book, entitled “
Creatures of a Day: And Other Tales of Psychotherapy,”
a stunning collection of essays chronicling his years as a therapist.
Salon spoke with Yalom about “Creatures of a Day,” the act of therapy
and how aging has affected his creative process.
This interview has been lightly edited.
How did you choose which therapy sessions to include in the book?
I
have a separate file that I keep which is full of ideas for writing,
and I sometimes put things in there if something really strikes me in a
session. I wrote this book by going over a huge file of these — probably
a hundred of them — and I just kept reading them over and over and over
again until one of them seemed to throb with some energy and I began to
work on that one. After that, I just did the same thing over and over
again. Once I found the story, it came fairly easily and quickly and
fluidly, but sometimes the times between stories — especially as the
book went on — took longer and longer.
That was my
writing style; I wasn’t describing the therapy of a patient so much as I
was picking a really pregnant episode and then expanding from that.
Why do you think the times got longer?
The
times were longer because I’m old! [laughs] There used to be a time
when these things would come to me very quickly, but my mind’s not
working as quickly as it did before.
You recount conversations in some detail in these books. How do you reconstruct a session? Do you record them?
Oh,
no. I never record sessions. I describe them and then just use a
writer’s freedom to recreate the conversation. I know the person I was
working with very well, so I could put words for him and put words for
myself.
advertisement
How you define the existential perspective? How do you use it in everyday therapy?
The
existential perspective has value for certain patients but not for
every patient. I never thought of existential psychotherapy as being a
separate free-standing school, as much as these are issues that every
therapist has to know because they’ll come up in a great many patients.
If I’m seeing patients, for example, who are in grief or who have a
fatal illness or who are going through a separation and being very
frightened about being alone, who are going through retirement and
wondering about what their life is going to be like at that point and
what value their life is going to have — these kinds of issues will come
up for so many patients. Those are the patients I think of using a more
philosophical approach for, but things like that will come up in almost
all my patients.
Obviously the sessions in the
book are particularly striking, but is it always like that, day to day?
Do these values work their way into your work?
I
work with a patient who feels that he is a fake, that nothing he says
is really authentic, and I try to work with him on what that means and
the history of that idea and how it came to be. What does he mean by
“real”? What does he mean by “fake”?
I don’t think my
work is a great deal different from therapists who are working at deeper
levels. I tend to engage my patients quite openly and be a little bit
more free about disclosing my own thoughts and feelings. Nothing is more
important to me than creating an intimate and trusting relationship
with a patient.
Are these universal concerns? Or
are they largely Western? What about people who don’t have the luxury
of thinking about meaning?
You can think of a certain
kind of pyramid of needs, as Maslow did a long time ago. First are the
needs of just staying alive and getting food and shelter, and those are
the needs that really demand your attention. Once those needs are met,
once you have more comfort and time, then you have the freedom to start
thinking about other concerns that I think are there in all human
beings; but if you’re busy searching for food all the time you don’t
think about them very much. In this Western world, in this culture in
which I live and in which live the patients I work with, these are the
concerns I encounter.
I’m always very uncomfortable when
people ask me about these sorts of things because I can’t speak for
everyone! I see a select group of people. It was different when I was
younger, when I was seeing a lot of people in the hospitals. A lot of
people were in charity hospitals, but that’s not the case right now.
It’s hard for me to make generalizations, but I think that everyone has
certain deep concerns that are intrinsically philosophical. The idea of
death, for example: Everyone knows that at some point in their life
they’re going to die, and there’s a tremendous amount of fear about
that. That has ramifications for many about how they live their lives.
Has your experience of aging changed your views on finding meaning?
I
feel that as I’ve gotten into my later decades — my 70s and 80s — I’m
feeling a lot of comfort and a lot of lack of stress at this point. I
think it has a lot to do with not living a life that’s full of regrets. I
work with that concept a whole lot with my patients; they talk about
all the regrets they have about what’s happened in the past, and I like
to focus in on What’s your life right now? If we were to meet a year or
two from now, what new regrets would you have built up? How could you go
about constructing a regret-free life for yourself?
I’ve
been living in that situation for quite some time. I choose what kind
of work I do; I’m writing, which I love to do; I’m teaching, which I
also spend a good deal of my life doing; I’m a doctor; I have a very
loving relationship with my wife… I just don’t see myself building any
regrets at all, and that seems like a very good way for me to live. I
just wish I could help my clients achieve that also.
What do you feel is the most important thing for people to take away from this interview?
This
book that I’m writing, “The Creatures of the Day,” it’s great that the
general public reads it but to be honest, my secret target audience for
this book — and almost for every book I’ve written — is the young
psychotherapist. I’ve been a professor at Stanford for almost all of my
adult life, and I have a sense of being a teacher. I’m writing this, in
effect, to help instruct other therapists, so I have a lot of messages
in here about how to do therapy, about the importance of constructing a
certain kind of space and intimate and trusting relationship with the
patient. They can draw out of it things that maybe we could never really
have known or imagined or predicted ourselves; each of them may draw
different things out of the same kind of space.
I talk a lot about
how the therapist can be and the whole level of how you interact with
patients, the honesty you have about your own self. I’m teaching that
kind of a mode of therapy right now, rather than maybe the more ancient
modes where the therapist was invisible and only makes interpretations
to the patient. I don’t think that’s the best model for therapy, so I
tend to interact closely with patients.
Each of the
stories brings up some kind of a philosophical issue that we have to
look at. For example, the patient from the title story confessed after a
while that he had been concealing something very important from me. We
worked on why that was. Why would he want to deceive me when he’s here
for help? He thought it was so important that I have a certain image of
him in my mind. I began to work on that: What did that mean? Why was
that useful? The way each patient got help was extremely different, but
it was the same person that was offering the help and the same kind of
situation; people will draw different things from the same kind of
therapeutic safe space that I set up for them.
Irvin Yalom (Credit: Reid Yalom)
Joanna Rothkopf is an assistant editor at Salon,
focusing on science, health and society. Follow @JoannaRothkopf or email
jrothkopf@salon.com.
No comments:
Post a Comment