An Open Letter To A New Generation Of Therapists And Their Patients

I recently finished reading The Gift of Therapy by Irvin D. Yalom, M.D.

POSSIBLE SPOILER ALERT

  Rating: 4/5 stars

"Speaking directly to the current generation of counselors, The Gift of Therapy lays out simple suggestions that blend personal experience with professional objectivity. This is a book that will remind you why you entered the field in the first place. With tips on avoiding diagnosis (except for insurance purposes), when to disclose personal information, and why it's important to leave time between patient appointments, the recommendations are aimed at therapists, but they may be useful to patients who want to know what to expect from their counselors. Some references to the DSM-IV may be a little over the layperson's head, but in general, the writing is clear and understandable for lay readers as well as professionals. 

Each chapter is just a few pages long, a nice format for busy folks whose reading time occurs in snippets. A single topic is addressed in each chapter, and author Irvin Yalom doesn't waste any time in getting to the point. Many of the sections revolve around balancing the "magic, mystery, and authority" that come with the job of freeing your clients of their reliance on you. 

From when to offer an occasional hug to finding the perfect time for deeper questioning, Yalom's experienced observations will help you achieve even greater professional effectiveness while avoiding some of the more obvious traps in this HMO-directed age of mental health care"

Irvin D. Yalom’s The Gift of Therapy is a guidebook written for people entering the psychotherapy profession. The text’s many concise and enlightening chapters cover a range of topics that unveil Yalom’s therapeutic theory and practice, focusing on his experiences with individual therapy, group therapy, and existential therapy. Written with tremendous spirit, deep compassion, and candid intelligence, The Gift of Therapy is an essential examination of one of modern life’s most challenging and rewarding vocations.

I found it extremely helpful and can’t wait to put the lessons contained here into practice.

– A therapist’s primary function, Yalom says, is to “remove obstacles” that stand in the way of a client’s natural growth and healing process. It is not within the therapist’s capacity to directly “fix” clients, so the appropriate goal is to help identify and clear out impediments to client autonomy and self-actualization.

–Yalom presents a very egalitarian and nonhierarchical view of the therapist-client relationship, referring to both parties as “fellow travelers” in the mysterious and challenging journey of life. To keep things balanced, he also offers a scrupulous analysis of the professional boundaries necessary to form and maintain a strong therapeutic alliance.

–Yalom focuses a lot on the difference between content (the concrete details discussed in therapy) and process (how those details influence the client-therapist relationship). While I occasionally found Yalom’s examples a bit too therapist-focused, I nonetheless see this as a very useful approach. His repeated insistence that “Therapy should not be theory-driven but relationship-driven” resonates strongly with my intuitions about how to pursue a successful therapeutic practice.

–As an existential therapist, Yalom’s theoretical orientation revolves around four central concerns of human life: (1) Death, (2) Isolation, (3) Meaning, and (4) Freedom. There is no formal structure or programmatic method for delivering existential therapy, and Yalom emphasizes that it can be fruitfully complementary to any other therapeutic modality.

–A critical facilitating component of Yalom’s process is the therapist’s ability to model intelligent and compassionate interpersonal skills that neutralize a client’s defense mechanisms and invite them to reciprocate. The key to ameliorating a client’s social dysfunction is often found by leveraging the “here-and-now” of therapeutic encounters to co-create positive, exploratory, and respectful dynamics that the client can then begin to apply elsewhere.

–Yalom asserts that effective therapy always contains elements of spontaneity and creativity that arise naturally and unexpectedly during sessions. Further, he recommends “shaping the therapy” over time to fit the specific character and needs of each client. This makes him naturally skeptical of therapeutic approaches such as cognitive-behavioral therapy and other “empirically validated therapies” that are friendly to the constraints of modern experimental design. In his view, these methods overvalue standardization and manualization, and usually fail to generate long-term change and progress even if they effectively alleviate short-term suffering. I don’t yet have the requisite experience to have a strong opinion on this one way or another.

– I appreciated Yalom’s thoughts on this topic, especially his suggestion to eschew “full interpretation” and instead pragmatically “pillage and loot” a client’s dreams for interpretations and lessons that support personal insight and growth

Check out Gift of Therapy, and discover what happens when you open your mind to the gift of therapy.

Happy Reading :)