In 1989, a Stanford professor of psychology published a collection of stories inspired by his work with patients. He wrote about their struggles to come to terms with what he called the four "givens" of the human experience: mortality (the inevitability of death), freedom (the ability to determine our own lives), existential isolation (the impossibility of being completely known by others) and meaninglessness (the absence of an overarching reason for our lives).
Personal, vulnerable, revealing and beautifully written, Irvin Yalom's "Love's Executioner" became a New York Times bestseller and demystified the process of therapy for thousands of readers. With 1999's "Momma and the Meaning of Life," Yalom once again exposed the process of the therapeutic encounter for a popular audience, gently guiding readers to a deeper understanding of the value of therapy.
Now, the 83-year-old psychotherapist and author has published "Creatures of a Day," a book whose subtitle, "And Other Tales of Psychotherapy," points to its similarities with his earlier collections. Yet "Creatures" is its own beast: a book that circles around the crisis of our mortality and finds redemption in our capacity for growth, in love and in language.
On Saturday, March 14, Yalom will give a talk at Palo Alto's Lucie Stern Community Center.
The title of his latest book comes from the Roman emperor Marcus Aurelius, who writes in "The Meditations": "All of us are creatures of a day; the rememberer and the remembered alike. All is ephemeral. ... Always reflect that soon you will be no one and nowhere."
Over the phone last week, Yalom talked about his book as a teaching tool and the stories in it as narratives that emphasize the importance of the therapeutic relationship.
"My primary secret audience always is the young psychotherapist," he explained. "Earlier on in my career I wrote textbooks and I smuggled stories into them, but in these books I let the narrative do the teaching. I am trying to show how important it is that there be a genuine and important relationship between therapist and patient. And I am trying to say to students, 'Look: You don't need to be so hidden.'"
It's a very different vision of therapy from Sigmund Freud's psychoanalytic model that requires that the therapist maintain a dispassionate distance, and even from the approach to clinical therapy espoused by more contemporary psychologists. Yalom acknowledged that not everyone in his field shares his enthusiasm for self-disclosure.
"I am rather far out on the continuum of therapists who feel it's helpful to reveal oneself," he admitted.
In "Creatures of a Day," Yalom reveals himself to both reader and patient, allowing the reader into the sanctity of the one-on-one therapy session. Though he works carefully to conceal the true identity of his patients by changing names and combining elements of various cases, he himself appears in these stories without such disguise. In one story, he admits to his own curiosity about a patient's life steering him away from the central issue; in another, he acknowledges that his impatience makes him push too hard. In "Get Your Own Damn Fatal Illness," Yalom describes returning to a patient's letters after her death, only to realize he hadn't read them carefully the first time. Yet all along, he tempers his admissions of his shortcomings with a confident narrative voice and a generous attitude toward both himself and his patients.
Among the most powerful stories in the collection is "Show Some Class for Your Kids," in which Yalom recounts a session with a nurse who reports having been "scorched" by life and who carries a deep well of grief and resentment, yet who is still able to help her own patients face the end of their lives with dignity.
When asked what he has learned about himself over more than 50 years of work as a therapist, Yalom spoke about his work with people who are terminally ill.
"I always have a few patients in my practice with a lethal illness, and I have learned a tremendous amount about myself through working with them," he said. "Early on, when I started working with groups of people with cancer, I heard many people say, 'What a pity that we had to wait until now, until we're riddled with cancer, to learn how to really live.' Terminally ill people talked about living authentically, without being so defensive or hidden. I thought, Perhaps there's some way to use our foreknowledge of death to learn how to live and not wait until we have a fatal illness."
How can one learn to live authentically and without unnecessary defenses?
For example, Yalom suggested, "Draw a line from left to right on a sheet of paper. The left edge of the paper represents your birth; the right is your death. Mark on that line where you are now. Meditate on that for a while."
Is therapy appropriate for everyone? Yalom tends to think so.
"I think everyone can profit from some form of therapy. It's a way of learning about yourself. It's the whole idea of Socrates: The unexamined life is not worth living. I agree completely."
What: Dr. Irvin D. Yalom, presented by the Center for the Study of Group Psychotherapy
Where: Lucie Stern Community Center ballroom, 1305 Middlefield Road, Palo Alto
When: Saturday, March 14, 11 a.m.-1 p.m.
Cost: $50 through March 12, $60 on-site. Two CEUs available.
Info: Go to csgp.org.