Irvin d yalom download

Yalom Original Title: Becoming Myself: A Psychiatrists Memoir Book Format: Hardcover Number Of Pages: pages First Published in: October 3rd Latest Edition: October 3rd Language: English category: psychology, non fiction, biography, autobiography, memoir, biography, autobiography, philosophy, medicine, psychiatry, health, mental health, biography memoir, social science, social work Formats: ePUB Android , audible mp3, audiobook and kindle. Yalom Lying on the Couch by Irvin D. Yalom Related Books.

This item is not yet published. You may pre-order a copy and we will send it out when it becomes available. Free delivery worldwide. Zoom On Slack. Visual Studio Xcode. But until now, it has lacked a coherent structure. In Existential Psychotherapy, Irvin Yalom finds the essence of existential psychotherapy, synthesizing its historical background, core tenets, and usefulness to the practice. Organized around what Yalom identifies as.

A Matter of Death and Life. A year-long journey by the renowned psychiatrist and his writer wife after her terminal diagnosis, as they reflect on how to love and live without regret. Unfortunately, as Yalom points out, all too often we fail to see these as such, and offer help in the form of superficial, pseudoscientific psychologizing, technical trivialities and medications that often do more harm than good. Read reviews that mention existential psychotherapy mental health irvin yalom great book buy this book found this book existential psychotherapy book is a must read read this book psychology existentialism meaning freedom isolation philosophy field alone approach ideas patient.

Life is not a simple journey especially when we pick up so much detritus on the way. I intend to us it in my classes this year and for as long as it remains in print. We can notify you when this item is back in stock. Amazon Drive Cloud storage from Amazon. Editorial Reviews Review A classic for those studying existential psychotherapy and indeed for all clinicians.

While, used humbly and wisely, these things are not without value, their value is often fatally limited by their failure to see the larger context of life and its challenges. The fundamental concerns of therapy and the central issues of human existence are woven together here as never before, with intellectual and clinical results psychotherqpy will surprise and enlighten all readers. Amazon Music Stream millions of songs.

He points out that individuation co-occurs with psychopathy less often and appears to be a more effective defense compared to fusion. This website uses cookies to improve your experience while you navigate through the website. Therapy is like a living Rorschach test—patients project onto it percep- tions, attitudes, and meanings from their own unconscious. Some wondered why I delayed so long. Even the banal Kleenex box may be a rich source of data. One patient apologized if she moved the box slightly when extracting a tissue.

Another refused to take the last tissue in the box. You must be expecting a heavy session today. Another brought me a present of two boxes of Kleenex. Most of my patients have read some of my books, and their responses to my writing constitute a rich source of material.

Some are intimidated by my having written so much. Some express concern that they will not prove interesting to me. I shall have much more to say about the use and care of this instrument.

This time-honored strategy has limitations: not only is the work apt to be intellectualized but all too often it is based on inaccu- rate data suppled by the patient.

The here-and-now offers a far better way to work. Once this is done, the work becomes much more accurate and immediate. Keith, a long-term patient and a practicing psychotherapist, reported a highly vitri- olic interaction with his adult son.

What are my tasks in this situation? A more immediate task was to offer some immediate comfort and assist Keith to reestablish equilibrium. Far better, I thought, to identify and work through a here-and-now equivalent of the unsettling event. But what here-and-now event? As it happened, I had recently referred to Keith a patient who, after a couple of sessions with him, did not return.

Keith was convinced that I would judge him harshly, that I would not forgive him for failing, and that I would never again refer another patient to him.

Note the symbolic equivalence of these two events—in each one, Keith presumed that a single act would forever blemish him in the eyes of someone he treasured. I told him that he was misreading me entirely, that I had no doubts about his sen- sitivity and compassion and was certain he did excellent clini- cal work. It was unthinkable for me to ignore all my long experience with him on the basis of this one episode, and I said that I would refer him other patients in the future.

Alice and crudity. Alice, a sixty-year-old widow desper- ately searching for another husband, complained of a series of failed relationships with men who often vanished without explanation from her life. In our third month of therapy she took a cruise with her latest beau, Morris, who expressed his chagrin at her haggling over prices, shamelessly pushing her way to the front of lines, and sprinting for the best seats in tour buses. After their trip Morris disappeared and refused to return her calls.

Rather than embark on an analysis of her relationship with Morris, I turned to my own relationship with Alice. I was aware that I, too, wanted out and had pleasurable fantasies in which she announced she had decided to terminate. Even though she brashly and successfully negotiated a considerably lower ther- apy fee, she continued to tell me how unfair it was that I should charge her so much.

Overall, she was without delicacy and, just as she had done with Morris, turned our relationship into some- thing crude. I knew that this here-and-now reality was where we needed to work, and the gentle exploration of how she had coarsened her relationship with me proved so useful that months later some very astonished elderly gentlemen received her phone calls of apology.

Mildred and the lack of presence. As soon as her husband touched her sexually she began to reexperience traumatic events from her past.

As I examined the here-and-now relationship between the two of us I could appreciate many similarities between the way she related to me and the way she related to her husband.

I often felt ignored in the sessions. In one session he described a frustrating encounter with a girlfriend who, in his view, was obviously jerking him around, yet he was para- lyzed with fear about confronting her.

The session felt repeti- tious to me; we had spent considerable time in many sessions discussing the same material and I always felt I had offered him little help. I could sense his frustration with me: he implied that he had spoken to many friends who had covered all the same bases I had and had ultimately advised him to tell her off or get out of the relationship.

You travel an hour to see me and you pay me a good deal of money. Yet we seem to be repeating ourselves. I say the same things as your friends, who give it to you free. You have got to be disappointed in me, even feeling ripped off and angry at me for giving you so little.

I was pretty close. I asked him to repeat it in his own words. The whole interchange proved useful to Albert. His feelings toward me were an analog of his feelings toward his girlfriend, and the experience of expressing them without a calamitous outcome was powerfully instructive. But once that is accomplished, how then do we proceed?

How can we use these here-and-now observations in the work of therapy? I know that. And yet I keep on doing it. Is there a history to this? I know I irritate a lot of people and yet I keep doing it.

There must be some kind of payoff for you. I wonder, what is it? Fastidious in her habits, she revealed how unnerved the faulty screen door made her. And not only the door, but also my cluttered desk, heaped high with untidy stacks of books. She also stated how very impatient she was with me for not working faster with her. It seems hard for you to say positive things about me and about our work together. What do you know about that? Louise silently shook her head.

And the underlying war? And of the path as well. What do you imagine? Note in this vignette that I drew upon incidents that had occurred in the past, earlier in our therapy. This is particularly evident in group therapy. Con- sider, for example, an historical episode in group work. In , the state of Connecticut sponsored a workshop to deal with racial tensions in the workplace. Nota bene: The content refers to the actual words and concepts expressed.

News spread about these evening staff meetings, and two days later the members of the groups asked to attend. There are several published accounts of this momentous session at which the importance of the here-and-now was dis- covered.

All agree that the meeting was electrifying; members were fascinated by hearing themselves and their behavior dis- cussed. Many years ago, when I was attempting to develop a more effective mode to lead brief-therapy groups on the acute inpa- tient ward, I visited dozens of groups in hospitals throughout the country and found every group to be ineffective—and for precisely the same reason.

I ultimately formulated, in a text on inpatient group therapy, a here-and-now approach for such acutely disturbed patients, which, I believe, vastly increased the degree of member engagement. The same observation holds for individual therapy. Therapy is invariably energized when it focuses on the relationship between therapist and patient. Every Day Gets a Little Closer describes an experiment in which a patient and I each wrote summaries of the therapy hour.

If in the session you feel bored or irritated, confused, sexually aroused, or shut out by your patient, then regard that as valuable information. This is precisely why I so emphasize personal therapy for therapists. If you develop a deep knowl- edge of yourself, eliminate the majority of your blind spots, and have a good base of patient experience, you will begin to know how much of the boredom or confusion is yours and how much is evoked by the patient.

So rather than be dismayed at boredom, welcome it and search for a way to turn it to therapeutic advantage.

When did it begin? What exactly does the patient do that bores you? I wonder, what is your level of connection to me today? Is your feeling sim- ilar to mine? But later, as I thought about it, I realized I would not have hesitated to rearrange my schedule for any of my other patients. It was because I did not look forward to seeing him. There was something about his mean-spiritedness that had worn me down. My feeling worn down by Martin had vast implications.

Further- more, he groused often because his girlfriends did not do their full share of driving, trip planning, or map reading.

And he was doing exactly the same to me! It was my recogni- tion of this process that permitted me to avoid responding crit- ically that is, take it personally but to realize this was a pattern that he had repeated many times and that he, at bottom, wanted to change. There are few human sit- uations in which we are permitted, let alone encour- aged, to comment upon the immediate behavior of the other.

It feels liberating, even exhilarating—that is precisely why the encounter-group experience was so compelling. But it also feels risky, since we are not accustomed to giving and receiving feedback. Therapists must learn to package their comments in ways that feel caring and acceptable to patients. In other words, talk about how you feel, not about what the patient is doing. Sometimes it is best to offer commen- tary at the moment; other times it is best simply to store the incident and return to it later.

Tell me, what was that like for you? How did it feel to let down barriers here? To allow me to see your tears? Or consider a patient who may have been very shaken dur- ing a session and, uncharacteristically, asks for a hug at the end.

Keep in mind that effective therapy consists of an alternating sequence: evocation and expe- riencing of affect followed by analysis and integration of affect. How long one waits until one initiates an analysis of the affec- tive event is a function of clinical experience.

Often, when there is deep feeling involved—anguish, grief, anger, love—it is best to wait until the feeling simmers down and defensiveness diminishes. Again and again I was so moved that I sought to offer her some comfort. But I never succeeded. Every time I tried I got bitten. But she was so brittle and so hypersen- sitive to perceived criticism that I waited for many weeks before I shared that observation. Everything—especially episodes containing heightened emotion—is grist for the mill.

Many unexpected events or reac- tions occur in therapy: Therapists may receive angry E-mail or calls from patients, they may not be able to offer the comfort desired by the patient, they may be deemed omniscient, they are never questioned, or always challenged, they may be late, make an error in billing, even schedule two patients for the same hour.

What about today? How much distance between us today? In fact, it is particularly important to start setting norms in the early ses- sions. In the initial session, I make certain to inquire about how patients chose to come to me. I interview you but it is also an opportunity for you to size me up and develop opinions about how it would be to work with me. How does the reality of seeing me match those expectations? Any concerns about a therapist who is also a writer?

What questions do you wish to ask me about that? O ften during the course of therapy patients may describe examples of deception in their life—some incident when they have either concealed or distorted information about themselves. There is always some concealment, some information withheld because of shame, because of some particular way they wish me to regard them.

The general rabbit-ears strategy is simply to scan all material in the session for here-and-now implications and, whenever possible, to take the opportunity to swing into an examination of the therapy relationship. Once the transfer- ence the living manifestation of earlier parental relationships was available for study in the analysis, the therapist might more accurately reconstruct the early life of the patient.

But forget the blank screen! It is not now, nor was it ever, a good model for effective therapy. The idea of using current dis- tortions to re-create the past was part of an old, now aban- doned, vision of the therapist as archaeologist, patiently scraping off the dust of decades to understand and thus, in some mysterious manner, undo the original trauma.

Did Freud himself generally follow the blank-screen model? Often, perhaps generally, not. Think of him stopping patients from rushing on to other topics and instead slowing them down to bask with him in the after- glow of an enlightening insight. Freud rose and let the dog out. Now he is coming back to give you a second chance. He made strong suggestions to them, he intervened on their behalf with family members, he contrived to attend social functions to see his patients in other settings, he instructed a patient to visit the cemetery and meditate upon the tombstone of a dead sibling.

B e R e a l 77 interactive style. Nonetheless, jokes, parodies, and misunder- standings of the nondirective approach hounded him till the end of his life. In group therapy it is exceedingly evident that one of the tasks of the group therapist is to demonstrate behavior that the group members gradually model themselves after. It is the same, though less dramatic, in individual therapy.

The psychotherapy outcome literature heavily supports the view that therapist dis- closure begets client disclosure. I have long been fascinated with therapist transparency and have experimented with self-disclosure in many different for- mats. Perhaps my interest has its roots in my group-therapy experience, in which the demands on the therapist to be trans- parent are especially great. Group therapists have a particularly complex set of tasks because they must attend to not only the needs of each individual patient in the group, but to the cre- ation and maintenance of the enveloping social system—the small group.

Hence, they must attend to norm development— particularly the norms of self-disclosure so necessary for the successful small-group experience. The therapist has no more potent method to build behavioral norms than personal modeling. Many of my own experiments in therapist self-disclosure originated as a response to the observation of therapy groups by students.

Psychotherapy training programs rarely offer students an opportunity to observe individual psychotherapy sessions— therapists insist on the privacy and intimacy so integral to the individual therapy process. But almost every group training pro- gram provides for group observation either through a one-way mirror or video playback. The group therapists, of course, must obtain permission for observation, and group members will generally grant that permission but do so grudgingly.

To eliminate these disadvantages of group observation, I asked the group members and the students to switch rooms after each group meeting: the group members move into the observation room, where they observe the students and me dis- cussing the group. In another format for personal transparency, I routinely write a detailed and impressionistic summary of outpatient group meetings and mail it to members before the next meet- ing.

This technique had its origins in the s when I began leading groups for alcoholic patients. B e R e a l 79 most alcohol counselors had decided that it was best to leave alcoholic group treatment in the hands of AA. I decided to try once again but to employ an intensive here-and-now format and to shift the focus from the alcohol addiction to the under- lying interpersonal problems that fueled the urge to drink.

All group members were required to participate in AA or some other program to control their drinking. The here-and-now focus galvanized the group. Meetings were electric and intensive.

Unfortunately, far too intensive! I employed a series of techniques. First, a here-and-now agenda written for each meeting on the blackboard containing such items as the following: To enable John and Mary to continue examining their differences but to deal with each other in a less threatening and hurtful manner.

To help Paul request some group time to talk about himself. Second, we used video playbacks of selected portions of the meetings. Third, after each meeting I dictated and mailed to the mem- bers a weekly summary which was not only a narrative of the content of each session but also self-revealing.

Of all these methods, the weekly summary was by far the most effective, and since then I have made a regular practice in my once-a-week groups to mail a detailed summary to the group members before the following meeting. If I have a co- leader, we alternate responsibility for the summary. Recall the experiment in which I and a patient named Ginny exchanged our impressionistic summaries of each ses- sion.

This format was also a challenging exercise in therapist transparency. The patient had so idealized me, had placed me on such an elevated pedestal, that a true meeting between us was not possible. B e R e a l 81 attempted to reveal the very human feelings and experiences I had: my frustrations, my irritations, my insomnia, my vanity.

This exercise, done early in my career, facilitated therapy and liberated me a good deal in subsequent therapeutic work. Freud, more drawn to speculative questions about the application of psychoanalysis to the under- standing of culture, was basically pessimistic about therapy and rarely tinkered with methods to improve therapy technique. Who should pay whom? She felt the procedure had facilitated therapy and that Ferenczi was unwilling to continue because he feared having to acknowledge that he was in love with her.

Ferenczi held a contrary opinion. My novel Lying on the Couch attempts to rerun his experiment in contemporary therapy. There is every reason to reveal oneself to the patient and no good reason for con- cealment. Yet whenever I begin to address therapists on this issue, I observe considerable discomfort, which stems in part from the imprecision of the term self-disclosure.

Therapist self- disclosure is not a single entity but a cluster of behaviors, some of which invariably facilitate therapy and some of which are problematic and potentially counterproductive. Let us examine each in turn. Shamanistic training and practices have always been veiled in mystery, whereas Western physicians have, for cen- turies, used accoutrements designed to inspire awe and maxi- mize a placebo effect: white coats, walls studded with prestigious diplomas, and prescriptions written in Latin.

I propose a diametrically opposed view of the healing process throughout this text. The establishment of an authen- tic relationship with patients, by its very nature, demands that we forgo the power of the triumvirate of magic, mystery, and authority.

Psychotherapy is intrinsically so robust that it gains a great deal by full disclosure of the process and rationale of treatment. Patients are already burdened with the primary anxiety that brings them to therapy and it makes little sense to plunge them into a process that may create secondary anxiety—anxiety from exposure to an ambiguous social situation without guidelines for proper behavior or participation.

Therefore it is wise to pre- pare patients systematically for the process of psychotherapy. Preparation of new patients is particularly effective in group therapy because the interactional group situation is so intrinsi- cally alien and frightening. New group members, especially those without previous group experience, are often made anx- ious by the power of the small group—the group pressure, the degree of intimacy, the overall intensity.

Preparation for individual psychotherapy is also essential. Though individuals are likely to have had experience with intense relationships, it is highly unlikely that they have been in a relationship requiring them to trust fully, to reveal all, to hold nothing back, to examine all nuances of their feelings to another, and to receive nonjudgmental acceptance. Because the here-and-now focus may seem unusual to patients I present its rationale.

It is for this reason I shall often ask you to examine what is happening between the two of us. But here-and-now disclosure should not be indiscriminate; transparency should not be pur- sued for its own sake. All comments must pass one test: Is this disclosure in the best interests of the patient?

Over and again in this text I shall emphasize that your most valuable source of data is your own feelings. A patient customarily described problematic incidents in his life but rarely gave me a follow-up. I often felt shut out and curious. I wondered what happened, for example, when he confronted his boss for a raise?

Perhaps some of my curiosity was voyeuristic, emanating from my desire to know the ends of stories. But I felt also my reactions contained important infor- mation about the patient.

Did he never put himself in my posi- tion? Did he not think I had any curiosity about his life? Perhaps he thought of me as a machine without any of my own curiosity and desires. Clinical illustration.

A patient experienced a sense of pervasive illegitimacy and shame in all his personal and busi- ness transactions. He hated the way he tried to impress me with his cleverness and his intelligence. For example, he loved languages and, though English was his second language, he reveled in mastering its nuances and con- fessed that he had often searched the dictionary before ses- sions for esoteric words to use in our discussion.

I felt dismayed at his self-castigation. For a moment I could experi- ence the force of his guilt and self-criticism, since I was a full accomplice: I had always taken great delight in his wordplay and, without doubt, had encouraged his behavior. Here I am sitting with you in this room and you are withdrawn from me.

Why should I be different from you? I need people like you do. And I need you to stop keeping away from me. I feel so much a nothing. I never do anything in my life. But around the third type of disclosure, the personal life of the therapist, there swirls considerable controversy. If therapist disclosure were to be graded on a continuum, I am certain that I would be placed on the high end. Yet I have never had the experience of disclosing too much.

On the con- trary, I have always facilitated therapy when I have shared some facet of myself. I was leading an outpatient group at the time, and my co-therapist, a young psy- chiatric resident, was uncertain what to do and simply informed the group that I would be absent because of a death in my fam- ily. The group meetings were being videotaped for research and teaching purposes, and upon my return a week later I viewed the tape of the meeting—a productive, highly energized session.

It is axiomatic that if a group actively avoids some major issue, then no other issue will be addressed effectively. Some wanted to know details of the death and funeral, others asked about how I was handling it, others inquired about my relationship to my mother and sister.

I answered all with great candor and told them, for example, of my fractious relationship with my mother and how I had chosen to live in California partly in order to put three thousand miles between my mother and me. She had been a dragon in many ways, I told them, but she had lost her fangs as she had aged and in the last several years our relation- ship had grown much closer and I had been a dutiful son.

Finally the group asked whether there was anything they could do for me in the meeting. Finally, I said that I believed that I now had the energy to work effectively in the group, whereupon the group turned back to group business and had an extremely productive meeting. For years afterward, I used the videotape of this meeting to teach group process. I feel certain that my disclosure not only removed a potential roadblock to the group but that my model- ing self-disclosure was a liberating event for it.

She exploded with great fury and accused me of attempting to compare my grief with hers. Long ago a colleague worked with a patient whose child had died of cancer. The long course of therapy had been helpful but not entirely successful.

My colleague, who had also lost a young child twenty years earlier, chose not to share that infor- mation with his patient. Many years later the patient contacted him again and they resumed therapy. This disclosure, which was novel for him, proved vastly instrumental in accelerating the therapy work.

If patients want to know whether I am married, have chil- dren, liked a certain movie, read a certain book, or felt awkward at our meeting at some social event, I always answer them directly.

Why not? How can one have a genuine encounter with another person while remaining so opaque? And why did I make the choice I did?