Gift of Therapy

291 Pages·2007·0.87 MB·English

The Gift of
Therapy
an open letter to a new generation
of therapists and their patients
Irvin D. Yalom, M.D.
to Marilyn,
soul mate for over fifty years.
still counting.

contents
Introduction x
Acknowledgments xx
chapter 1 Remove the Obstacles to Growth, 1
chapter 2 Avoid Diagnosis (Except for
Insurance Companies), 4
chapter 3 Therapist and Patient as
“Fellow Travelers,” 6
chapter 4 Engage the Patient, 11
chapter 5 Be Supportive, 13
chapter 6 Empathy: Looking Out
the Patient’s Window, 17
chapter 7 Teach Empathy, 23
chapter 8 Let the Patient Matter to You, 26
chapter 9 Acknowledge Your Errors, 30
chapter 10 Create a New Therapy
for Each Patient, 33
chapter 11 The Therapeutic Act, Not
the Therapeutic Word, 37
chapter 12 Engage in Personal Therapy, 40
v c o n t e n t s
chapter 13 The Therapist Has Many Patients;
The Patient, One Therapist, 44
chapter 14 The Here-and-Now—Use It, Use It,
Use It, 46
chapter 15 Why Use the Here-and-Now?, 47
chapter 16 Using the Here-and-Now—
Grow Rabbit Ears, 49
chapter 17 Search for Here-and-Now Equivalents, 52
chapter 18 Working Through Issues in
the Here-and-Now, 58
chapter 19 The Here-and-Now Energizes Therapy, 62
chapter 20 Use Your Own Feelings as Data, 65
chapter 21 Frame Here-and-Now
Comments Carefully, 68
chapter 22 All Is Grist for the Here-and-Now Mill, 70
chapter 23 Check into the Here-and-Now
Each Hour, 72
chapter 24 What Lies Have You Told Me?, 74
chapter 25 Blank Screen? Forget It! Be Real, 75
chapter 26 Three Kinds of Therapist
Self-Disclosure, 83
chapter 27 The Mechanism of Therapy—
Be Transparent, 84
chapter 28 Revealing Here-and-Now Feelings—
Use Discretion, 87
chapter 29 Revealing the Therapist’s Personal Life—
Use Caution, 90
c o n t e n t s vi
chapter 30 Revealing Your Personal Life—Caveats, 94
chapter 31 Therapist Transparency and Universality, 97
chapter 32 Patients Will Resist Your Disclosure, 99
chapter 33 Avoid the Crooked Cure, 102
chapter 34 On Taking Patients Further Than
You Have Gone, 104
chapter 35 On Being Helped by Your Patient, 106
chapter 36 Encourage Patient Self-Disclosure, 109
chapter 37 Feedback in Psychotherapy, 112
chapter 38 Provide Feedback Effectively
and Gently, 115
chapter 39 Increase Receptiveness to Feedback
by Using “Parts,” 119
chapter 40 Feedback: Strike When the Iron Is Cold, 121
chapter 41 Talk About Death, 124
chapter 42 Death and Life Enhancement, 126
chapter 43 How to Talk About Death, 129
chapter 44 Talk About Life Meaning, 133
chapter 45 Freedom, 137
chapter 46 Helping Patients Assume Responsibility, 139
chapter 47 Never (Almost Never) Make Decisions
for the Patient, 142
chapter 48 Decisions: A Via Regia into
Existential Bedrock, 146
chapter 49 Focus on Resistance to Decision, 148
chapter 50 Facilitating Awareness by Advice Giving, 150
vii c o n t e n t s
chapter 51 Facilitating Decisions—Other Devices, 155
chapter 52 Conduct Therapy as a Continuous
Session, 158
chapter 53 Take Notes of Each Session, 160
chapter 54 Encourage Self-Monitoring, 162
chapter 55 When Your Patient Weeps, 164
chapter 56 Give Yourself Time Between Patients, 166
chapter 57 Express Your Dilemmas Openly, 168
chapter 58 Do Home Visits, 171
chapter 59 Don’t Take Explanation Too Seriously, 174
chapter 60 Therapy-Accelerating Devices, 179
chapter 61 Therapy as a Dress Rehearsal for Life, 182
chapter 62 Use the Initial Complaint as Leverage, 184
chapter 63 Don’t Be Afraid of Touching
Your Patient, 187
chapter 64 Never Be Sexual with Patients, 191
chapter 65 Look for Anniversary and
Life-Stage Issues, 195
chapter 66 Never Ignore “Therapy Anxiety,” 197
chapter 67 Doctor, Take Away My Anxiety, 200
chapter 68 On Being Love’s Executioner, 201
chapter 69 Taking a History, 206
chapter 70 A History of the Patient’s
Daily Schedule, 208
chapter 71 How Is the Patient’s Life Peopled?, 210
chapter 72 Interview the Significant Other, 211
c o n t e n t s viii
chapter 73 Explore Previous Therapy, 213
chapter 74 Sharing the Shade of the Shadow, 215
chapter 75 Freud Was Not Always Wrong, 217
chapter 76 CBT Is Not What It’s Cracked Up to Be . . . Or,
Don’t Be Afraid of the EVT Bogeyman, 222
chapter 77 Dreams—Use Them, Use Them,
Use Them, 225
chapter 78 Full Interpretation of a Dream?
Forget It! 227
chapter 79 Use Dreams Pragmatically:
Pillage and Loot, 228
chapter 80 Master Some Dream Navigational Skills, 235
chapter 81 Learn About the Patient’s Life
from Dreams, 238
chapter 82 Pay Attention to the First Dream, 243
chapter 83 Attend Carefully to Dreams About
the Therapist, 246
chapter 84 Beware the Occupational Hazards, 251
chapter 85 Cherish the Occupational Privileges, 256
Notes 261
About the Author
Other Books by Irvin D. Yalom, M.D.
Credits
Cover
Copyright
About the Publisher