‘Real treatment, he says, requires an intimacy between therapist and patient that is born from a solid bond of trust.’

Below is an article I came across, written by Barbara Jamison, in which she reviews some of Yalom’s ideas, discussed in his book ‘The Gift of Therapy’ in which he extols the virtues of the therapist’s willingness to reveal himself and fully engage in the therapeutic relationship.

 

Letting the Patient Matter: Some Thoughts on Irvin Yalom’s View of The Therapeutic Relationship

by Barbara Jamison

In his recent book The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients, psychiatrist and writer Irvin Yalom recalls a poignant encounter with one of his cancer patients. The woman is embarrassed by her hair loss after chemotherapy, and during one of her therapy sessions, she reveals that she would like a sign from Yalom that her baldness does not repulse him. Yalom, who has always admired this patient for the intelligence that illuminates her features, tells her he’s not repulsed at all. In fact, he asks if he can act on his impulse to run his fingers through the lovely gray strands of hair remaining on her head. The result is a warm, intimate moment that is cathartic for both.

Such moments, related in his latest book, The Gift of Therapy, serve as vivid arguments for breaking down the walls that separate patient and therapist. Directed to a new generation of therapists and their patients, Yalom is a keen advocate for unmasking the therapist. One of the main reasons that patients fall into despair is that they are unable to sustain gratifying relationships. According to Yalom, therapy is their opportunity to establish a healthy give-and-take with an empathetic counselor; one who is not afraid to show his or her own vulnerabilities.

Opening the Secret Door

A professor emeritus of psychiatry at Stanford University and the author of several widely read books and novels on psychotherapy including the best-selling therapeutic memoir Love’s Executioner and various classic textbooks on group psychotherapy and existential psychotherapy. Yalom’s insight into this world throws open the secret door to therapy, both for counselors and the patients who visit them.

What we see behind Yalom’s door is a far cry from the stereotype of a therapist. From comic strips to Hollywood features, the analyst is often portrayed seated behind a desk or a notebook, literally out of reach and out of sight of the person being analyzed.

As patients, we perceive that person sitting across from us as a powerful and impenetrable figure, yet we’re expected to reveal ourselves up to their scrutiny.

As patients, we perceive that person sitting across from us as a powerful and impenetrable figure, yet we’re expected to reveal ourselves up to their scrutiny. Within the charged atmosphere of the 50-minute therapeutic hour, our psyches are exposed, while the therapist maintains an enigmatic mask.

This may be the traditional model of psychoanalysis, but Yalom challenges it as ineffective and ultimately unhealthy. Real treatment, he says, requires an intimacy between therapist and patient that is born from a solid bond of trust. After all, a patient regularly entrusts a therapist with intimate revelations, so the therapist must be able to respond with true spontaneous empathy rather than stock therapeutic phrases. Nor does empathy evolve in a vacuum. “Friendship between therapist and patient is a necessary condition in the process of therapy,” says Yalom, and he encourages the therapist to ‘let the patient know that he or she matters to you’.

 

Irvin Yalom’s work and ideas have been hugely influential in my own practice and have served to inform my own opinions of what matters most in the therapeutic relationship and what heals.

katycounsellingherts@outlook.com

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