Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients

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Overview

The culmination of master psychiatrist Dr. Irvin D. Yalom's more than thirty-five years in clinical practice, The Gift of Therapy is a remarkable and essential guidebook that illustrates through real case studies how patients and therapists alike can get the most out of therapy. The bestselling author of Love's Executioner shares his uniquely fresh approach and the valuable insights he has gained—presented as eighty-five personal and ...

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The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients

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Overview

The culmination of master psychiatrist Dr. Irvin D. Yalom's more than thirty-five years in clinical practice, The Gift of Therapy is a remarkable and essential guidebook that illustrates through real case studies how patients and therapists alike can get the most out of therapy. The bestselling author of Love's Executioner shares his uniquely fresh approach and the valuable insights he has gained—presented as eighty-five personal and provocative "tips for beginner therapists," including:

  • Let the patient matter to you
  • Acknowledge your errors
  • Create a new therapy for each patient
  • Do home visits
  • (Almost) never make decisions for the patient
  • Freud was not always wrong

A book aimed at enriching the therapeutic process for a new generation of patients and counselors, Yalom's Gift of Therapy is an entertaining, informative, and insightful read for anyone with an interest in the subject.

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Editorial Reviews

From Barnes & Noble
An unorthodox thinker and professor emeritus of psychiatry at Stanford University, Irvin D. Yalom, M.D., reflects upon the practical, philosophical, and emotional dynamics of therapy through the lenses of both patient and therapist. This thought-provoking collection of essays covers topics that include self-disclosure, occupational privileges and hazards of the therapist, dream interpretation, talking about death, and the existential components of therapy. Described by the author as "a nuts-and-bolts collection of [my] favorite interventions or statements," The Gift of Therapy is a welcome and well-deserved addition to the library of anyone seeking excellence and a deeper understanding of the therapeutic process.
Boston Globe
“An absorbing guide”
Boston Globe
“An absorbing guide”
Publishers Weekly
If the future of psychotherapy lies in psychopharmaceuticals and the short-term therapies stipulated by HMOs, argues Yalom, then the profession is in trouble. Yalom, the recipient of both major awards given by the American Psychiatric Association, professor emeritus of psychiatry at Stanford and the author of both fiction and nonfiction volumes about psychotherapy, writes this book in response to that crisis. Based on knowledge gained from his 35 years of practice, the resulting book of tips (a "gift" for the next generation of therapists) is an enlightening refutation of "brief, superficial, and insubstantial" forms of therapy. Yalom, who references Rilke and Nietzsche as well as Freud's protege Karen Horney and the founder of client-centered therapy, Carl Rogers, describes therapy as "a genuine encounter with another person." He suggests that therapists avoid making DSM IV diagnoses (except for insurance purposes), since these "threaten the human, the spontaneous, the creative and uncertain nature of the therapeutic venture." He also encourages psychotherapists to use dream analysis, group therapy and, when appropriate, wholly inventive forms of treatment. Traditionalists will probably squirm at some of his suggestions (particularly "Revealing the Therapist's Personal Life" and "Don't Be Afraid of Touching Your Patient"). Other tips, though, such as "Never Be Sexual with Patients" are no-brainers. Although the book dies somewhat in the second half, and not much here is new, the wise ideas are perfectly accessible. (Jan.) Forecast: Yalom has explored many of these ideas before. His followers will certainly be charmed, and newcomers patients as much as therapists may be won over by his openness and tender tone. Copyright 2001 Cahners Business Information.
Library Journal
These two books defend the professional treatment of psychological problems by listening and responding in the Freudian manner, and they deplore the current dominance of neuroscience, pharmacology, and behaviorism. In Why Psychoanalysis?, French psychoanalyst, historian, and critic Roudinesco refers to our "depressive society" and our loss of subjectivity in the era of individuality. She fiercely defends Freud against "fanatical" opponents, even claiming that he was not antifeminist. Roudinesco will appeal to scholars of Freud and Jacques Lacan, of whom some knowledge is assumed. Unfortunately, though Roudinesco wants psychoanalysis to be a science, she often waxes polemical when a clear, objective evaluation of Freud is needed. For that, a general audience will be better served by Elio Frattaroli's Healing the Soul in the Age of the Brain (LJ 8/01). For a more readable presentation of the cultural nexus of psychiatry, Julian Leff's The Unbalanced Mind (LJ 11/15/01) is outstanding. In The Gift of Therapy, Yalom (psychiatry, emeritus, Stanford) writes for both the professional and the lay reader a good idea, since educated consumers help bring professionals into the real world. He favors some self-disclosure by therapists, home visits, meeting with significant others, nonsexual touching, and time for reflection on each session. In 85 short chapters, he presents little pearls of ideas shaped from 35 years in practice. Yalom's view that the therapist is also healed in the process reminds this reviewer of James P. Carse's philosophy. Yalom's latest is essential for therapy trainers and fine for general libraries with psychology and self-help collections. For a general selection of this respected psychiatrist's earlier work, including fiction, consider The Yalom Reader (Basic Bks: Perseus, 1998). E. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, DC Copyright 2001 Cahners Business Information.
From The Critics
Having reached his 70th year, Yalom (psychiatry, Stanford U.) worries about where the next generation of effective psychotherapists will be trained, noting that the big medical corporations are primarily interested in pushing medicine. He advises students against sectarianism and suggests a therapeutic pluralism in which effective interventions are drawn from several different therapy approaches. He does not include an index. Annotation c. Book News, Inc., Portland, OR (booknews.com)
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Product Details

  • ISBN-13: 9780061719615
  • Publisher: HarperCollins Publishers
  • Publication date: 5/12/2009
  • Series: P.S. Series
  • Pages: 320
  • Sales rank: 71,889
  • Product dimensions: 5.30 (w) x 7.90 (h) x 0.80 (d)

Meet the Author

Irvin D. Yalom, M.D., is the author of Love's Executioner, Momma and the Meaning of Life, Lying on the Couch, The Schopenhauer Cure, When Nietzsche Wept, as well as several classic textbooks on psychotherapy, including The Theory and Practice of Group Psychotherapy, considered the foremost work on group therapy. The Professor Emeritus of Psychiatry at Stanford University, he divides his practice between Palo Alto, where he lives, and San Francisco, California.

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Read an Excerpt

Chapter One



Remove the Obstacles to Growth



When I was finding my way as a young psychotherapy student, the most useful book I read was Karen Horney's Neurosis and Human Growth. And the single most useful concept in that book was the notion that the human being has an inbuilt propensity toward self-realization. If obstacles are removed, Horney believed, the individual will develop into a mature, fully realized adult, just as an acorn will develop into an oak tree.

"Just as an acorn develops into an oak..." What a wonderfully liberating and clarifying image! It forever changed my approach to psychotherapy by offering me a new vision of my work: My task was to remove obstacles blocking my patient's path. I did not have to do the entire job; I did not have to inspirit the patient with the desire to grow, with curiosity, will, zest for life, caring, loyalty, or any of the myriad of characteristics that make us fully human. No, what I had to do was to identify and remove obstacles. The rest would follow automatically, fueled by the self-actualizing forces within the patient.

I remember a young widow with, as she put it, a "failed heart" -- an inability ever to love again. It felt daunting to address the inability to love. I didn't know how to do that. But dedicating myself to identifying and uprooting her many blocks to loving? I could do that.

I soon learned that love felt treasonous to her. To love another was to betray her dead husband; it felt to her like pounding the final nails in her husband's coffin. To love another asdeeply as she did her husband (and she would settle for nothing less) meant that her love for her husband had been in some way insufficient or flawed. To love another would be self-destructive because loss, and the searing pain of loss, was inevitable. To love again felt irresponsible: she was evil and jinxed, and her kiss was the kiss of death.

We worked hard for many months to identify all these obstacles to her loving another man. For months we wrestled with each irrational obstacle in turn. But once that was done, the patient's internal processes took over: she met a man, she fell in love, she married again. I didn't have to teach her to search, to give, to cherish, to love -- I wouldn't have known how to do that.

A few words about Karen Horney: Her name is unfamiliar to most young therapists. Because the shelf life of eminent theorists in our field has grown so short, I shall, from time to time, lapse into reminiscence -- not merely for the sake of paying homage but to emphasize the point that our field has a long history of remarkably able contributors who have laid deep foundations for our therapy work today.

One uniquely American addition to psychodynamic theory is embodied in the "neo- Freudian" movement -- a group of clinicians and theorists who reacted against Freud's original focus on drive theory, that is, the notion that the developing individual is largely controlled by the unfolding and expression of inbuilt drives.

Instead, the neo-Freudians emphasized that we consider the vast influence of the interpersonal environment that envelops the individual and that, throughout life, shapes character structure. The best-known interpersonal theorists, Harry Stack Sullivan, Erich Fromm, and Karen Horney, have been so deeply integrated and assimilated into our therapy language and practice that we are all, without knowing it, neo-Freudians. One is reminded of Monsieur Jourdain in Molière's Le Bourgeois Gentilhomme, who, upon learning the definition of "prose," exclaims with wonderment, "To think that all my life I've been speaking prose without knowing it."

The Gift of Therapy. Copyright © by Irvin Yalom. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.
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Table of Contents

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

Chapter One



Remove the Obstacles to Growth



When I was finding my way as a young psychotherapy student, the most useful book I read was Karen Horney's Neurosis and Human Growth. And the single most useful concept in that book was the notion that the human being has an inbuilt propensity toward self-realization. If obstacles are removed, Horney believed, the individual will develop into a mature, fully realized adult, just as an acorn will develop into an oak tree.

"Just as an acorn develops into an oak..." What a wonderfully liberating and clarifying image! It forever changed my approach to psychotherapy by offering me a new vision of my work: My task was to remove obstacles blocking my patient's path. I did not have to do the entire job; I did not have to inspirit the patient with the desire to grow, with curiosity, will, zest for life, caring, loyalty, or any of the myriad of characteristics that make us fully human. No, what I had to do was to identify and remove obstacles. The rest would follow automatically, fueled by the self-actualizing forces within the patient.

I remember a young widow with, as she put it, a "failed heart" -- an inability ever to love again. It felt daunting to address the inability to love. I didn't know how to do that. But dedicating myself to identifying and uprooting her many blocks to loving? I could do that.

I soon learned that love felt treasonous to her. To love another was to betray her dead husband; it felt to her like pounding the final nails in her husband's coffin. To love another as deeply as she did her husband (and she would settle for nothing less) meant that her lovefor her husband had been in some way insufficient or flawed. To love another would be self-destructive because loss, and the searing pain of loss, was inevitable. To love again felt irresponsible: she was evil and jinxed, and her kiss was the kiss of death.

We worked hard for many months to identify all these obstacles to her loving another man. For months we wrestled with each irrational obstacle in turn. But once that was done, the patient's internal processes took over: she met a man, she fell in love, she married again. I didn't have to teach her to search, to give, to cherish, to love -- I wouldn't have known how to do that.

A few words about Karen Horney: Her name is unfamiliar to most young therapists. Because the shelf life of eminent theorists in our field has grown so short, I shall, from time to time, lapse into reminiscence -- not merely for the sake of paying homage but to emphasize the point that our field has a long history of remarkably able contributors who have laid deep foundations for our therapy work today.

One uniquely American addition to psychodynamic theory is embodied in the "neo- Freudian" movement -- a group of clinicians and theorists who reacted against Freud's original focus on drive theory, that is, the notion that the developing individual is largely controlled by the unfolding and expression of inbuilt drives.

Instead, the neo-Freudians emphasized that we consider the vast influence of the interpersonal environment that envelops the individual and that, throughout life, shapes character structure. The best-known interpersonal theorists, Harry Stack Sullivan, Erich Fromm, and Karen Horney, have been so deeply integrated and assimilated into our therapy language and practice that we are all, without knowing it, neo-Freudians. One is reminded of Monsieur Jourdain in Molière's Le Bourgeois Gentilhomme, who, upon learning the definition of "prose," exclaims with wonderment, "To think that all my life I've been speaking prose without knowing it."

The Gift of Therapy. Copyright © by Irvin Yalom. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.
Read More Show Less

Customer Reviews

Average Rating 4.5
( 28 )
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See All Sort by: Showing 1 – 20 of 28 Customer Reviews
  • Posted October 10, 2009

    more from this reviewer

    Awesome read for a counselor starting out

    I am currently in graduate school and plan on working as a counselor once I've finished. I have found this book informative and enjoyable to read. The insights are shared in a way that is unique from other books, since this one doesn't follow a typical textbook format. Highly recommended.

    3 out of 3 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted December 2, 2005

    Inspirational -- A Terrific Read

    I am a fan of Yalom and this book did not disappoint! As a psychologist in private practice, I enjoyed reading and learning from this master therapist. As a teacher, I found the brief chapters easy to read and accessible to students and practitioners of all levels.

    2 out of 2 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted September 7, 2006

    A Great Read

    This book is great. I am a student currently studying psychology and found this to be very helpful in teaching me more about the events that go on in a therapists office that you can not find in a textbook.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted September 4, 2006

    A must-read for therapists

    I'm a therapist and I recommend this book to all my colleagues - seasoned therapists and trainees alike.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted October 29, 2002

    Suprising but not as good as....

    I much preferred Dreams: Gateway to the True Self. It just had more depth and insight to the questions we really want answered.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted December 17, 2012

    Beyond Awesome!

    How could I, a lowly counseling psychology masters student, ever provide negative feedback to the most awesome Irv Yalom?! In fact, this may be one of the single most important books I have ever read in the history of my masters degree on the subject of actually being in the room with a client. It is at once funny, touching, deeply personal, and most importantly, very educational. This book comes with my highest recommendation.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted October 3, 2011

    a must-read for novice and expert therapists!

    This book has been refreshing to read. The format is conversational, almost as though Yalom is talking out his thoughts to the reader. Yalom is clear to state that the points made are his opinion but I find that his techniques do not always disagree with other therapy orientations...overall, The Gift of Therapy is a very good book to have in one's therapist library, to read over and over.

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  • Posted August 15, 2011

    A great read!

    Yalom is incredibly insightful. I like the format; it made for quick and easy reading to have each topic labeled so clearly.

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  • Anonymous

    Posted October 3, 2004

    Starts Great/Dies in Middle

    This book started off great. It was immediately engaging, warm and wise. However midway through it just seemed to drift off. The chapters began to all sound the same; the wisdom was waning, only to be replaced by a bit of self-aggandizement. I began to sense that Dr. Yalom was taking up too much space in the therapeutic hour. Interestingly the book seemed to be doing the same thing.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted December 25, 2002

    For therapists . . . and others

    Although THE GIFT OF THERAPY is written primarily for therapists and their patients, it offers a gift as well to those who are not currently in therapy--or who have never been. Many of the "tips"--85 in all--give advice about how to establish a caring, supportive, empathetic relationship, the heart of therapy according to Yalom. But is this not the heart of any meaninful relationship, whether with friend, lover, child, or even close business associate? This book distills the experience of decades of doing therapy, both individual and group, in jargon-free language (remember Yalom is also a novelist), but it also calls on the wisdom of a tradition that includes Freud and Jung, Nietzsche and Kierkegaard, and contemporary therapists as well. I just reread GIFT OF THERAPY after six months, and was happily surprised at how often I had called upon the ideas in the book to enhance and deepen my everyday relationships

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    Posted January 31, 2011

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