In these tales I hope to convey how a focus on the here and now can be used advantageously. Again and again I call attention to my bond with the patient: I do process checks; I inquire repeatedly about the state of our encounter during the current session; I ask if the patient has questions for me; I search for commentary on our relationship in dreams. In short, I never fail to place the highest priority on the development of an honest, transparent, helping bond between us.
I hope also that these stories will increase therapists’ awareness of existential themes. In these ten stories I view my patients as suffering from maladies that defy traditional categorization. A young man attempts to ward off death terror through sexual vitality, an elderly man wrestling with the limitations of aging grasps for youthful spontaneity with its sense of unlimited horizons, a dying patient searches for meaning, a nurse ministers to others but cannot comfort herself, one person yearns for a better past, and another attempts to compensate for his missing sense of self by planting his banner in my memory.
Far more patients grapple with existential issues than is generally thought. The patients in these stories deal with anxiety about death, about the loss of loved ones and the ultimate loss of oneself, about how to live a meaningful life, about coping with aging and diminished possibilities, about choice, about fundamental isolation. To offer help, therapists need a keen sensibility to existential issues and must reach a formulation of what ails and what must be done that differs radically from formulations offered by clinicians of other orientations.
Note to the Reader
In the service of confidentiality, I have heavily disguised each patient’s identity and, on a few occasions, introduced parts of other patients’ histories or, occasionally, fictional scenes into a story. I showed every living patient the final draft of his or her story and obtained approval and written permission for publication. Though Paul (“The Crooked Cure”) and Astrid (“Show Some Class for Your Kids”) had died long before, I disguised their stories and identities beyond recognition; I believe they would have been pleased for their experiences to be used to teach others. Ellie (“Get Your Own Damn Fatal Illness”) died as I was writing her story, but she approved my description of the project, was pleased I would be using her words, and insisted only that I use her real name.
Acknowledgments
My son, Ben Yalom, the primary editor for this book, negotiated with grace the perils of editing his fathers writing and was enormously helpful at all stages of this work. And my wife, Marilyn, always my toughest critic, provided assistance from start to finish. My literary agent, Sandy Dijkstra, was, as always, a treasure. My heartfelt thanks also to my many friends and colleagues who read one or more of these stories and offered useful suggestions: Svetlana Shtukareva, David Spiegel, Robert Berger, Herb Kotz, Ruthellen Josselson, Hans Steiner, Randy Weingarten, and all the members of the Pegasus writing group.
Irvin D. Yalom, Creatures of a Day: And Other Tales of Psychotherapy
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