Love's Executioner

Yalom wrote what is still a definitive tome on group therapy, in addition to many other things, but I wanted to read his writing on individual psychotherapy and more of his personal reflections about the practice. I think a star rating is sort of beside the point on this one. I found it useful to read and use as a self-reflective tool for my own practice.

There are parts of this that have aged TERRIBLY, as they should. For example, Yalom is highly fat-phobic, and his story of a woman working toward weight loss is frankly painful to read. He's also very focused on people's physical appearances generally, has a tendency to sexualize women that he recognizes but doesn't always manage successfully, and although he is good at spotting how anxiety about mortality shows up for his therapy clients, I would argue significantly less good at recognizing how what I'd bet is his own death anxiety shows up around some of his own ageism about his older clients.

I've seen lots of reviews commenting on his judgment of his therapy clients, and I can imagine reading this as someone who is or has been in therapy and feeling shocked and quite unsettled, wondering if all therapists feel this way all the time. I actually think some of this might be an artifact of what this book is: Yalom selected episodes of therapy that he found especially challenging, and times when we struggle to be effective are often times we struggle with countertransference toward the people we are finding “difficult to help” in a way that reflects our performance anxiety as opposed to the people themselves being “difficult.” My guess would be that he often treated people in therapy toward whom he did not have these strong reactions (likely even the majority of the time), but also those times would be less interesting to a reader for other reasons, too.

For therapists reading Yalom, I would urge myself and others not to turn away from his petty judgments and biases. Are we not all capable of the same???? I think if we see Yalom as qualitatively different from us, as opposed to just writing about the relatively extreme reactions that all therapists can have at times to people they serve, that weakens our own ability to identify the times that we are similarly problematic. Yalom is effective at destroying the idea of therapist neutrality for himself, and our field is still heavily colonized! What could be more reflective of the hegemony of White supremacy than to treat the therapist's perspective as “neutral”?? If psychotherapy is going to have a future outside of that origin story, we have to grapple meaningfully with deeply embedded but seriously flawed ideas such as there being an “objective reality” that is somehow unimpacted by one's worldview. I would argue that there is more harm to be done to people entering therapy by the therapist who has not closely examined the specific ways they personally are most likely to cause harm to others than the therapist who is uncomfortable with the idea that they might cause harm at all. To me, this is how the idea of intention /= impact plays out in mental health. Of course my intentions are good. My intentions are irrelevant to the impact I have on others, so I need to pay much more attention to the actual results of my work than my good intentions for my work.

For people who have been in therapy reading Yalom, I do find myself wishing that he had given more context to some of his strong reactions, if such context existed. Like more discussion of how he wrestled with his biases in his own therapy (which he superficially references), and the process of getting consent from the therapy clients he depicts - I imagine that some relational repair work would have been needed for them to reconcile their experience of the therapy as it was versus how it became after reading his version of it, as well. A good therapist might indeed sometimes have the challenges Yalom lays bare, and it is also the good therapist's responsibility to attend to those challenges fearlessly and persistently.

All in all, I find this book functional, I suppose. One of Yalom's strengths is his willingness to admit that there were times when he had no idea what the next right thing to do was, which is a truth that therapists continue to find uncomfortable, and I appreciated what he offered as food for thought for the ways my own frailties (different than his, but still very present!) show up in the work I try to do with others.