A Psychiatrist's Memoir
Get a peek behind the curtain at the life of a therapist.
Do you ever struggle with personal insecurities, question your life's purpose, or become overwhelmed by thoughts of mortality? We must set aside the time and space to make sense of these problematic concerns or seek healing. As a result, we frequently go about our days accompanied by a constant buzz of dread.
In the following sections, we will examine the personal and professional lives of renowned psychotherapist Irvin D. Yalom. We'll follow him from his humble beginnings to his ascent to international prominence as a psychiatrist and novelist and then to the inevitable conclusion. We will discuss psychology and philosophy, personal and professional connections, and emotional anecdotes drawn from the lives of other prominent persons and his own.
As we follow Yalom's shockingly open account, we will finally be able to confront some of our own existential issues. Consider this summary both a mirror and a memoir, offering insightful teaching and profound inspiration.
1. Son, spouse, and father.
"You've killed him! "You've killed him!" Irvin D. Yalom can still hear his mother's loud voice as she screams these things at him.
Yalom was only 14 years old when he awoke at night to see his father, Benjamin, groaning with chest problems. The family doctor had been summoned, but waiting for his arrival was as painful for the young Yalom as it was for the elder. Irvin's mother, overcome with worry, misdirected her grief at her son. They had never been close, but this occurrence drew a line in the sand. His father ultimately recovered, but for the following few years, Yalom seldom spoke to his mother. Everyone would be relieved if Yalom left home at 22 to attend medical school.
Yalom tears as he recalls his tumultuous connection with his parents. His life was vastly different from theirs. They came to Ellis Island from Russia without money or English and worked 17-hour days for the rest of their adult lives. On the other hand, Yalom was born and raised in Washington, DC, and while his childhood was far from the American Dream, it was the best his parents could provide. Unfortunately, Yalom and his parents could never fully reconcile, which is one of his few regrets.
Fortunately, Yalom found a continual saving grace in Marilyn, his high school sweetheart, and, until she died in 2019, his wife of over 60 years.
Yalom recounts meeting Marilyn at 15 when his life changed dramatically. She became the sun, around which he circled. Both eventually became teachers and prolific authors, as we'll see in the following parts, and they had four children with a family dynamic that couldn't have been more different from Yalom's. Their home was a bustling sanctuary for their children and their children's friends; they had a long history of vacationing together, and they even cooperated on various artistic and literary endeavors later in life.
Many of us may identify with complicated and challenging family situations. These relationships are some of the most impactful we'll have, but they're just as easy to get wrong as suitable.
Yalom's poor ties to the past are a source of grief for him. It's no surprise he's worked hard to strengthen his current relationships.
2. The student.
For 14-year-old Yalom, the night of his father's chest symptoms was crucial in two ways. As discussed in the last part, it molded his connection with his parents, influencing how he parented his children. It also highlighted Yalom's decision to become a doctor.
Dr. Manchester was the family physician at the time. He arrived in the early hours of the morning, and as soon as he entered the house, he dispelled all of the young Yalom's anxiety and pain. Yalom knew from away that he wanted to provide comfort and competence for others, just as Dr. Manchester had been for him. Unfortunately, that was not a simple strategy to execute.
Back then, medical institutions maintained stringent limitations on the number of Jewish students they would accept. Yalom was interested in attending George Washington Medical School, which only admitted five Jews annually. The competition was intense. According to a famous joke at the time, Jewish men had two options: become doctors or fail.
Yalom proceeded on three frantic years of education, putting everything aside - even his relationship with Marilyn - to impress medical schools with the best marks. Yalom remembers little of his undergraduate years except for severe worry and episodes of insomnia. Today, Yalom sincerely wishes he had seen a therapist.
Despite an almost spotless straight A+ record (except a B+ in German), 18 of Yalom's 19 medical school applications were denied owing to Jewish quotas. But the only acceptance was from George Washington Medical School.
Yalom eventually relocated to Boston University Medical School at the end of his first year, when he proposed to Marilyn, who had recently acquired a position at Wellesley College.
In stark contrast to his college years, Yalom relished his internship and residency experiences. Perhaps the memory of Dr. Manchester's comforting reassurance had become so ingrained in Yalom's consciousness that he couldn't help but approach his individual patients and group therapy members with a rare gentleness and authenticity; regardless, this led to remarkable success from the start of his practice. On the one hand, Yalom found this unexpected. He had never been or felt "special." On the other hand, Yalom felt instinctively that he had something special to give the field. Yalom couldn't have predicted it then, but the impact of that "something" is still felt today, more than 60 years later.
3. Therapist and teacher
While his residency years are favorably remembered, Yalom's lack of a comprehensive explanatory system became apparent early in his practice.
At the time, there were two primary schools of thought: psychoanalysis and biopsychological. However, the young practitioner found that both needed to be more comprehensive. Fortunately, Yalom discovered an odd option.
The book was Existence by Rollo May, and while he read it, Yalom wondered if history's sages could provide the missing piece of the jigsaw. Yalom thought they could. And so began what would become a lifetime love affair with philosophy, guiding Yalom to the "something" he felt he could uniquely contribute.
Further investigation would have to wait. Yalom joined the Army in 1960 and was stationed in Hawaii. He was eager to get started when he returned to the mainland two years later and accepted a professor job at Stanford University's School of Medicine.
Stanford proved to be a vibrant terrain for Yalom. He was allowed complete freedom to teach and conduct research, surrounded by enlightened colleagues, and enjoyed near-perfect weather all year. This favorable environment, combined with his continued study of modern psychiatry and ancient philosophy, inspired Yalom to transform his area dramatically in two ways while at Stanford.
First, Yalom revitalized and organized group therapy. In fact, he produced the canonical textbook on the subject: The Theory and Practice of Group Psychotherapy.
Second, he suggested an utterly novel theory: existential therapy. Yalom saw that traditional approaches were failing patients by neglecting the often complex issues of isolation, mortality, freedom, and meaning, so he put them front and center. He believed that tackling these universal issues head-on resulted in better patient outcomes, such as reducing death anxiety and reconnecting people with their passion and purpose.
Despite these ground-breaking developments, many of us continue to avoid these severe conversations if we do not practice psychotherapy. So Yalom's most significant contribution may have been his covert introduction of these ideas into popular fiction.
4. The Author
Saturdays were sacrosanct to 12-year-old Yalom. But not because of Shabbos (the Sabbath).
Every week, Yalom would ride his red push bike to his neighborhood library, which was forty minutes away. He'd borrow the maximum number of books (six at a time) and devour them all before the following Saturday when he'd repeat the cycle.
But Yalom was not browsing the children's area like his peers. No, the young Yalom was tackling the massive biography shelves, beginning with "A" and working his way down the alphabet of names.
Yalom's love of books remained largely concealed during his early adulthood. He read much, yet it did not influence his professional activity. He wrote constantly, but primarily scholarly and scientific works. However, something within Yalom felt compelled to employ narrative storytelling to expose therapeutic concepts to a larger audience. So, as appears to be a recurring theme in his life, he followed his instincts and recorded the 1974 album Every Day Gets a Little Closer. Although not entirely "fiction" in the strictest sense, it was sufficient. Yalom was hooked.
Yalom began living a double life as a Stanford instructor, therapist, and budding fiction writer. So, until he retires from Stanford in 1994, whenever a book was ready to be born, Yalom would ask for a sabbatical, which he did multiple times, and write eccentric works like When Nietzsche Wept, The Schopenhauer Cure, and The Spinoza Problem.
It's worth noting that these novels were more than just adorable passion projects. When Nietzsche Wept won the Commonwealth Club of California's prize for best fiction and was named book of the year, The Spinoza Problem received the Prix des Lecteurs in 2014.
And somewhere along the road, Yalom discovered that singular "something" he sensed but couldn't articulate as an intern psychotherapist: he was a weaver of psychiatry and philosophy and shared this tapestry with his patients and the general public.
5. The Elder.
Yalom observes his larger audiences today with amusement and asks, "Why is there such a rush to see me?" He and they both understand that he is nearing the end of his life.
It would be natural to expect that a distinguished existential psychiatrist if anyone, would be most at peace on the path to death. However, Yalom's situation has been more complex.
For starters, until he turned 70, he believed he'd die at 69, the age his father died. Staggering nightmares depicting mortality had visited him repeatedly - and continue to do so - leading him to spring out of bed in the middle of the night to shake them. And, while his work with end-of-life patients provided frequent reminders to live fully and with few regrets, it also served as a constant reminder that life is finite and that we would all return to dust eventually.
Nonetheless, Yalom admits that the perspective from his ninth decade is better than anticipated. True, he has lost several of his closest friends, including three of his best buddies and his cherished older sister - and, more recently, his beloved Marilyn - but he has found peace and happiness he has never known. While there are fewer witnesses to his best moments, he can relive his favorite novels and movies as if for the first time. Most importantly, he still enjoys his profession, keeping a six-day weekly routine of writing and seeing patients, two talents he says he is finally "getting good at."
Yalom is still keen enough to see that he has become somewhat "idealized" in his old years. We all want the calming presence of a wise elder, and for many, Yalom provides that role. The increase in attendance at his presentations and the number of letters arriving in his inbox indicate a general knowledge that the end is near and time is of the essence.
One of the founding fathers of existential psychiatry publicly admits to experiencing spells of death dread, which should be encouraging. Yalom's continued commitment to improving and contributing should be inspiring.
Final Summary
The human experience raises profound concerns about life, meaning, and death. Psychotherapy can be an excellent tool for helping us make sense of our experiences and recover.
Irvin D. Yalom, one of today's most distinguished psychiatrists, has battled to grasp identity, life, and mortality.
And yet, there is hope. Yalom's commitment to learning, growing, and contributing is as strong now as it has always been, encouraging and possibly instructive. If therapy is still regarded as helpful by a master therapist after all these years, we might want to find out why.