The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients (P.S.)

Each chapter is just a few pages long, a nice format for busy folks whose reading time occurs in snippets. A single topic is addressed in each chapter, and author Irvin Yalom doesn't waste any time in getting to the point. Many of the sections revolve around balancing the "magic, mystery, and authority" that come with the job of freeing your clients of their reliance on you.

From when to offer an occasional hug to finding the perfect time for deeper questioning, Yalom's experienced observations will help you achieve even greater professional effectiveness while avoiding some of the more obvious traps in this HMO-directed age of mental health care. --Jill Lightner

Product Description

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.

Irv Yalom's "open letter to a new generation of therapists and their patients" speaks to three essential aspects of myself: the psychotherapist, the human being, and the writer.

As a psychotherapist I am validated for thinking outside the traditional boxes and challenged to keep learning with every client I see. Yalom offers everything from specific suggested questions to ask clients to the wisdom of his experience such as "therapy should not be theory-driven, but relationship-driven," and "though the physicality of death destroys us, the idea of death can save us."

As a human being I am reminded that there is seldom --- if ever --- only one valid explanation for how we become who we are. And I am enlightened by Yalom's reminder of Paul Tilich's list of four "ultimate concerns" --- death, isolation, meaning, and freedom.

As a writer I am thoroughly entertained by how Yalom puts a sentence together. For instance, speaking of the importance of dream interpretation in therapy, he writes, "Pillage and loot the dream, take out of it whatever seems valuable, and don't fret about the discarded shell."

Most of all, as I close my now well-worn, underlined and dog-eared copy of Irv Yalom's new book, I am inspired by the man and the psychotherapist who has been, and remains, a hero of mine. (I suppose Irv would consider that literary transference.)

Bottomline: great book for therapists and non-therapists alike.


The Gift of Therapy   December 16, 2003
Suzanne Retzinger (Santa Barbara, CA United States)
54 out of 55 found this review helpful

The Gift of Therapy
by Irvin Yalom, M.D.
Reviewed by Suzanne M. Retzinger, Ph.D.

Waiting for my brother to complete his three-hour dialysis, I browsed the bookshelf provided for the waiting. I came across Love's Executioner and read it for the first time. I had read Yalom's Theory and Practice of Group Psychotherapy text in grad school - like all requirements. Now he grabbed me by the shoulders and forced me to listen - inspired, I had to read more and found The Gift of Therapy (2003, Perennial edition; 263 pages $12.95).

Yalom is the first, of many that I've read on the therapeutic relationship, who doesn't "talk" about the therapeutic relationship - but "shows" it - a path for the bold to venture, a real connection between therapist and patient. My interest in his work lies in his openness about his own feelings and how he uses them therapeutically. Nothing, he says, "takes precedence over care and maintenance of my relationship to the patient,... and how we regard each other." Most patients come to therapy starving for intimacy, their conflicts being precisely in this area - and it is the therapeutic relationship, itself, that creates change.

For this reason, the "blank screen" model is far from what Yalom sees as effective patient therapist relationship; he sees therapist opaqueness as counterproductive. Because of the alienated nature of many clients' lives, the here and now space between therapist and patient is what matters. It's about the space that we create with our clients and how we use that space - "the betweenness". Yalom spells out 3 levels of therapist transparency that can be productive or not, asking of each, "is this disclosure in the best interest of the client?".

Standardization, he believes, renders therapy less effective, threatening therapist spontaneity. Therapy is a journey - and in Yalom's view the therapist and client are "fellow travelers". Whatever relationship there is, we build together with our clients. Be "prepared to go wherever the patient goes" - The long brown path before me leading wherever I choose (Walt Whitman - Song of the Open Road).

The relationship is key - I know - I've heard this from the beginning: in school, supervision, exam study courses, yatta, yatta, yatta. But at the same time I hear "don't get too close", or "reveal anything about yourself", "god forbid you touch a client" - a double message - the unspoken message: hold your nose, close your eyes, use a 10-foot pole. In my first career - research - I learned to jump in with all I have - open my eyes, my ears and each and every sense, throw away that pole. Yalom breathes life into therapy by attending to the inbetweens, the emotions that arise in this space and discussion of this process with the patient.

Western culture is awash in alienation; therapy is a process that can renew intimacy for those who choose this path. It is a "dress rehearsal for life", says Yalom. Affect and analysis are altering sequences, microcosms of our patients' lives that must be examined for lasting change to occur. Feelings, thoughts, words along with their analysis are not taboo; they are the stuff of intimacy. We must not confuse intimacy with sex, Yalom says. Sex is always inappropriate with clients, intimacy is not.

Yalom expresses his concern with the direction the mental health field has taken. With the growing alienation in our world, people are becoming less important. Even in our profession we see fewer sessions provided by HMO's, medication in place of human contact, focus on technique, fear of intimacy because of lawsuits. In this age of pharmaceuticals, HMOs, and lawsuits, is the relationship being lost? This book (as well as his others) is a wakeup call, a reminder for us all - the experienced as well and the novice - that we are in the business of healing relationships and not to loose them in the shuffle.

Since that first day at the dialysis center where I found Love's Executioner, I've read much of what Yalom has written. It's not only the brilliance of what he writes that draws me in, but the way he writes that touches me. His books are "serious, down to earth, and pulse with levity and life".

Yalom's book The Gift of Therapy is a gift to therapists past, present, and future. Like Yalom, we need to `show' and not `tell' our clients the road to connectedness. My hope is that this, and other works like this, will not be lost in a world so desperately in need of human connection.


Bite Sized Therapy Nugs   November 18, 2005
My Uncle Stu (Boston)
58 out of 61 found this review helpful

Psychiatry residency is challenging in a different way than other medical specialties. Medical school prepares you for the medical aspects of psychiatry, specifically the neuroscience and pharmacology. But for therapy, medical schools barely touch on it. Things that help are being in therapy yourself, or having at least been in therapy, as well as seeking out really good supervision. Good books help too. But picking up those first couple patients is scary and the PGY-2 year is too exhausting to spend hours and hours reading up on the art of therapy. Yalom's "The Gift of Therapy" was given to me by one of my chief residents during my PGY-2 year and was very helpful. I've since had time to read more of Yalom's works and have enjoyed many of his therapeutic tales as well as his group therapy primer, but for where I was at that time, "The Gift of Therapy" was just what the doctor ordered. The key is extremely short chapters. It's a book that can be by the bedside (or stuffed in a white coat pocket if that's your style) and read just a couple of pages at a time. Some chapters focus on nuts-and-bolts everyday issues but what is particularly helpful are the chapters that give the flavor of the process. Many of the chapters help to reinforce the `it's all grist for the mill' notion, that there are few true mistakes, that almost anything you do in therapy creates opportunities and provides data on how the patient reacts and relates. This is an important concept and also, for me, alleviated some of the anxiety of being a new therapist. It's much better to approach outpatients with enthusiasm as opposed to angst, and no doubt patients can feel that difference as well. I also very much appreciate Yalom's attitude about not adhearing to a particular model or modality of therapy, but the recognition that different situations call for different approaches, that flexibility is the greatest tool for the therapist.

Nothing turns me off more than hearing analysts knock cognitive behavioral therapy or vice versa, just to pick an obvious example. Before my medicine days, I studied Anthropology, and it was this very same kind left me bored and disenchanted. The majority of people's energy went into "deconstructing" other people's ideas rather than contributing something positive and helpful. Yalom emphasizes that certain discrete symptoms are best treated with CBT type approaches, some questions call for an existential approach, sometimes analytic techniques are best, and so on. Especially in training, the focus should be on acquiring as many tools as possible, staying flexible, and maintaining an open mind. He also models the importance of continually refocusing on the here-and-now and counter-transference. These may be rudiments, but early on in training it can't be overemphasized. Especially coming from a western medical model, these fundamental concepts tend not to come naturally. So this book is exactly what you need as a PGY-2: good, light reading that is also helpful, instructive, and helps generate some confidence and enthusiasm towards outpatient work.


I laughed, I cried...I was moved!   May 16, 2002
Rocco B. Rubino (Ohio)
52 out of 59 found this review helpful

Long after Dr. Yalom has departed for that great therapist's office in the sky, this book will still be known as a must read for the novice and veteran counselor because of the common-sense and compassionate advice it offers. This is Dr. Yalom's Opus Magnum.

I first came across Dr. Yalom's works when I took a required course in group therapy, and his text on the subject was the reference for the course. It did not take me long to gain a sense of awe at his wisdom, the likes of which can only be compared to something usually reserved for a demi-god. Nevertheless, Dr. Yalom is a wise man who has "been there," and his writings reflect the wisdom of his years.

The Gift of Therapy will renew your sense of passion for the mental health field. Dr. Yalom has a way of giving his readers insight into the therapy process, which affords the practioner or therapist-to-be a vantage point that will make him or her appreciative of all of the good we can do in the service of humankind.

There were times when reading this book, when I had to set it down and ruminate on what I had just read; Dr. Yalom has a way of expressing the profound, without pedantry, and the sublime, without silliness. After reading this book I am literally in awe of this "giant" and I am proud that we are both serving humanity in the same field.


a book of tips   January 19, 2002
Maria from London (London UK)
34 out of 38 found this review helpful

This is the latest book by Irvin Yalom, whose books I've been following over the years. From the very first page of the introduction, Yalom's writing is gripping & right to the point. He mentions turning 70 years old, which has made him feel a need to "pass on" his knowledge & some of his experience to younger generations of therapists & patients. This is what he tries to do in this substantial book, a book of tips, long on technique & short on theory (as Yalom himself says).

Each "tip" that Yalom gives comes from years of experience & in most cases, makes perfect sense. Something that should be noted is that his book is not written, I think, for the non-psychologically trained reader. It's aimed towards psychotherapists, & tries to steer them in the direction of good choices & good therapeutic work with clients / patients. Most tips may seem like common sense to most psychologists / psychotherapists, but if you think a little bit more about them, most of them are not used as often as they should be. Also, apart from the more obvious tips, Yalom offers a whole range of extremely innovative (& maybe some times controversial) pieces of advice. These chapters alone are, in my opinion, well worth the price of the book, since they make you sit down & think.

All in all, a great reference book for psychotherapists which comes alive through wonderful, clear writing, & lots of lively clinical examples.