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Existential therapy has been practiced and continues to be practiced in many forms and situations throughout the world. But until now, it has lacked a coherent structure, and analysis of its tenets, and an evaluation of its usefulness. Irvin Yalom, whose Theory and Practice of Group Psychotherapy has rendered such a service to that discipline since 1970, provides existential psychotherapy with a background, a synthesis, and a framework.Organized around what Yalom identifies as the four “ultimate concerns of life”—death, freedom, existential isolation, and meaninglessness—the book takes up the meaning of each existential concern and the type of conflict that springs from our confrontation with each. He shows how these concerns are manifested in personality and psychopathology, and how treatment can be helped by our knowledge of them.Drawing from clinical experience, empirical research, philosophy, and great literature, Yalom has written a broad and comprehensive book. It will provide an intellectual home base for those psychotherapists who have sensed the incompatability of orthodox theories with their own clinical experience, and it opens new doors for empirical research. The fundamental concerns of therapy and the central issues of human existence are woven together here as never before, with intellectual and clinical results that will surprise and enlighten all readers.
A Classic in the Field
| Customer Rating:  | The first thing that must be said about EXISTENTIAL PSYCHOTHERAPY is that it is not merely for professionals. The books is packed with insights and intelligent ideas for anyone with a bit of introspection. Irvin Yalom also has a very readable writing style. This should not be a surprise, as he has written both fiction and non-fiction books for the lay audience.
Yalom follows in the footsteps of Rollo May, the father of American existential therapy. May, however, did not view the existential perspective to be inconsistent with Freudianism. Indeed, May was, for years, the director of the William Alanson White Institute in New York City, a psychoanalytic institute. Yalom breaks with May on this point, establishing existential psychotherapy as a theoretical paradigm substantively distinct from psychoanalysis. Yalom does an excellent take down of Freud in this section, re-analyzing Freud's own case studies along existential lines to demonstrate that existentialism does a better job than traditional psychoanalysis of explaining certain patient's neurosis and dysfunction.
EXISTENTIAL PSYCHOTHERAPY explores four `givens' of existence, all of which press upon and influence our personalities, for better or worse. Of these, Yalom clearly sees the inevitability of death as the most fundamental. Several chapters of the book are devoted to man's knowledge that, at some point, we die. And although we may have individual beliefs about what may happen after death, they are exactly that - beliefs. We simply do not know if we continue past that point or not.
A second theme Yalom explores is isolation. There are several types of isolation, but, for instant purposes, the most relevant is existential isolation. No matter how close one is to another human being, no matter how many emotions or thoughts are shared, each one of us is, ultimately, alone. Alone to face his own death. Alone to take responsibility for his own life. Yalom taps into the works of various theologians for his exploration of this concept and the implications for our lives.
Next we have responsibility, which is inseparable from existential freedom. A distinction is drawn between existential freedom and political freedom or other types of freedom. Certainly, many aspects of our lives are not the result of free choice. At the most basic level, none of us chose to be born a particular race or sex. None of us would choose to be put into a concentration camp. But we are free to take responsibility for those choices that we have had up to this point in our lives, and we are also responsible for the stance we take towards our lives. This freedom is more psychologically deep than many people may think of when they think of responsibility. Of the four themes Yalom explores, this is probably the hardest one to really grasp.
Finally, we have meaninglessness. Life does not present us with its meaning (if there really is one) on a silver platter. Rather, we must construct meaning itself. Of course, for many, this takes the form of religion. But a secular meaning to life is also possible. Yalom borrows heavily from psychiatrist Victor Frankl in these sections, who considered the search for meaning to be of such importance that he named his system of therapy after it. (On a related note, an excellent fictional account of someone suffering from a lack of meaning in his life can be found in The Sunset Limited, a short play by Cormac McCarthy.)
EXISTENTIAL PSYCHOTHERAPY is as readable as it is thought provoking. There are many classics to choose from in man's exploration of the mind. This book is among the best. |
Essential Reading for Philosophers, Parents and Psychology Students
| Customer Rating: | I first picked up this book for a university assignment on Irvin Yalom and was amazed that I had got through an undergrad degree in psychology without hearing about him. This book is so interesting and accessible and I immediately clicked with his ideas and approach. Yalom comes across as very knowledgeable, explaining and challenging theories of psychology and how they support or contrast to the existential approach. He offers much practical advice and food for thought. The book is very enlighting for parents in regards to how children perceive and deal with death. There has not been enough written on that subject. I have almost finished reading the book and when I do I plan to start reading it all over again.
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A psychotherapy practice could be built on this book!
| Customer Rating: | | I have recommended this book to one client who found it extremely useful as a means of managing his fear of death. Yalom's idea that the fears associated with the existential concerns of isolation, freedom, death, and sense of purpose form part of our subconscious-conscious dynamics is brilliant and original. He makes the argument that the anxieties associated with these concerns form a very early part of our experience and that they're repressed when the newborn is taught that it is not OK to experience these fears because he/she is either "special" or protected by a higher power, such as God. He states that the existential crises challenge these defenses creating depression, panic attacks, and other disorders. He develops these and many other useful notions all throughout the book. It is a long but fairly easy and clear read. If you're stymied by the length of the book you could start with his "The Gift of Therapy". Enjoy! |
Not morbid in the least
| Customer Rating:  | Yalom points out that people often use one of two opposite methods for quelling death-anxiety: the "myth of specialness" in which a person places themselves outside of humanity so as not to die, and the myth of an ultimate rescuer, where a person clings to the idea of a savior to whom they can be subjugated. Both are dysfunctional. Other than saying that love ameliorates but does not eliminate death-anxiety, Yalom fails to offer a construct for balancing inward and outward-directed methods of dealing with that most terrible of all prospects, one's personal annihilation.
Although Dr. Yalom addresses existential guilt, defined as the guilt from failing to lead a self-actualized life, he does not address the emotional fallout that may stem from the human situation of needing to "kill to live", the fact that on some level the natural state of man's existence incorporates murdering other creatures. I would also have enjoyed learning more about how, on a personal level, one can overcome the isolating forces inherent in a competitive society, and why no less the direct experience of another's death is, in many cases, insufficient to motivate movement towards a more integrated way of functioning in the world.
The fact that Dr. Yalom has stimulated these critical thoughts is a tribute to the rich quality of insights his book offers. Throughout the book he intersperses valuable bits of wisdom. I paraphrase: "exhortation rarely works with a patient", "typical of a person who claims to feel unloved is an unwillingness to love", "when a patient begins to make an important revelation, the best way to encourage it is to make a meta-comment on the circumstances that surround the revelation, for example how it makes the patient feel, rather than on the subject matter itself."
"Existential Psychotherapy" does what all great books do, it intimately brings the reader into an environment they might not otherwise be able to visit, in this case his conversations and therapy sessions with dying patients. Despite the "morbid" nature of the topic, I closed the final page enriched. |
Most Illuminating Psych Book I've Read
| Customer Rating: | As a psychiatrist, I have yet to read a more illuminating book on how mental illnesses can develop, and how to help patients' to become free of them.
Existential Psychotherapy presents a theory of the existential forces that drive all human beings--knowledge of death, of our aloneness in the world, and of "meaninglessness" (the utter inconsequence of our one life in the entirety of the universe). It shows how these forces are powerful influences in shaping human mental health and illness.
Other reviewers here point out that the basic existential issues Yalom presents are well-known to academics and to many literate people who are exposed to them in that good, broad, liberal arts education we (still?) get in college. But what Yalom achieves in this book, has not to my knowledge been accomplished before (nor since): a presentation of these ideas to an audience of clinicians in a lucid, beautifully written, way that is salient to the daily practice of psychotherapy.
Yalom is a rare psychiatrist who is not only a master of the art of teaching and practicing psychiatry, but for this book, ventured into philosophy, literature, history, and sociology, and then integrated the wisdom each brings to the study of human nature, into a clear and cohesive whole, a beautifully written theory of the existential dimension of men's fears, drives, and actions, and how this dimension creates mental illness or health, depending on how each person handles it.
What is amazing is how such a book is now buried in the archives of (relative) obscurity, while others, recycling the same old tired ideas, reign on.
So what do these lofty insights in Yalom's book contribute that is unique and powerful to us lowly practitioners toiling daily in our offices in the (seemingly more banal) task of helping patients with daily crises, complaints, resistance to change, and painful repetitions of self-destructive life choices?
One very important tool: a true understanding of the power of existential concerns, not only in creating mental illness and self-destructive life paths, but, by shining a light on them-- capturing that elusive force of change: MOTIVATION. This force, and how to harness it to help patients overcome their suffering, has for me been one of my greatest challenges as a doctor. And one for which most books on psychotherapy have fallen short in helping me tackle.
In the sections "death" and "will", (two of the four main sections in the book), Yalom forges a path that I could follow, to help my patients free themselves of the fears that block motivation for change. In short, Yalom shows how the anxiety about, (and thus avoidance of) awareness of our death and aloneness, can cripple us into denial, and resistance to changing those of our behaviors that shield us from these truths. But, these very fears, when faced and reframed--as the awareness of one's finite limits, and of the freedom that comes along with one's aloneness, become extremely potent engines for change. Other peoples' judgements, and fear of failure, lead us to believe that the human "judges" are the most important threat in our lives. But in Yalom's world, these feared judgements pale in comparison to the the consequences of inaction. When we live with acute awareness that we waste our only life when we are beholden to judges who are after all, mortal and alone just like us, this can shake us up to MOVE and LIVE, in this finite life, in a way other insights cannot.
This example of how avoidance of existential fears leads to anxiety, low self-worth, and depression, is but one vignette in this book. Yalom applies his theory to the gamut of mental illness, and includes discussion of how narcissism, perversions, obssessions, masochism, sadism, ...the list goes on, are fueled by existential concerns. Yalom argues that they all boil down to one of two main strategies we humans employ to "forget" Death, Aloneness, and Meaninglessness: Either we escape too much into the protective cover of the GROUP, and become mindless group robots who drone through life until illness, or loss forces us to suddenly face our mortality, at which point many of us panic, or become depressed, OR, we get sucked into this defiant delusion : "I am SPECIAL"...smarter, more rebellious, unfettered by the social conventions of meek men, thus free of death's jaws". This reaction then can lead to reckless, impulsive, pseudo "powerful" behaviors that are often the fuel of many "acting out" mental problems: addiction, sociopathy, sadism, and narcissism.
Enough of my words-read and feel the power of Yalom's words in this great book. |
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