The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients

The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients | Irvin Yalom | First class

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The Gift of Therap...

	The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients Irvin Yalom Harper Perennial, 2003 - 288 pages average customer review:based on 37 reviews view larger image
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highly recommended

Bite Sized Therapy Nugs

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.

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First class

If you're thinking of entering the psychotherapy experience this book will help you develop awareness of what to look for. It will also really help you recognize red flags that will help you run - not walk - from some of the garbage that is being presented as psychotherapy today. However, it is definitely not a cookbook. As a therapist, I found it's premises validating and helpful. It felt good to know that some of my therapy values are shared by someone of Dr. Yalom's stature. I came away thinking that I have been very privileged and fortunate to have had some of the teachers that I've had.

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Tips on how to do Good Work

Although I'm not currently working as a therapist, I still enjoy reading books about therapy from time to time. I read Yalom's Theory and Practice of Group Psychotherapy in graduate school and highly enjoyed it, so I hoped I would find this book interesting as well.
In this text Yalom offers advice to therapists that he has gleaned through his years of work as a therapist and as a client. Some of the main things he discusses here are how important it is for a treatment provider to have experienced their own time as a client, how to use the "here and now" in treatment and how vital it is to his own theory of change, and the use of dreams in treatment. Obviously these are just a few of the things he focuses on, but these are what stood out as important and resonated with my own theories of change. The style of the book is great - each chapter discusses one small aspect of the treatment process and some of the chapters flow together as a good lecture in "how to..." should. I think that the best thing about this book is that the chapters are short - they range from one page to at the most four or five pages. This format gives the reader the ability to read the chapter then sit and think about the implications of what was said and how it can be useful to them. As a reader you don't feel the need to go on to the next "part" immediately because the "chapter line" so clearly delineates a new thought or suggestion.
I highly suggest this book to all treatment providers and students of therapy practices. I wish that there were more books like this that gave the reader a view into the minds of eminent scholars in different fields.

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Good

Yalom is helpful but at times settles into the grandfatherly role too easily, failing to interrogate his own beliefs as thoroughly as he should. Bad therapists could take some of his good ideas and use them to unhelpful purposes because the vagueness of the writing at times borders on sentimentality. A more rigorous approach would have avoided this and allowed Yalom's common sense a deeper coherence.

reviews: 1, 2, 3, page 4, 5, 6, 7, 8

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