Considering the status of psychotherapy today – what renowned psychotherapist Irv Yalom refers to as an “economically driven health-care system (that) mandates a radical modification” in treatment – a book of tips and quick advice is an excellent companion for the therapies of today that promote brief and symptom-oriented treatment.
In “The Gift of Therapy,” Yalom divides his manuscript into 85 single-serving sections. The psychiatrist explores various topics, including the nature of the therapist-patient relationship, use of the here-and-now, self-disclosure, existentialist concerns, dreams and everyday conduct in therapy. Yalom urges readers to use their own creativity to “adapt and apply” his lessons to their experience in the therapeutic atmosphere.
While reflection on each of Yalom’s intellectual morsels is beyond the scope of this writing, several lessons rose to the surface to provide exceptional psychological nourishment.
Yalom challenges the cure-happy section of psychotherapy immediately. In chapter two, he advises therapists to avoid diagnosis – except for the insurance companies, he adds. Yalom reminds the reader that diagnosing is not an exact science. In fact, saddling a client with a biological label may cause harm. Attaching a nonscientific sticky note to a client for life may bring blinders into the equation – for both the client and the therapist – and the DSM label limits the ability of both parties to objectively work together for a solution.
In chapter four, Yalom reminds therapists of the importance of intimacy. Engaging the client is essential, and the author advocates a continued check-in with the client regarding their relationship. This isn’t magic. The best relationships – friends, lovers, family – boast of this engaging element that is the lifeblood for connection.
Chapter nine brings up a vital lesson – the necessity of the counselor acknowledging errors. A respected professor once said to me, “You will make mistakes. Get use to it.” Clients are usually aware of the humanness of their therapists. By brushing aside blunders, therapists harm the relationship with their client. They miss a glorious opportunity to promote good faith. Therapists should concede their errors and check-in with a client afterward.
In chapter 15, Yalom coos about one of his favorite babies – the use of the here-and-now in therapy. Discussions about events that transpire during a session establish a foundation for relevant work with the client. Yalom reminds readers that many people “fall into despair because of their inability to form and maintain enduring and gratifying interpersonal relationships.” By paying close attention to the here-and-now, the therapist establishes the sessions as a laboratory for clients to explore the dynamics – both positive and negative – of their interactions.
Use of the here-and-now should be a required ingredient of therapy, according to Yalom. Therapists should inquire about the space between the client and themselves during each session. However, Yalom also urges therapists to handle the here-and-now carefully. While its liberating use can provide great benefits, a misplaced comment can result in an explosion.
Caution should also be exercised when considering self-disclosure. Some anecdotes can encourage clients, sparking movement into advanced work and previously unresolved and unconsidered topics. When a therapist decides to reveal personal information, he or she should also explore the process of the patient’s queries. A reason usually exists for the client’s questioning; this is an excellent opportunity for exploration.
In chapters 41 through 44, Yalom offers tips on discussing death and life meaning. Always the existentialist at heart, Yalom encourages an examination into the significance of one’s subsistence. While this topic might seem better suited in work with senior and terminally ill patients, all clients can benefit from discussing their purpose in life and lack of invincibility. Therapists who decline to dismiss this subject may spur their clients into meaningful exploration.
In chapter 52, the author suggests waiting for the client to begin each session – hopefully, the client will hone in on the “point of urgency” in their life. If Yalom opts to start the dialogue, he refers to the previous session in an attempt to make therapy a continuous session.
Clinical notes are the subject of chapter 53. Yalom’s advice is simple: Take them. He also reminds the reader to take a few minutes after each session to record the important issues. Therapists who write notes at the conclusion of a multiple-client schedule are playing mental roulette, gambling that they will accurately record the highlights of their sessions. Yalom suggests alleviating the onslaught of note-taking and other activities by scheduling 15 minutes in between each session, even if this causes appointments to be at odd intervals. This short break allows therapists to compose themselves and enter the next session with a focused mind.
The physical boundaries between a client and therapist can cause uncertainty in the relationship. In chapters 63 and 64, Yalom states two mandates – one, touch your client; two, never be sexual. Yalom perceives a great therapeutic benefit from an occasional touch – such as a handshake or pat on the shoulder – though he maintains that a therapist must be aware if any of the actions would be viewed as sexual. Therapists should not be so terrified of touch that they interact with their client in an artificial and automatous manner that harms the relationship.
Near the end of his book, Yalom converses about the importance of dreams and their benefit to therapy. Neophyte therapists should not fear dream dialogue, Yalom says; in fact, he believes that dreams provide excellent fodder for discussion and are an enormous asset. The author acknowledges that full interpretation of dreams is impossible and impractical. After reading Yalom’s chapters on dream work (as well as his book Momma and the Meaning of Life: Tales of Psychotherapy), I can comprehend and appreciate the functionality of dreams in the therapeutic setting.
No comments:
Post a Comment