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The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients,9780060938116

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

by
Edition:
1st
ISBN13:

9780060938116

ISBN10:
0060938110
Format:
Paperback
Pub. Date:
12/17/2002
Publisher(s):
HarperCollins Publications
List Price: $13.95
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  • 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




Summary

As an award-winning author of both nonfiction and fiction and a psychiatrist in practice for 35 years, Yalom imparts his unique wisdom in this remarkable guidebook for successful therapy.

Author Biography

Irvin D. Yalom, M.D., is the author of Love's Executioner, Momma and the Meaning of Life, Lying on the Couch, and When Nietzsche Wept, as well as several classic textbooks on psychotherapy, including Existential Psychotherapy and the most widely used work on group therapy, The Theory and Practice of Group Therapy. He is Professor Emeritus of Psychiatry at Stanford University and divides his practice between Palo Alto, California, where he lives, and San Francisco

Table of Contents

Introduction xiii
Acknowledgments xxiii
Remove the Obstacles to Growth
1(3)
Avoid Diagnosis (Except for Insurance Companies)
4(2)
Therapist and Patient as ``Fellow Travelers''
6(5)
Engage the Patient
11(2)
Be Supportive
13(4)
Empathy: Looking Out the Patient's Window
17(6)
Teach Empathy
23(3)
Let the Patient Matter to You
26(4)
Acknowledge Your Errors
30(3)
Create a New Therapy for Each Patient
33(4)
The Therapeutic Act, Not the Therapeutic Word
37(3)
Engage in Personal Therapy
40(4)
The Therapist Has Many Patients; The Patient, One Therapist
44(2)
The Here-and-Now---Use, It, Use It, Use It
46(1)
Why Use the Here-and-Now?
47(2)
Using the Here-and-Now---Grow Rabbit Ears
49(3)
Search for Here-and-Now Equivalents
52(6)
Working Through Issues in the Here-and-Now
58(4)
The Here-and-Now Energizes Therapy
62(3)
Use Your Own Feelings as Data
65(3)
Frame Here-and-Now Comments Carefully
68(2)
All Is Grist for the Here-and-Now Mill
70(2)
Check into the Here-and-Now Each Hour
72(2)
What Lies Have You Told Me?
74(1)
Blank Screen? Forget It! Be Real
75(8)
Three Kinds of Therapist Self-Disclosure
83(1)
The Mechanism of Therapy---Be Transparent
84(3)
Revealing Here-and-Now Feelings---Use Discretion
87(3)
Revealing the Therapist's Personal Life---Use Caution
90(4)
Revealing Your Personal Life---Caveats
94(3)
Therapist Transparency and Universality
97(2)
Patients Will Resist Your Disclosure
99(3)
Avoid the Crooked Cure
102(2)
On Taking Patients Further Than You Have Gone
104(2)
On Being Helped by Your Patient
106(3)
Encourage Patient Self-Disclosure
109(3)
Feedback in Psychotherapy
112(3)
Provide Feedback Effectively and Gently
115(4)
Increase Receptiveness to Feedback by Using ``Parts''
119(2)
Feedback: Strike When the Iron Is Cold
121(3)
Talk About Death
124(2)
Death and Life Enhancement
126(3)
How to Talk About Death
129(4)
Talk About Life Meaning
133(4)
Freedom
137(2)
Helping Patients Assume Responsibility
139(3)
Never (Almost Never) Make Decisions for the Patient
142(4)
Decisions: A Via Regia into Existential Bedrock
146(2)
Focus on Resistance to Decision
148(2)
Facilitating Awareness by Advice Giving
150(5)
Facilitating Decisions---Other Devices
155(3)
Conduct Therapy as a Continuous Session
158(2)
Take Notes of Each Session
160(2)
Encourage Self-Monitoring
162(2)
When Your Patient Weeps
164(2)
Give Yourself Time Between Patients
166(2)
Express Your Dilemmas Openly
168(3)
Do Home Visits
171(3)
Don't Take Explanation Too Seriously
174(5)
Therapy-Accelerating Devices
179(3)
Therapy as a Dress Rehearsal for Life
182(2)
Use the Initial Complaint as Leverage
184(3)
Don't Be Afraid of Touching Your Patient
187(4)
Never Be Sexual with Patients
191(4)
Look for Anniversary and Life-Stage Issues
195(2)
Never Ignore ``Therapy Anxiety''
197(3)
Doctor, Take Away My Anxiety
200(1)
On Being Love's Executioner
201(5)
Taking a History
206(2)
A History of the Patient's Daily Schedule
208(2)
How Is the Patient's Life Peopled?
210(1)
Interview the Significant Other
211(2)
Explore Previous Therapy
213(2)
Sharing the Shade of the Shadow
215(2)
Freud Was Not Always Wrong
217(5)
CBT Is Not What It's Cracked Up to Be...Or, Don't Be Afraid of the EVT Bogeyman
222(3)
Dreams---Use Them, Use Them, Use Them
225(2)
Full Interpretation of a Dream? Forget It!
227(1)
Use Dreams Pragmatically: Pillage and Loot
228(7)
Master Some Dream Navigational Skills
235(3)
Learn About the Patient's Life from Dreams
238(5)
Pay Attention to the First Dream
243(3)
Attend Carefully to Dreams About the Therapist
246(5)
Beware the Occupational Hazards
251(5)
Cherish the Occupational Privileges
256(5)
Notes 261

Excerpts

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

Chapter One

Remove the Obstacles to Growth

When I was finding my way as a young psychotherapy student, the most useful book I read was Karen Horney's Neurosis and Human Growth. And the single most useful concept in that book was the notion that the human being has an inbuilt propensity toward self-realization. If obstacles are removed, Horney believed, the individual will develop into a mature, fully realized adult, just as an acorn will develop into an oak tree.

"Just as an acorn develops into an oak..." What a wonderfully liberating and clarifying image! It forever changed my approach to psychotherapy by offering me a new vision of my work: My task was to remove obstacles blocking my patient's path. I did not have to do the entire job; I did not have to inspirit the patient with the desire to grow, with curiosity, will, zest for life, caring, loyalty, or any of the myriad of characteristics that make us fully human. No, what I had to do was to identify and remove obstacles. The rest would follow automatically, fueled by the self-actualizing forces within the patient.

I remember a young widow with, as she put it, a "failed heart" -- an inability ever to love again. It felt daunting to address the inability to love. I didn't know how to do that. But dedicating myself to identifying and uprooting her many blocks to loving? I could do that.

I soon learned that love felt treasonous to her. To love another was to betray her dead husband; it felt to her like pounding the final nails in her husband's coffin. To love another as deeply as she did her husband (and she would settle for nothing less) meant that her love for her husband had been in some way insufficient or flawed. To love another would be self-destructive because loss, and the searing pain of loss, was inevitable. To love again felt irresponsible: she was evil and jinxed, and her kiss was the kiss of death.

We worked hard for many months to identify all these obstacles to her loving another man. For months we wrestled with each irrational obstacle in turn. But once that was done, the patient's internal processes took over: she met a man, she fell in love, she married again. I didn't have to teach her to search, to give, to cherish, to love -- I wouldn't have known how to do that.

A few words about Karen Horney: Her name is unfamiliar to most young therapists. Because the shelf life of eminent theorists in our field has grown so short, I shall, from time to time, lapse into reminiscence -- not merely for the sake of paying homage but to emphasize the point that our field has a long history of remarkably able contributors who have laid deep foundations for our therapy work today.

One uniquely American addition to psychodynamic theory is embodied in the "neo- Freudian" movement -- a group of clinicians and theorists who reacted against Freud's original focus on drive theory, that is, the notion that the developing individual is largely controlled by the unfolding and expression of inbuilt drives.

Instead, the neo-Freudians emphasized that we consider the vast influence of the interpersonal environment that envelops the individual and that, throughout life, shapes character structure. The best-known interpersonal theorists, Harry Stack Sullivan, Erich Fromm, and Karen Horney, have been so deeply integrated and assimilated into our therapy language and practice that we are all, without knowing it, neo-Freudians. One is reminded of Monsieur Jourdain in Molière's Le Bourgeois Gentilhomme, who, upon learning the definition of "prose," exclaims with wonderment, "To think that all my life I've been speaking prose without knowing it."

The Gift of Therapy
An Open Letter to a New Generation of Therapists and Their Patients
. Copyright © by Irvin Yalom. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.

Excerpted from Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients by Irvin D. Yalom, Irvin Yalom
All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.


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