EXPLORING (ALMOST) EVERYTHING ABOUT THERAPY

watercolour by Simone Bell

INTRODUCTION

In 2002 Dr. Irvin Yalom published a book called The Gift of Therapy, subtitled, “An open letter to a new generation of therapists and their

patients”.

Dr. Yalom is a psychiatrist, psychotherapist, emeritus professor and novelist who, at the time The Gift of Therapy was published, was 71 years old. When last I checked, he is still living at 94 and although he stopped working people as a psychotherapist, he is still writing.

I learned Dr. Yalom has retired from practicing psychotherapy in his 2024 book, Hour of the Heart.

In the Introduction to The Gift of Therapy, Yalom gives his reasons for writing the book:

“It is daunting to realize that I am entering a designated later era of my life. My goals, interests and ambitions are changing in predictable fashion … when attention turns from expansion of oneself toward care and concern for succeeding generations. I want to pass on what I have learned. And as soon as possible.”

As it happens I’m entering a "designated later era" of my life too (Designated era … aka: getting old :-). It’s certainly possible that I may not be any better at being a counsellor than I was at the beginning of my career, but I believe I’ve learned a few things along the way. And reading Yalom has encouraged me to reflect on my own professional life as I approach 30 years as a Registered Clinical Counsellor (RCC #1154) practicing on Vancouver Island in British Columbia, Canada.

With a series of columns I’m going contribute my own thoughts about the practice of therapy.

Using the short chapters of The Gift of Therapy as guideposts, I’m going to reflect on my experience of the therapeutic relationship, and raise some questions about its place in our culture. Of course you know I believe that therapy is undeniably helpful for people in distress - and can contribute to positive social change.

Psychotherapy, or mental health counselling, didn't exist as a profession until the early part of the 20th century. The ubiquitous term “Mental Health” evolved out of the 19th century practice called “mental hygiene". Before that people relied on the elders in their community - or poets, artists, philosophers, saints and the like to give life some meaning. But for a multitude of reasons that are beyond the scope of this column, the therapist has become the answer when someone gets to a place in their life when they feel overwhelmed, distressed, stuck in a problem with life and relationships that cry out for a solution. Therapy has become the first choice for many when they reach out for help. Or as is really common, a loved one, friend or even employer says “either you get some counselling or ….. “.

In using The Gift of Therapy as a starting point I want to be clear that my intention is not to debunk Yalom’s advice and observations.

Not at all. I find his perspective very thoughtful, passionate, empathetic and wise, and I’m hoping to learn a lot from this exercise.

But I think it's important to point out right away that, as a medical doctor, Yalom's perspective on the therapeutic relationship is different than mine. For example, he takes pains to point out that “I intend to encourage throughout a therapeutic relationship based on engagement, openness, and egalitarianism". But his use of the word "patient" (a person who is ill being treated by someone who has the training and tools to fix or cure them) implies a hierarchical relationship.

I much prefer the term "client" (a person who engages the professional services of another) because it allows for a more collaborative relationship of care more than cure. But even "client" isn't quite right, but saying or writing "a person I'm working with" or some such phrase is a bit unwieldy and awkward. (How about "interlocutor" for awkward?)

Just words? Maybe, but their use is just one example of what this work means for me and why I'm taking the time to share my thoughts about it

Next time I'll share my thoughts about Yalom's chapter 1: "Removing Obstacles to Growth". It that chapter he shares his belief (and mine) about the main reason people decide to see a therapist.

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