PART 1: REMOVING OBSTACLES TO DEEPER HUMAN CONNECTION

watercolour by Simone Bell

I'm continuing the dialogue I began last time in my blog: Exploring (Almost) Everything About Therapy

A brief recap: 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 an American 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 still a practicing writer and therapist.

In my last column I began a continuing dialogue with the chapters of The Gift of Therapy. I'm using the book as a focal point for sharing some of my thoughts, based on my experience, of the theory and practice of psychotherapy.

Continuing with my dialogue:

Chapter !: “Remove Obstacles to Growth”

Irvin Yalom picked up on psychotherapist Karen Horney’s idea in her 1950 book Neurosis and Human Growth, that “...the human being has an inbuilt propensity toward self-realization … if obstacles are removed, the individual will develop into a mature, fully-realized adult, just as an acorn will develop into an oak tree.”

Yalom describes the feeling, as a young psychotherapist, of not having to “...inspirit the patient with the desire to grow with curiosity, will, zest for life, caring, loyalty, or any of the myriad characteristics that make us fully human. No, what I had to do was to identify and remove obstacles. The rest would follow automatically, fuelled by the self- actualizing forces within the patient.”

Simply put, Yalom's task became “... to remove obstacles blocking my patient’s path.”

For me, there is a positive foundation presumed in all this. But I wonder about a couple of things:

First, what are the “obstacles” he is referring to?

I’m going to be presumptuous and guess he means they are within the person. That is, people who come to therapy are burdened by obstacles - inner attitudes and core beliefs - that they may have learned or otherwise integrated about themselves, others and the world they inhabit.

But my problem with that is, what about the obstacles that are outside the person? Obstacles that are, to use a sweeping generalization, endemic to the world they live in? What I mean is, there are obstacles created by a toxic culture, at home, work or in the world at large. Obstacles over which a person is powerless and therefore cannot be removed in a therapist’s office.

And then there are the realities of individual neurobiology that lead to the so-called emotional and mental disorders. Are these obstacles that are within the person, or obstacles created by cultures and communities. In any case, the neurodivergent person cannot “remove” perceived obstacles about the way their nervous system (which of course includes the brain) functions. Nor can the person whose nervous system is overwhelmed by developmental or shock trauma and as a consequence inhabits a life of chronic anxiety and depression.

There may be therapists who assume that life in our current culture and economy is a level playing field of equal opportunities and resources - financial and otherwise. And they may believe they encounter people in their practice whose everyday life and history is free of threat and danger, prejudice, abuse or the trauma of everyday life. And that the removal of inner obstacles that trip a person up is a realistic course of action.

But I don’t suppose there are many therapists who hold that view. And I’m certain that Yalom doesn’t.

The second thing I wonder about in Yalom's stated task as a therapist is that he doesn't explain what he means by "my patient's path".

Of course the word path assumes a movement toward something or somewhere. A journey of sorts that he doesn't explain in this short chapter. Sometimes when somebody uses the word path it's not very important, by when Yalom uses it without explanation, it calls into question (as it did for me) his concept of obstacles. What are the obstacles blocking a person's path? And even more important, to what destination is the path headed?

Being famiar with some of his other writings I believe I can answer those question for him. Actually, it's not a stretch to answer them because it's my belief as well that the longing for human connection is the path, and the main reason most people undertake a therapeutic relationship. Of course, there are a multitude of variations on the desire for deeper, more intimate relationships - and just as many obstacles getting in the way.

Actually, I can see a path unfolding with this dialogue that I've undertaken. No spoiler intended, but the destination is greater intimacy with people that matter to us, which hopefully creates an abiding sense of belonging and safety.

Some of the obstacles? The challenge to open up and be vulnerable for one, because it's common not to feel safe to do so. The belief that one doesn't give a damn is another. The need for others and craving connection, is for sissies ... it goes on. I'll be unpacking more about the path to closer, better relationships and its obstacles as this dialogue continues.

Next time I'll reflect on Chapter 2 of the Gift of Therapy: "Avoid Diagnosis"

If you'd like to receive these blogs directly in your email inbox, you can register with your name and email address below. (You can unsubscribe at any time.)