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Introduction to The Yalom Reader

When Basic Books, my publisher for the past three decades, first proposed this book, I shuddered. I had always thought an anthology to be a posthumous collection of a writer's work. Or, if not posthumous, then a retrospective—a collection compiled at the very end of one’s writing career. So it seemed to me that the proposal was just one more life stage marker, another melancholy reminder of aging—like retiring from Stanford University; developing senile plaques and aching knees; saying farewell to tennis; watching my children marry, settle into professions, and have children themselves.

Gradually, however, I warmed to the idea of a reader-cum-retrospective because I thought it offered a curtain call for many beloved, long-forgotten works. Eagerly I blew the dust off old files and reread my darling articles concerning such things as the hypnotic treatment of plantar warts, postpartum blues, aggression in voyeurism, LSD, Hemingway, organic brain diseases of senility, family therapy for ulcerative colitis. But it did not take long to realize that I might be the sole interested reader of such an arcane, disconnected, and often outdated collection. Consequently, I put them away (except for the Hemingway article—that stayed) and saw the wisdom in the publisher’s view that the sensible raison d’être of such a reader would be to chart the arc of my writing career as it has progressed, over thirty years, from research reports in professional journals to fiction.

My early books were texts of psychotherapy. My most recent works are novels of psychotherapy. Hence, I have two sets of readers: psychotherapists who have been assigned my textbooks during their formal training, and lay readers, casually interested in psychotherapy, who are drawn to the storytelling format of my later work. I hope in these pages to introduce each of these audiences to the other pole of my work—to expose, in a gentle fashion, the lay reader to a more theoretical, empirically based view of psychotherapy and, on the other hand, to instill in practicing therapists a greater appreciation of the centrality of narrative in the process of psychotherapy.

This volume has three parts, reflecting my major interests: (1) group psychotherapy, (2) existential psychotherapy, and (3) writing. From the beginning, in my effort to understand, illuminate, and teach psychotherapy, I have been fascinated with two major therapy approaches: group therapy and existential therapy. I was first trained to think as a medical scientist, and my group therapy texts were informed, whenever possible, by empirical research. Later, as I explored the field of existential therapy, it became apparent that empirical research had less to offer: questions surrounding the deep subjective responses to the human condition do not lend themselves to empirical investigation. Consequently much of my work in existential therapy is informed primarily by philosophical investigation—my own and that of others.

Part III of this volume, “On Writing,” chronicles the powerful interest in narrative that has lurked behind all my professional writing, has inserted itself from time to time in my texts, and ultimately, in later years, has taken over altogether.

Although I can trace my attraction to literature to my earliest years, there was a specific moment in my education that brought home to me the power of narrative. In my first two years of medical school I had performed well enough in my basic science classes. A diligent student, I was always near the top of my class but performed mechanically with no passion for any part of a scientific medical curriculum. As a third year student I took a psychiatry clerkship and was assigned my first patient. Though I’ve long since forgotten her name, I remember her well: a young, depressed, freckled-faced lesbian with long red braids carelessly bound with thick rubber bands.

I was extremely uncomfortable in our initial meeting. It was obvious to both of us that I knew next to nothing about psychiatry. Perhaps that was a help; she was highly distrustful of my field (rightly so—those were the days when homosexual acts were illegal, and she would have been officially diagnosed as a sexual deviant). And not only was I ignorant about psychotherapy: I also knew nothing at all about lesbians aside from one titillating passage in Proust where Swann spied on two women making love.

What could I possibly offer her? All I could do, I ultimately decided, was to allow her to be my guide and to explore her world as best I could. Her previous experience with men had been horrendous, and I was the first of my sex to listen, respectfully and attentively, to her. Her story touched me. I thought about her often between our meetings, and over the weeks we developed a tender, even loving, relationship. She seemed to improve rapidly. How much of her improvement was real? How much of it was a reward for listening and caring? I never knew.

All psychiatric students were asked to present a case at the weekly case conference. When my turn came I looked around the room in terror at my audience of psychiatric faculty as well as several luminaries of the Boston Psychoanalytic Institute. Finally I screened them out of mind, gulped, and began. That was forty years ago. I remember little of the conference aside from the stillness and deep silence in the conference room as I told them about my meetings with my patient and the development of our loving feelings toward each another. No one moved or took notes, and in the ensuing discussion, each participant psychiatrist seemed oddly at a loss for words. To my astonishment many offered lavish, even embarrassing, praise for my presentation; others simply commented that my presentation spoke for itself and nothing more needed to be said.

My experience in that conference was an epiphany—a moment of sudden, deep, clarifying insight. How had I evoked such interest from that distinguished audience? Certainly not by displaying any grasp of theory. Nor by describing a course of systematic effective therapy. No, what I had done was something quite different: I had conveyed the essence of my patient and our relationship in the form of an interesting story. I had always known how to tell stories and now I believed I had found a way to put that ability to good use. I walked out of that conference forty years ago certain that psychiatry was my calling. And certain, too, that in some manner, as yet unknown, my particular contribution to psychiatry would be as a storyteller.

Aside from the many section introductions and three new essays on narrative, the text of this volume is excerpted from published books and articles and edited for brevity, readability, and continuity. I have been blessed with the opportunity to work on this project with my son, Ben Yalom, a writer and editor extraordinaire. He has edited this volume from inception to finish, and I am deeply indebted to him for his expert advice in the organization of this volume, for the content of the introductions, and for the selection and editing of the excerpts. I am also grateful to my publishers at Basic Books: Joann Miller for suggesting this volume, and Gail Winston and John Donatich for supporting the project to the finish.