Bests & Worsts Reviews from Amazon

Dr. Yalom is a good writer and offers a unique perspective here on his decades of work in psychotherapy. It's definitely thought-provoking reading, and very easy to follow. But it left me with questions for the author (and some serious reservations)--never a good feeling at the end of a book. On the one hand, I appreciate that his training was to remain distant from patients where, as he described it, even helping an elderly woman put on a coat would be frowned on. I appreciate that, through experience with real-life patients, he realized the importance of establishing warmth, an interpersonal connection, a -human- relationship with patients rather than a distant "psychiatrist-as-remote-God-like" figure. However, reading many of the chapters here, I couldn't help but think some of the therapy methods he describes could be too intimate and too seductive with his patients. I kept feeling that it would be very easy to act like this and wind up crossing the line--or being misunderstood--in a therapy setting. Sexual attraction (and, as he says, even unconsummated love that is mutually felt) is a recurrent theme in so many stories he shares from his practice. There seemed to me to be much too much emphasis on talking about the therapist-patient relationship each week. Dr. Yalom writes, over and over, that he realizes he is far more important to his patients, personally, than they are to him. And yet he also seemed to intentionally intensify their feelings for him in the course of therapy, giving example after example of how he pushed them to share dreams about him, fantasies about him, etc. Where there was conflict between what he felt and what they felt, the solution was often to focus on how they were thinking and feeling erotically and/or emotionally about him. When a patient describes how she bonded with her husband when they jointly laughed at something she quoted Yalom saying, he resents the shared jokes about him with her husband, and reminds her that the three of them are in a relationship "triangle". At least in this retelling, its unclear that this intense emotional intimacy with patients is genuinely best for the patient. I'm not saying there's any sexual misconduct. In fact, Yalom clearly says that a therapist should never, ever become sexually involved with a patient as it is "a serious betrayal and does great harm to both". He is unequivocal about this and says it is better to even see a prostitute than violate the patient's trust. Nevertheless, putting an outright physical relationship aside, I do feel his methods/remarks as he describes them here, often seem very "seductive" in the broader sense, especially as so many women seek treatment with him for their relationship issues (including loneliness, marital and sexual problems, and low self-esteem). Its possible that being on first-name basis with a therapist who routinely discloses himself and his personal feelings about you--and who says and shows that he cares about you personally--may be therapeudic. But as recounted in this book it sometimes seems ...a potentially inappropriate pattern with female patients. (I'm also interested that his bi-monthly "leaderless" support group that has met for years consists of 11 psychologists/psychiatrists--ALL of whom are men. Ironic, given his intimate and seductive approach to female patients in therapy, how that "missing" female psychiatrist regularly might be just the right person to offer HIM feedback). Yalom does quote a renowned psychotherapist who bluntly questions his methods, saying, "Doesn't the intense personal intimacy you have with patients interfere with their ability to terminate treatment?" A great question, and one that, imo, he should have worrying about a great deal more than he shows here. Anyway, I liked the idea that an emotionally engaged therapist can help a patient more than a distant one. He tells a good story, the short chapters are a bit brave style-wise and serve the reader well. I liked how he revisited Freud in a positive way, reminding us of the historical context of his insights and achievement. I recommend this book, but with a discussion group. Otherwise, it leaves too many questions about the advisability of intentionally building relationships of intense intimacy and dependency with patients. Alone, it left me with too many unresolved questions and criticisms. As the focal point of group/class discussion, however, it would be perfect.