Love's Executioner and Other Tales of Psychotherapy by Irvin D Yalom

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Love's Executioner and Other Tales of Psychotherapy by Irvin D Yalom

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Category: Popular Science
Rating: 4.5/5
Reviewer: Phil Lewis
Reviewed by Phil Lewis
Summary: A powerful collection of tales from the therapist's couch. Dr Yalom has a gift for bringing his patients to life on the page, creating characters as memorable as those from the best fiction. A must read.
Buy? Yes Borrow? Yes
Pages: 288 Date: January 1991
Publisher: Penguin
ISBN: 978-0140128468

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I’ll come clean. I don’t know much about psychotherapy. That’s not to say I’m not interested - it’s often a subject that’s preoccupied me in quieter moments. But in terms of actually knowing, really knowing, anything about it – nope. I’m all too aware of the many people much cleverer than me who’ve dedicated their lives to it. I work in a fairly small medical library, and we have a fifteen volume set of Freud and a four volume set of Klein, along with numerous thick tomes on various aspects of psychoanalysis (it seems we’re missing a few Freuds – the complete run comes to twenty four.)

So it can be a little daunting for the novice to find an entry point. This is where Dr Irvin D. Yalom comes in. A highly respected psychiatrist and psychotherapist in his own right, for the last forty years Dr Yalom has complemented his clinical work with a series of books more accessible to the general reader. “Love’s Executioner”, first published in 1989, is the story of ten patients that, for whatever reason, have stayed with the author. Names have been changed and details sometimes subtly altered to ensure anonymity. These are true stories of real people and their personal battles, all played out on Dr Yalom’s couch or in group therapy sessions. What is striking throughout is the author’s honesty, both in his views of his patients and of their progress (or lack of). The result is at times brutal, funny, shocking, redemptive, and above all, painfully human.

Dr Yalom’s early work was influential in the development of existential psychotherapy, a school with the basic assumption that anxiety is caused, at root, by a person’s inability to cope with the “givens of existence”. Reading in the prologue that these four “givens” include the inevitably of death and the ultimate meaninglessness of life, it is tempting for the reader to become disheartened. It’s in the genius of Dr Yalom’s writing that this book is neither cumbersome nor oppressive. True, the stories deal unflinchingly with difficult issues and dark places (that’s kind of the whole point). But the narratives of the patients are, for the most part, redemptive. Dr Yalom has a gift for characterisation that leaps off the page. Some of the patients here will live as long in my head as the most memorable characters from fiction.

We start with Thelma, a polyester-clad septuagenarian in the grips of a destructive love obsession with her former therapist with whom she’d had a brief affair eight years previously. She is stuck in the past, constantly reliving the 27-day affair, unable to properly function in the present. Dr Yalom recounts his efforts to strip away this obsession, to expose the rawness underneath, and eventually become the eponymous executioner and return Thelma to a semblance of normality.

The amount of time and effort required for tiny steps forward is startling, and the intensity of the therapeutic journey can leave the reader exhausted. This is a common theme throughout the ten stories.

Dr Yalom also has a gift for embodying the patient at a given moment in therapy – he is particularly adept at conjuring his feelings for the patient upon first meetings, and again when the therapy has run its course. The difference is often startling. Carlos, the 39-year-old womanising misanthrope with terminal lymphoma who we meet in the second story (“If Rape Were Legal”), is a particularly moving transformation. The author never flinches in his honesty when describing his own feelings – most notably in “Fat Lady”, in which his disgust at his patient’s obesity is all too apparent. Though honest, Dr Yalom is not cruel, and these details are included only when relevant to the course of therapy and eventual outcome.

For those interested in learning more about psychotherapy, and those curious about the therapeutic process itself, this is a must read. Even for the general reader with little interest in psychotherapy, the human stories here are completely absorbing. This is a book about humanity, about finding meaning in seemingly hopeless situations. It will stay with me for a long, long time.

Further reading suggestion: The Good Story: Exchanges on Truth, Fiction and Psychoanalytic Psychotherapy by Arabella Kurtz and J M Coetzee and Why We Do the Things We Do: Psychology in a Nutshell by Joel Levy. You might also appreciate Online Therapy: Reading Between the Lines by Jethro Adlington.

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