by Irvin D. Yalom, M.D.
A collection of detailed accounts of Yalom’s experiences with 10 of his psychotherapy patients, this book is a voyeur’s (or auditeur’s) delight. Who could resist being intrigued by the stories of such people as the 70-year-old woman still obsessed with a brief love affair with a much younger man (and former therapist) eight years after the fact, or the 45-year-old woman with a split personality whose alter ego emerges suddenly in the middle of a therapy session and starts alternately sneering at the uninspired decor of Yalom’s office and flirting with him.
Yet the book raises troubling questions. Yalom, for example, says that he has changed the details of his patients’ lives enough to disguise them and has obtained the permission of nine of them to recount their stories (the 10th died before the book was finished). The patients’ relationships to Yalom, however, may well have precluded them from objecting to his thus using their lives. And revealing their most intimate details—their concerns over death, their children, their spouses, sex—seems a horrific violation of trust, particularly in a book aimed at wide popular audiences.
Furthermore Yalom, a Stanford professor and author of several psychotherapy textbooks, reveals himself to be so concerned with his feelings in relationships with his patients that it often seems they should charge him the exorbitant hourly fees, not the other way around. Discussing an obese patient, for instance, he writes, “I have always been repelled by fat women. I find them disgusting: their absurd sidewise waddle, their absence of body contour—breasts, laps, buttocks, shoulders, jawlines, cheekbones, everything, everything I like to see in a woman, obscured in an avalanche of flesh…. How dare they impose that body on the rest of us?”
Talking of another patient, a woman grieving over a young daughter’s death, he says, “I was transfixed by the unfolding drama, as each week offered a new, exciting and entirely unpredictable episode.” And, he writes, he hates to have a patient hospitalized for treatment because it is “a public acknowledgment of my failure.”
Okay, Irv, just pull up a dust jacket and tell us how you really feel about that.
Yalom writes smoothly and straight forwardly; a number of the cases he writes about ended, he acknowledges, with unhappy or indifferent results. He also has a sense of humor. When one patient, talking about hearing voices after his father died, stops and says, “You think I’m crazy?” Yalom replies, “No, I’ve told you before, you don’t have the knack for it.”
The book leaves an uneasy feeling, as if the reader has opened someone else’s mail, seen some interesting stuff, not stolen anything—and not gotten caught. (Basic Books, $19.95)