The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients

“I did not have to do the entire job; I did not have to inspirit the patient with the desire to grow, with curiosity, will, zest for life, caring, loyalty, or any of the myriad of characteristics that make us fully human. No, what I had to do was identify and remove obstacles. The rest would follow automatically, fueled by the self-actualizing forces within the patient.”

Irvin D. Yalom explains that his main goal during therapy was focusing on his patients’ “obstacles,” or specific challenges, and this helped him to avoid feeling overwhelmed in his role as a therapist. He borrows Karen Horney’s concept of self-actualization, arguing that every person is wired to self-actualize and achieve emotional and mental health. With this quotation, Yalom prompts therapists to consider how they might help their own patients to identify and overcome their obstacles.

“Instead, I prefer to think of my patients and myself as fellow travelers, a term that abolishes distinctions between ‘them’ (the afflicted) and ‘us’ (the healers). […] We are all in this together and there is no therapist and no person immune to the inherent tragedies of existence.”

Yalom develops the theme of Openness and Equality in the Therapist-Patient Relationship as he explains his egalitarian approach to relating to his patients. While some psychoanalytical models emphasize the differences between therapists and their clients, Yalom believes that therapists should remember their shared humanity. In doing so, they can better relate to their patients and avoid condescending to them. This quotation also adds to Yalom’s point that therapists can and should experience personal growth through their interactions with their clients.

“It is extraordinarily difficult to know really what the other feels; far too often we project our own feelings onto the other.”

Yalom encourages therapists to carefully evaluate their own interpretations of their patients’ feelings and to avoid making quick assumptions about their patients’ experiences. This idea builds on the theme of Therapists’ Personal Development and Self-Awareness, as he argues that therapists should have a good understanding of their own biases and feelings to avoid conflating their own experiences with that of their patients.