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There have been massive gains in the field of psychotherapy in the contemporary society. Irvin Yalom is one of the globally respected psychotherapists for his contribution towards advancing the discipline. In his enlightening book Love's Executioner and Other Tales of Psychotherapy Yalom sheds light on the concerns rooted in existence which he calls the existential givens (including death, freedom, isolation and meaningless). Yalom maintains that psychotherapy equips individuals with an awareness of these issues and forms the basis of human development (Yalom, 2012). Overall, Yalom employs real life experiences of his clients’ struggles with the existential givens to demonstrate his belief that a transparent and genuine connection in the therapeutic encounter offers the most favorable environment for emotional healing.
Yalom refers to the ideas as givens because they are inescapable and reflect the truths of existence. Firstly, there is the anxiety that arises from the inevitability of death for every person and their loved ones (Yalom, 2012). The reality of death is haunting to many people and hence they tend to avoid this topic. It is undeniable that death is the only certainty in life, since all organisms die without exception (Correia, Cooper, & Berdondini, 2014). Individuals can lead fulfilled lives if they understand that there is neither escape nor refuge from the shadow of death. Existential psychotherapy intends to penetrate, identify and accept the destructive and unhelpful multiple defenses that try to diminish the reality and finality of death (Alegria et al., 2016). Only then can people embrace death and lead full meaningful lives.
The second existence given is the freedom of individuals to impact their lives as they want. Yalom maintains that although liberty is generally a positive thing, the realization that individuals are free to choose how their lives will unfold leads many people to fear or denial of that feeling (Yalom, 2012). Existential freedom brings responsibility whereby the individual is accountable for the choices and actions they make. The seeds of wisdom arise when people learn to accept the responsibility that comes with freedom, which empowers and puts individuals in control of their lives.
The third existential given suggested by Yalom is the idea of isolation. People often put great effort into avoiding the pain of being alone. The fear of failing to accomplish close and personal relationships with others sabotages all endeavours to relate with people (Yalom, 2012). Moreover, the awareness that every person came into this world alone and they will die alone tends to generate such grief that many people fail to engage in meaningful relationships (Correia et al., 2014). Individuals should understand that before they can have a relationship with others they must forge a connection with themselves. Overall, psychotherapy tackles isolation by encouraging people to find a way to take it into them to form meaningful relationships with others.
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The final existential given that Yalom elaborates on is the lack of any obvious sense of life. Man has the ability to seek his purpose but conflict arises when human beings realize that the world is actually meaningless (Yalom, 2012). People try to adhere to artificial meaning structures which unravel their capability to survive in a meaningless world. Yalom believes that accepting and facing these givens is an essential part of dealing with existential anxiety. Although confronting the givens of existence may be painful, it is the ultimate path to healing.
Yalom provides real-life experiences of real people to illustrate the way the existential givens apply. For example, in the story “If Rape Were Legal” the case involves Carlos who is a terminally ill patient, since he is suffering from cancer (Yalom, 2012). Yalom describes Carlos as an isolated man as he cannot form meaningful relationships with others. From the beginning, Carlos presents himself as a misogynist and actually seems proud of that. Carlos suffers from obvious depression. He holds an opinion that if rape was legal he would do it once in a while. Yalom realizes that Carlos has high chances of recovery, since many of his noxious traits and beliefs are open to modification (Yalom, 2012). After undergoing the therapy, Carlos finally learns to accept his mortality which enables him to make peace not only with himself but also with his group mates and family.
Yalom understands that Carlos’ depression arises from death as a given of existence. In this case, one of the primary aims of therapy is to help Carlos to face his impending death without fear, and make him realize that he has the freedom of choice to shape the direction that his remaining life can take. The idea is to equip Carlos with self-respect, self-motivation, and self-growth (Yalom, 2012). Yalom helps Carlos get rid of his isolation by enrolling him in a group therapy. While initially Carlos cannot form friendly relationships with others, he eventually adapts himself to the new environment. Besides, through shared experiences he realizes that everybody has some existential fears and based on that starts to view others in a different light. Moreover, Yalom engages Carlos in individual therapy with the hope that eventually he would see the irrationality of his thoughts and would strive to change his mentality. For example, Yalom encourages Carlos to develop empathy when he declares that rape should be legal. Yalom asks Carlos to picture the life his daughter would lead in an environment where rape is an everyday occurrence (Yalom, 2012). Yalom makes Carlos realize that although he is facing death, there is still a chance to change his lifestyle to become a better and happier person. Carlos overcomes his inability to form meaningful relationships when he learns to appreciate others (Alegria et al., 2016). Eventually, he learns to accept his mortality and finds a deep sense of life which leads to a greater feeling of fulfillment even on his deathbed. There are lessons that the counselor can learn from this story. For example, Yalom demonstrates the need for unconditional positive regard, empathy, reflective listening, and non-judgmental attitude even when dealing with the most severe cases.
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Another patient that Yalom focuses on is Penny as illustrated in the short story “The Wrong One Died”. Penny lost her 13–year-old daughter to leukemia four years ago but she was still unable to recover from her grief. The woman felt guilty that despite warnings of the doctors that her daughter would not survive she kept insisting that her child would live (Yalom, 2012). She also felt guilty because she could not remember her daughter’s death, since she (Penny) was unconscious during her final hours. Penny realizes she needs psychotherapeutic help from Yalom when she understands that obsessive episodes of guilt were influencing her negatively making it hard to forget her daughter.
From Penny’s case Yalom brings to light the concept of loss of meaning in life which arises when a parent loses a child. People perceive this tragedy as equivalent to losing the future. Yalom reveals that losing a child is like losing one’s project (the parents have high aspirations and hopes for their children) (Yalom, 2012). It is for that reason that Penny felt that the death of her daughter had left her with no meaning of life. However, Yalom makes Penny realize that it is only human to grieve but living with the dead requires one to learn to live with the living first. Yalom makes Penny understand that she is unable to live here and now because of concentration on the past. Penny realizes that she had been obsessed with her dead child to such extent that she forgot about her other two children. The woman overcomes the loss of meaning of life when she learns to move past her loss by focusing more on what she can achieve rather than what she had lost (Yalom, 2012). The lesson learnt in this case is that the counselor has the role to encourage the client to realize what they should do to get well by guiding them towards a self-generated and self-directed therapeutic change. Yalom directs Penny towards a journey of self-discovery and she is able to overcome her initial loss of meaning in life.
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The other patient that Yalom concentrates on is Elva illustrated in the story “I Never Thought It Would Happen to Me.” Yalom had been seeing Elva, who is a widow, for quite some time and she was on the path to recovery. However, one day Elva visits Yalom after a robbery in which she lost her purse and three hundred dollars (Yalom, 2012). The incident leaves Elva in shock and she suffers posttraumatic stress. Consequently, she does not feel secure and senses that her world order has come crumbling. The purse snatching reignites forgotten memories of the death of Elva’s husband and she suddenly becomes acutely aware that he is no longer around to protect her.
Yalom perceives this meeting with Elva as the most favorable moment for counseling ever. The fact that Yalom desists from tackling the problem based on her past is intriguing. Instead he helps the woman discover that her fear is unwarranted and although the criminal managed to rob her that time, in future she should take precautions such as not to carry such a big bag that looks as if it is full of valuables (Yalom, 2012). Yalom manages to quell Elva’s fear that the robbery had anything to do with the absence of her husband. As a result, she realizes that it is within her power to prevent such incidences (Yalom, 2012). The conclusion that one can draw from this case is that in offering counseling some of the most basic lessons can have a great impact hence the need to encourage the client to take practical measures as part of the solution to their problems.
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Another patient that Yalom includes is Marie in the story “Two Smiles.” Since her husband’s death Marie remains frozen in life yet it has been almost 7 years. Although Marie has been the patient of Yalom for almost three years, he feels that he never understood her (Yalom, 2012). During this particular visit, Marie agrees to see a hypnotherapist for her pain, which she suffered after being hit by a cable car. She gets the therapy in Yalom’s office in his presence. It is during that time that Yalom starts to reflect on his therapeutic journey and realizes that Marie’s therapy has been unsuccessful mainly due to her continued isolation.
Through the story of Marie, Yalom understands that there are reasons that can hinder individuals from forming meaningful bonds. For example, Yalom reflects on the relationship between Marie and her dentist Dr. Z (Yalom, 2012). The doctor was a long-time friend of Marie’s back in college and although he wanted to court her, she refused. Years later their paths cross and although the doctor tries to lure her again, she says no to him and he starts to harass her. However, there is nothing much that she can do but because of it all her distrust in the medical practitioners becomes evident such that she cannot share her feelings openly. The more Yalom tries to prod her the more agitated she becomes (Yalom, 2012). There is no progress in Marie’s therapy and Yalom reveals that not all cases are actually successful, since there may be some factors beyond the client’s control that may hinder them from complete recovery. The lesson that one can learn from Marie’s case is that the outcome of the therapy may not always be successful but stopping to work with clients (no matter how stubborn they appear) should never be an option.
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In another short story “In Search of the Dreamer” Yalom introduces his 64-year old patient called Marvin. Marvin has been suffering from severe migraines and was referred to Yalom by a neurologist who had been unsuccessful in controlling the migraines. Marvin discloses to Yalom that he has been experiencing headaches for the past six months and it happens whenever thoughts of his lowered sexual functioning appear in his mind (Yalom, 2012). However, after some sessions, Yalom realizes that Marvin harbors deep fears for his marital life, since there are certain problems with his marriage. Finally, Yalom is able to have a session with Marvin and his wife and eventually solve the underlying issue of Marvin’s migraines.
In this case, Yalom presents the idea of the need for marital counseling to avert troubles in marriage. While at first Yalom focuses on giving individual therapy to Marvin, he also realizes the need to include both Marvin and his wife. She eventually agrees to come after realizing that her husband was undergoing tremendous positive change (Yalom, 2012). Yalom guides them towards having a heart-to-heart talk and the communication between them improves. Both of them reveal their hidden fears that were initially a barrier to their communication. After undergoing rigorous therapy, Marvin and his wife can communicate better and they use that chance to allay their fears. For instance, he learns that his wife fears social gatherings because she is not that well-educated and would not be able to hold intellectual conversations with others. At the same time, the wife is able to reassure him that contrary to his belief she does not deny him conjugal rights as a tool of control (Yalom, 2012). The lesson learnt is that as a counselor one must always listen to both sides of the story and work towards reconciliation.
Life is hard as it is and counseling and psychotherapy exist because sometimes life can be overwhelming and individuals may need someone to talk to and guide them back on the road to their right mental states. Counseling and psychotherapy are helping approaches which focus on the emotional turmoil encountered by the clients (Alegria et al., 2016). Their aim is to assist individuals in gaining an insight into the difficult or distressful events that they are undergoing, gain greater understanding of their motivation after which they can find more appropriate ways of coping with difficulties or causing changes in both their thinking and behavior. Psychotherapy offers a chance for individuals to explore their feelings, beliefs, thoughts and relevant events that can range depending on childhood and personal history (Correia et al., 2014). Based on the nature of problem, therapy may be short or long term for adults, adolescents, children, couples, and families on an individual level or within groups whose members share similar problems.
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Overall, counseling and psychotherapy aim at helping individuals overcome personal difficulties and work towards positive changes. They provide a safe and secure setting for the individuals to explore and develop an insight into the issues affecting them including decision making, coping with crisis, improving relationships, developmental issues, development of personal awareness, perceptions and internal or external conflict (Correia et al., 2014). As a counselor one must realize that they are cannot be the fixer of all issues, but rather should strive to bond and begin a journey with the patient by collaboratively working together to guide them in the discovery of how to overcome or cope with the problems encountered in life.
Yalom demonstrates that there are anxieties caused by realization of the four concerns namely death, freedom, isolation and meaningless. The role of psychotherapy is to confront and accept the realities by exploring the optimum of life rather than becoming preoccupied with the common weaknesses and failures in human functioning. Throughout the stories the emergent theme is the need of individuals to make the choice of expanding their self-awareness which is crucial to their growth. The counseling process equips the individuals with some understanding including the fact that in certain ways they keep themselves prisoners by concentrating on past decisions yet they have the power to make new ones. Overall, the lesson that psychotherapy advances is that although it is beyond their power to change certain events in their lives, individuals have the ability to change the way they view and react to such events.
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