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on 9 November 2008
This is a collection of patient case studies by psychiatrist Yalom. It was given to me as a gift by a friend who is a great admirer of Yalom's work. I am not working in the field of therapy or counseling but as I had took a few psychology classes in college I am somewhat familiar with the some of the classic texts of psychology (Freud, Jung, Piaget, etc) and I am accustomed to reading case studies.

Yalom often describes his own feelings and reactions during therapy, something that might be helpful for a future councilor but his style is too simplistic. To follow his example and give my critic in a personal tone rather than a professional one: I was left disliking the man intensely, the idea that I could give access to my private life to this man was revolting. His patients are all viewed critically at first and then -in some extent- some manage to gain his compassion or at least his respect. In none other of the case studies the shallow notions of the psychiatrist were so evident. He describes with great detail -and snobbery- the appearance among others of an elderly depressed woman who neglects her looks, of an obese young woman for whom he feels such revolt he cannot stand looking at her, of an advanced cancer patient who has the illusion that he can attract women even his illness and chemotherapy have ruined his appearance.... When moving beneath appearances he has the same attitude towards the weaknesses of his patients. How much better the clinical detachment of traditional analysts. Yalom does not accept one method of therapy -such as Freudian, Jungian etc- which is a great idea and liberating but it seems as if it has left him open to seeing his patients as acquaintances rather than patients.

I understand that he adopts this tone in an effort to reveal all with sincerity. But I was left thinking that a better writer could do so with more tact and less callous expressions. Yalom tries to point out that therapy is a process which involves two people and wants to reveal himself as much as his patient, pity that his self is not more appealing. It is a difficult task which he sets and he is not equal to it: it takes a lot of professionalism and dignity for the psychiatrist to expose himself and still convince he is worth getting paid pounds per minute of his time.

This becomes more apparent when he attempts to present his more sophisticated and sensitive aspects where you read quotes from and references to canonic art works that have nothing to do with the subject whatsoever.

One of my professors at grad school used to say that you need to learn to write well when you are still in the beginning of your career but then once you make a name of yourself you can damp the rules and start either experimenting -if you are serious about your work- or as is so often the case just start vomiting and selling words to publishers who are only to happy to sell a badly written book if it is authored by 'a name'. I think Yalom falls in the second category, whatever professional attributes he has are not apparent in this book which is more like an unedited journal of a psychotherapist than a book about analysis. If this was written by a student it would be returned back for rewriting.

Seeing that it got good reviews by previous reviewers I guess even that will get an audience. For me it was not good enough and I am grateful to amazon for the opportunity to vent for loosing so many hours of my life.
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TOP 1000 REVIEWERon 4 May 2014
Freud's case studies have become famous not least because they are well written. There have also been arguments that they are largely fiction. Yet case studies often are fictionalised because there is a need to protect patient confidentiality. In the early pages of this book, Irvin D Yalom, explains this, suggesting nobody would guess the true identity of the patients stories he tells, with their permission.

In the first chapter, Yalom explains his own theoretical bent which is existentialist, stating:

"I focus on what is going at the moment between a patient and me rather than on the events of his or her past."

He has explored the fuller theoretical implications of this kind of therapy in more detail for therapists in his larger volume Existential Psychotherapy. But the chapter here gives a good brief account of this, which will suffice for most people. This is followed by the ten cases described.

Yalom is an excellent, literate, and, at times, even exuberant writer. There is an honesty which reveals itself in his descriptions of patients, which are not always flattering. In one, for example, he mentions he has a prejudice against fat women, and his description fully unravels the extent of it though at the end he does come to like the patient he has taken on. All through he examines his own feelings and what they might tell him about the patient in front of him, something a therapist often has to do. In this we get an excellent picture of what it is to be a therapist.

The details of patient symptoms are described, and make for fascinating reading rather like Oliver Sachs' neurological portraits. In all of them there are fears of isolation, and seeking for personal meaning that he states none of us can completely escape. This is very existentialist, and shows also in Yalom's quoting and referring to Sartre and Nietzsche, the latter whose ideas, he admits later, carry a great deal of weight with him.

In his pursuit of truth, Yalom can perhaps sound ruthless, as for example, in the title case history when he says he is "love's executioner," someone who has to break through enchantment. Yet there are also flashes of humour, for example mentioning how sometimes good therapy gets wasted on patients. He tells the reader of how moved he is with many of the people's stories, and there is a genuine compassion for their suffering, but he also shows that therapists also can get impatient with this. Perhaps there is a hint of arrogance here, but he is aware of that too.

These are all beautifully written. Perhaps the best written case studies since Freud's. But a lot has been learned since the origins of psychoanalysis, and so this updates on them. But most of all they are enlightening reading for students of psychotherapy and the general reader.
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on 24 May 2013
I value Irvin D. Yalom's books on his psychotherapy work hugely, because the weight of his arguments go far outside the field of psychotherapy, and explore what the beingness of human entails. Much of what he explores in the one-to-one sessions can be translated into the relationship each of us has, firstly, with ourselves, and secondly, with 'the other'. This to me is the fascination of the existential approach : how we deal with these givens: isolation, meaninglessness, mortality and freedom.

These are not just problems for those society might perceive of as 'unwell' and needing help - they are the bedrock of being a self-conscious embodied being, and flow, like a deep river, more or less acknowledged and observed, through our day to day moment to moment lives

The wonderful and shocking title of the book refers to the role of therapy in helping us to see clear and live outside denial - the denial of the challenges of those four givens. The psychotherapist is here cast as the executioner of illusion - not of love itself, but the giddy, distorting, exhilarating, wondrous 'being in love' state. We all crave and enjoy this - but it is an illusory state, a kind of unreal, seductive, beautiful madness; it is intoxication, and is possibly the most potent of intoxicants. The broken illusions and despairs of the Western Romantic Tradition bring many into therapy. How do we live with the loving, which will always bring losing (through mortality, if nothing else) when the champagne intoxication of blissfulness (in love) loses the bubble, and we taste it without that giddy sparkle

What I particularly like, from the psychotherapeutic encounter considerations of this book is that Yalom is able to say 'this is where I got in the way, this is where my own agenda inhibited the client's journey and progress' He is not afraid to step outside of the illusory framework of 'the objective, non-judgemental practitioner' and say that though this is what we may aim for, in theory, in the reality of practice as human beings we cannot help but bring our own prejudices into the treatment room. Far from being appalled by (for example) his honesty about his inability to see the real suffering individual behind his stereotypical very overweight client, I am impressed that he is honest enough to look at himself and his prejudices, and how they impact, negatively or positively, upon the process for the client, and offer that honesty to us, his readers. What is important is to be able to acknowledge our prejudices, not pretend we don't have them, or be in denial about the buttons clients (or any other human being) may push. We need to know what is our stuff, in order to really see our clients (or any other)

Some fellow professionals have criticised Yalom for writing so much about himself, however I think this is the strength of the book. It shows the willing, but inevitably imperfect practitioner in action. Self-reflection is always crucial, and its great to see such an obviously highly revered practitioner and teacher showing where he fails his clients, as well as where he supports them beautifully. The perfect therapist/client encounter (for the client) is an ongoing journey in process, sometimes practitioners and clients manage a session almost perfectly, sometimes the dynamic isn't quite right; its great to see honesty, rather than the great guru displaying his perfection. The really great guru is the one who lets us see his imperfections!
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on 31 December 2013
I read this great book in two days, interesting, informative and funny - excellent book for those interested in psychology.
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on 14 January 2017
First things first - this is not a self-help book. If that is what you are looking for, you may be disappointed. Having said that, I found it challenging in places, in a way that was both thought provoking and helpful.

The book is written largely from the perspective of the therapist. Dr Yalom is candid in revealing his own thoughts and feelings as each case unfolds. He admits where he doesn't like or 'connect' with a client, but, as the therapy evolves, he allows us to see how his opinion and feelings towards them evolve. He shows how their personal endeavours to overcome their issues earn his genuine respect. In this way, he reveals the 'human' side of a health care professional. I appreciate that some reviewers did not gel with his style, but I found it intriguing and refreshing.

I am familiar with, and enjoy studying, the principle of psychology and psychotherapy, but this book gives the subject a totally different slant. Well worth a read.

Why 4 stars instead of 5? Maybe it is me, but I found one or two of the case histories to be light weight in comparison to the others. Whereas this did not detract from my overall enjoyment of the book, it did feel a bit like padding.
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on 31 December 1999
Only once in a while do you come across a book -- in a shop, library, or friend's collection -- and find that, within just a few lines, it's prose jumps out at you from the page, haunting you, until you posess and devour it for yourself. This is such a book.
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on 2 April 1998
I loved this book because it illustrates so beautifully the inescapable challenges and contradictions at the centre of existence. In the words of one of Professor Yalom's patients "everyone has a heart" and we are permitted a rare insight into the therapeutic relationship to feel and understand how these hearts beat, bleed and heal. This book provides unforgettable insights on human relationships and the nature of therapy.
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on 23 April 1998
This is an eye-opener for anyone who has ever been in therapy. Yalom is brutally honest about his own prejudices and emotions experienced as a doctor conducting a course of therapy. He also demonstrates that human beings are capable of greater insight and self-examination than many of us have ever imagined.
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on 24 May 1998
Through the lives of ten patients, Yalom writes of the four central harsh facts of life all humans must confront. A wonderfully written book ... which focuses not just upon pain but upon our resilience and resourcefulness in the face of existence.
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on 15 February 2017
it has to give a star to be able to comment, but this book is terrible, the letters are not of the same font. I don't think it is authentic
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