[I]t followed me and made everything seem dark and dreary. My feeling of horror, instead of leaving me, was increasing.

“What nonsense!” I said to myself. “Why am I so dejected? What am I afraid of?” “You are afraid of me” — I heard the voice of Death — “I am here.”

— Leo Tolstoy

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ONE NIGHT, when Irvin Yalom was 14, his 46-year-old father suddenly developed such a severe chest pain that the family feared a heart attack. In her despair, young Irvin’s mother accused him of killing his father by being such a disobedient son. Yalom remembers waiting for a doctor, his 14-year-old self filled with horror, guilt, and anger. When, at 3:00 a.m., the doctor finally came, he let young Irvin listen through a stethoscope to his father’s strong heartbeat and assured the panicked boy that everything was going to be alright.

“Then and there I decided to be like him,” writes Yalom in his memoir Becoming Myself. He would dedicate his life to comforting those who, like his father, and like himself that night, were gripped by the anxiety of death and of guilt, overwhelmed by anger and incomprehension.

It was in medical school that Yalom started gravitating toward psychology among other medical fields. The study of the soul, he felt, could profit not only from a purely scientific approach, but also from the centuries-old (as well as contemporary) insights of writers and thinkers who, in their work, grappled with the same problems as any human being, except that they do it more intensely and more single-mindedly. Yalom came to combine his passion for therapy with an abiding interest in literature, particularly in those authors whose main preoccupation were existential problems. (This led him to the creation of his own approach often dubbed “existential therapy.”)

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In the place where I come from — Eastern Europe — people don’t hold much with psychotherapy. This is a consequence, most probably, of the intrusive, oppressive political regimes that reigned in that part of the world for most of the 20th century. To such a brutal intrusion, people responded by hiding their intimate thoughts and feelings from all except perhaps their closest friends. On top of that, the psychoanalytic schools in the region were squashed early on. Even though they’ve been revived over the last few decades, they are still not very popular: the infantilizing Freudian approach does not sit well with people who are unwilling to blame early life traumas for their present behavior. Their childhood, difficult as it may have been, often represents a tiny oasis of sanity in the midst of a crazed society. The home, unlike school, was free of ideology; it was the place where sometimes hard truths were spoken, such as the memories of Stalin’s terror. Many Russians have a tendency to idealize their parents, and many parents in Russia tend to never quite relinquish control over their adult children’s life. This proximity was often reinforced by a scarcity of housing, forcing two (often three) generations to live together in a small apartment. Psychotherapists — virtually strangers — would have a hard time making their patients trust them enough to voice complaints about the wounds inflicted on them by their parents.

Still, I have heard the name “Irvin Yalom” spoken by my Russian friends with admiration. Yalom, they say, looks to death, and not to infancy, as the main source of our inner troubles. He looks forward, not backward. We have to live bearing in mind our death, that “unfocused blur on the edge of vision,” that inevitable extinction that, in the words of Tolstoy, should not come, yet will always come. It intrigued me. Yet there is a second component of Yalom’s approach that is no less intriguing: his emphasis on authentically relating to others and on self-disclosure. On love, that is.

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For those less familiar with Irvin Yalom’s work, it should be noted that he is famous for two therapeutic breakthroughs. One is the realization that many problems in our life come from our inability to form authentic interpersonal relationships. This insight led Yalom to pioneer group therapy, in which participants analyze their relationships with, and their reaction to, other people in the group. Such groups thus become “laboratories” or “training grounds” where patients learn how to relate to those around them.

On one occasion, while leading such a group, Yalom stumbled upon what he would term “therapeutic self-disclosure,” as opposed to the traditional psychoanalytic stand of minimal self-disclosure, in which the analyst usually remains a blank for the duration of therapy, without even meeting the gaze of the patient on the couch. Yalom is still firmly convinced that the therapist’s openness and authenticity is of much greater help to the patient than a “correct” psychoanalytical interpretation.

For many years, Yalom led groups that consisted of people suffering from terminal cancer. This helped him make his second big breakthrough, which was the realization that the majority of our inner problems come from our unacknowledged dread of death. Sometimes he would ask a patient to draw a line symbolizing their life and then indicate the spot on the “line of life” where the present moment would be situated. This exercise helped the patient visualize the shortness of life and confront the horror that this realization inevitably triggers.

Yet even though the thought of death terrifies us, says Yalom, the consciousness of it also liberates us. Once we become aware of the finality of death and the fleetingness of life, we are stimulated to try to live our lives without regret. The thing that frightens us most, in Yalom’s opinion, is the impression that we haven’t lived our lives to the fullest, or that we have somehow wasted the time allotted to us. But it is never too late to turn one’s life around and live authentically, not even on the brink of death, as his work with terminally ill patients taught him.

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In Becoming Myself, Dr. Yalom admits:

[C]onfrontation with death would have to be the major focus of an existential approach to therapy. I believed this was because of the intensity and universality of our dread of death but […] I can’t dismiss the possibility that my view may have been unbalanced because of my own personal angst about death.

Reading his memoir is in itself therapeutic. By describing a life in relentless pursuit of learning and creativity — indeed, a life spent in the service of others — Yalom gives hope to the rest of us that life can be lived meaningfully and happily.

His book reads like the bittersweet meditation of a self-made man on a life well-lived. There is a photograph of his young parents, the immigrants who arrived to Ellis Island without any knowledge of English. They didn’t speak much of their life in the “old country,” and their son recognizes, with a tinge of melancholy, that most of his family history would remain forever unknown to him. There was the inevitable conflict: on the one hand, the embarrassment of the young, bookish son at his parents’ “ignorance,” and on the other, the parents’ inability to understand their son’s interests and ambitions, while supporting his education. Yalom talks about how much his mother’s demands and incomprehension both alienated and shaped him, and regrets not being closer with his father — a Jewish immigrant from a shtetl in the Russian Empire (now in Poland) who wrote poetry in his youth but resigned himself to the life of a shop-keeper in his new homeland. “Perhaps we failed one another,” writes Yalom, “he never inquired about my life or my work, and I never told him that I loved him.” Yet some of the most poetic pages of the memoir are dedicated to the memory of his father’s gentleness and beauty.

Early on, Yalom was drawn to frequenting the Washington Central Library (which became, as he puts it, his “second home”). His reading pattern was haphazard, and he regrets not having had a mentor. Yet he was exceptionally lucky in meeting his future wife, Marilyn, so early in his youth and learning so much from her. Marilyn, who became a famous scholar herself, was a passionate promoter of French language and culture and was responsible in part for Yalom’s turning to writers and philosophers of the past in order to deepen and expand his domain of psychology.

He describes the successive stages in his development as a therapist and as a writer, the author of not only what he calls “teaching novels,” but also of brilliant case studies in the tradition of Dr. Freud (brilliantly illustrated, in the field of neurology, by Dr. Sacks). This is not unlike Sherlock Holmes’s technique of uncovering mysteries. The genesis of the first collection of these stories from therapy, however, was far from cerebral. The inspiration for it came in the most unusual place, as Yalom relates in his memoir. While visiting Shanghai, he accidentally wandered into a beautiful, yet abandoned church. He saw a confessional booth:

After making certain I was alone, I did something I had always wanted to do: I slipped in and sat down in the priest’s seat! I thought of the generations of priests who had listened to confessions in this box and imagined all that they have heard — so much remorse, so much shame, so much guilt.

Sitting in the booth, Yalom felt envious of these priest’s therapeutic power inherent in their ability to give absolution and to make the sufferers feel forgiven. And then, he says, he slipped into a reverie and an entire plot of a story formed in his subconscious mind (“revealed itself”). He did not have any writing utensils on him, but this didn’t stop him: he found a stub of pencil in the church and recorded the plot on the blank pages of his own passport. The story would be the first in his Love’s Executioner case study collection. But the circumstances of that story’s birth — the author alone, in an abandoned church, in a confessional booth, thinking about forgiveness as a way to alleviate suffering — give a spiritual dimension to Yalom’s writing.

Why has the son of immigrants who wanted him to succeed in the new country, the supremely talented young man who could have chosen any field, dedicated his life to helping people confront death, the ultimate horror, and relate to each other with compassion? The silence of his parents on the subject of the old country, and what happened there, may have played a role. “[N]ever once did [my father] speak to me of the Holocaust,” says Yalom in his memoir, “or, for that matter, of anything else from the old country.” That silence was deafening considering that his father’s older sister perished in the Shoah along with her children, and so did the wife and the four children of Yalom’s Uncle Abe.

In the imaginary dialogue between young Irvin and older doctor Yalom, Irvin explains his parents’ silence by their desire to spare him the horror. The horror hit him later, however, when he saw a documentary on Nazi atrocities, and it never left him. The realization of the uniqueness and preciousness of human life, of its fragility and fleetingness, of the urgent imperative to talk to each other, to relate to each other, and to love each other before it is too late, has spurred Irvin Yalom into the creation of a distinctive body of work and of new paths in psychotherapy that help us persevere in love and work in the midst of loneliness and despair.

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Maria Rybakova is a Russian writer.