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Yalom: Creating a New Therapy for Each Client by Mike Swift.

Updated: Dec 6, 2021


Irvin Yalom is a Stanford emeritus professor of psychiatry, psychotherapist and author who’s spent most of his life working in the San Francisco Bay Area. I recently had the pleasure of attending an online audience with him, a week before his 90th birthday. It’s sad to think it might well have been one of the last opportunities to hear him talk in person. He spoke about his latest book, which he co-write with his wife, Marilyn, while she was dying of cancer. The latter part of the book he wrote alone, after her death, reflecting on his grief, as he was experiencing it. It’s called ‘A Matter of Death and Life’ if you want to look it up.


I highly recommend his writing if you’re interested in understanding what goes on in the mind of a Psychotherapist with 50 years’ experience. He never holds back and nothing’s off limits. He’s been a huge inspiration to me in my counselling career so far.


Since the online talk, I’ve been re-visiting some of his books and, for this post, I’d like to share some brief thoughts on one of the many pieces of advice he gives to therapists in ‘The Gift of Therapy’:


“The therapist must strive to create a new therapy for each client.”


In other words, there’s no set of procedures, techniques or actions a therapist can use that are right for every client. Underlying Yalom’s advice is a belief that the culture of ‘measurable results’ that exists within the world of western medicine, insurance and health-care is seriously detrimental to the effective practice of talking therapy. At its best, counselling is a spontaneous, creative process that unfolds and evolves in the relationship between therapist and client. Attempting to turn the experience of therapy into management-data is seriously at odds with its essence.


Another aspect of Yalom’s point, I think, is that - while this might not happen consciously - it's in the therapist’s remit to gently hone in on what seems to be most positive for each client. For example, for some it might be a more logical unpacking of their experience to gain insight, whereas for others it might be about a space to sit in and experience whatever feelings they have. Alternatively, the therapist might help the client to move from a place of logic into feelings, or vice-versa.


Personally, the thing I find most rewarding about being a counsellor is the co-creation of a unique relationship with each of my clients. I see my job as one of creating safety and trust, of going wherever the client goes, of working towards a space where it no longer feels like we’re ‘doing therapy’ but are just two people relating authentically. And there’s certainly no fixed way to get there.


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