Becoming Myself: A Psychiatrist's Memoir by Irvin D. Yalom
In 2004, Galaade staged a public event at the Marigny Theatre in Paris on the Right Bank (now the Theatre at St. Claude). I was to be interviewed (via an interpreter, of course) by the publisher of Psychologies, a popular French magazine. The theater is a grand old structure with a large orchestra, two balconies, and a majestic stage once graced by the great French actor Jean-Louis Barrault. When I arrived for the event, I was amazed to discover that it was sold out, and I noted, in wonderment, the long line of folks waiting outside. As soon as I entered the theater, I spotted a huge red velvet throne in the center of the stage, where I was expected to sit and address the multitudes. That was too much! I insisted they switch the throne for something less exalted. When the crowd filed in, I recognized a large coterie of Marilyn’s French-speaking friends, who for years could neither converse with me nor read my books. The interviewer asked just the right questions, I told many of my best stories, the translator was miraculous, and the evening could not have gone better. I could almost hear Marilyn purring as her friends realized I wasn’t such an idiot after all.
In 2012, a Swiss filmmaker, Sabine Gisiger, approached me about making a documentary based on my life. It seemed an odd proposition, but when I attended a showing at the Mill Valley Film Festival of Guru, her excellent film about Rajneesh, the manipulative cult leader who led a commune in Oregon, I grew more interested. When I asked her why she had selected me as the subject of a film, she responded that she had felt soiled by her work on Rajneesh and had resolved to make a film about a “decent person.” Decent person—that won me over.
We began a period of shooting that lasted more than two years, with Sabine as director, Philip Delaquis as producer, and their marvelous sound and film technicians. The crew made several visits to our home in Palo Alto, to Stanford, and to our family vacations in Hawaii and the South of France, and soon the entire cast felt like part of our family. I was filmed in many situations—while speaking publicly, bicycling, swimming, snorkeling, playing Ping-Pong, and once while soaking in our hot tub with Marilyn.
All along I wondered who on earth would want to see a film showing all these mundane aspects of my life. I had no financial investment in the film, but, having grown close to the filmmaker and the producer, I worried about the money they were going to lose. In the end, when my entire family and several close friends saw a private showing of an early version in San Francisco, I was relieved: Sabine and her film editor had done an excellent job winnowing down many dozens of hours into a coherent seventy-four-minute film. Over my protests, it was titled Yalom’s Cure. Still, I puzzled why anyone outside my immediate family and friends would have the slightest interest in seeing it. Moreover, I felt self-conscious and exposed. Though I’ve come to identify myself with my writing and consider my books, especially the stories and novels, to be major chapters of my adult life, the film takes little note of me as a writer and focuses instead on my quotidian activities. And yet, to my surprise, the film proved successful in Europe, ultimately playing in fifty cinemas to several hundred thousand spectators.
In the autumn of 2014, when it opened in Zurich, the filmmaker asked Marilyn and me to attend the world premiere. Though I had resolved not to travel overseas anymore, this was an invitation I could not refuse. We flew to Zurich and attended two showings, the first for an invited audience of therapists and dignitaries, and the second for a general audience. At the end of each showing I responded to questions and felt highly exposed, especially at the shots of Marilyn and me in the hot tub, even though only our heads and shoulders were visible. But I was thrilled by the scenes of a family vacation in which our granddaughter Alana and our grandson Desmond compete in a dancing contest. Another granddaughter, Lilli Virginia, a professional songwriter and singer, is heard singing as the film ends.
When it opened in France a few months later, Marilyn flew to Paris for the premiere and spoke to the theater audience after the film. She was thrilled to see our faces on the front page of Pariscope, a popular weekly guide to happenings in Paris.
PARISCOPE COVER, MAY 20, 2015.
A few months later the film opened in Los Angeles but, in contrast to Europe, it generated little interest. Despite a favorable review in the Los Angeles Times, it closed after only a few days.
In conjunction with our earlier trip to Zurich for the film’s opening, I had accepted an offer to speak in Moscow. The incentive was an unusually generous fee and a flight from Zurich to Moscow on a private jet. That flight turned out to be a story unto itself. There were only four passengers: Marilyn, me, a former patient whom I had seen for only one session many years before, and my former patient’s close friend, a Russian oligarch, who owned the plane. I was seated next to the oligarch, with whom I had a most genial conversation throughout the flight. He came across as a thoughtful, soulful individual, troubled by a few unhappy areas in his life. I empathized with his travails but, out of politeness, did not press too deeply. Only much later did I learn that the (unstated) purpose of the flight was for me to offer some therapy to this beleaguered man. If only I had known, if only someone had been more direct, I would have been more focused on helping him.
The host for my lecture was the Moscow Institute of Psychoanalysis, a large training university, and the venue was a site often used for rock concerts. The sponsors had planned to have simultaneous translation with 700 headphones available, but 1,100 people showed up, causing such chaos that the host abandoned the idea of simultaneous translation. He requested the return of the headphones and instructed a very anxious translator to translate live.
As I began my talk and noted that no smiles greeted any of my jokes, I realized there was a serious translation problem. Later my host told me that the unnerved translator needed about fifteen minutes to settle down, but thereafter did a fine job. Afterward the conference sponsors staged a dramatic performance, in Russian, of “Arabesque,” one of the stories in Creatures of a Day, about a Russian ballerina. Two extraordinarily beautiful actors dressed in exotic costumes dramatized the story, witnessed by a silent old man (I assume myself) sitting in the corner. The background of the action was a large film screen that projected an artist’s hand and brush in the act of creating beautiful, surreal designs in oil. At the end of the event both Marilyn and I had a marathon book signing.
Once in Moscow I accepted an unusual invitation to discuss existentialism with a group of bank officers for an hour and a half. We met in a beautiful large room on the top floor of a skyscraper. About fifty were in attendance, among them the bank president, one of the few who spoke English. I, of course, knew not a word of Russian, and translation made the discussion cumbersome. The audience seemed profoundly uninterested in existentialism and asked no questions. I assumed they were disinclined to engage in a free discussion in the presence of their managers, and I tried hard to explore this, but to no avail. The bank president sat in the front row riveted to his iPad, and after twenty minutes he interrupted our session to announce that the European Union had just levied even more damaging sanctions on Russia, and he would like us to use our remaining time to discuss their concerns about this turn of events. I was all for this, since there was obviously little enthusiasm for existentialism, but, once again, there was only silence. Once again I expressed my concern that members might be unwilling to voice opinions with their managers present, but, try as hard as I could, I could find no way to break the impasse. My work ended up with little to show for it aside from my fee, which was paid in a curious fashion. I was told I would receive it the next day at a dinner party the university was giving in my honor. The following evening, after dessert, someone surreptitiously handed me a plain unmarked envelope full of US currency. I assumed I was paid in this mysterious manner as a favor to me, on the (false) assumption that I would then avoid paying taxes on the income, but it’s also possible that for some reason the bank may have been looking for ways to get rid of extra cash.
THE AUTHOR WITH HIS WIFE, MARILYN, AT THE KREMLIN,
As I have grown older I have tried to avoid long flights and have come to prefer appearances via videoconference. This entails going to a local videoconference office near my home and addressing the audience and responding to questions for approximately ninety minutes. I’ve done dozens of videoconference presentations since I decided to stop traveling overseas, but a recent one, in May 2016, for Mainland China, was the most unusual. Three psychiatrists in China interviewed me for ninety minutes, while an interpreter, who had flown to San Francisco for the occasion, sat by my side and translated their questions and my responses. The following day my sponsors told me that the interview was seen by a large audience, but I was staggered when they emailed me a photo of the interviewers and a precise count: there had been 191,234 viewers.
When I expressed my surprise and disbelief at the size of the audience, my Chinese sponsor replied, “Dr. Yalom, like most Americans, you don’t truly appreciate the vastness of China.”
Every day, without fail, I receive emails from readers from many parts of the world, and I make a point of responding to each letter, generally with something as simple as “Thank you for writing” or “I’m very glad that my work is meaningful for you.” I’m careful to mention the person’s name so that the writer can be certain I’ve actually read his or her letter and am personally writing a response. This takes a good bit of time, but I feel I’m doing something similar to the daily lovingkindness meditation practiced by my Buddhist friends. Almost daily I get a request for a consultation from some part of the world, either by Skype or from individuals offering to fly to California to meet with me. The other day a man wrote asking if I would be able to Skype with his mother, a retired psychotherapist, on her one hundredth birthday.
Along with fan mail, readers sometimes send gifts, and our house is adorned with objects from Greece, Turkey, Iran, and China. But the most striking gift came from Sakellaris Koutouzis, a well-known Greek sculptor living and working on the small island of Kalymnos. I received an email from him requesting my address and informing me that he had enjoyed my books and was in the process of making a plaster bust of me from photographs he had found on the Web. I looked him up on the Internet and learned he was an accomplished sculptor, whose pieces were on display in different cities throughout the world. I insisted on paying the shipping costs, but he refused. A month later a larger-than-life-size bust arrived at my doorstep in a huge wooden box. It now sits in our house and is such a remarkable likeness that I feel spooked every time I look at it. Often I, or my children, adorn it with glasses, neckties, or one of my many hats.
THE AUTHOR WITH A SCULPTURE OF HIM BY SAKELLARIS KOUTOUZIS, 2016.
Much as I try to deflect such tokens of renown, I have no doubt they have enhanced my sense of self. I also believe that my seniority, gravitas, and reputation increase my effectiveness as a therapist. Over the past twenty-five years the majority of my patients have contacted me because they have read some of my writing, and they arrive at my office with a strong belief in my therapeutic powers. Having met well-known therapists in my life, I have some sense of how such encounters can leave their mark: I can still see the crevices of Carl Rogers’s face. Fifty years ago, I requested a conversation with him and flew down to Southern California to spend an afternoon. I had sent him some of my work, and I remember him telling me that though my group therapy textbook was well-done, it was my Ginny book (Every Day Gets a Little Closer) that he regarded as very special. And the faces of Viktor Frankl and Rollo May remain so clear in my mind’s eye that if I had artistic talent (I don’t) I could render them accurately from memory.
So, because of my reputation, patients reveal secrets they have never told anyone else, even previous therapists, and if I accept them nonjudgmentally and empathically, my interventions are likely to carry more weight simply because of their preconceptions about me. Recently, during the same afternoon, I saw two new patients who were familiar with my work. The first, a retired therapist, drove to my office from her home several hours away. She was worried about her tendency to hoard (in only one room of her home) and her obsessional behavior: upon leaving home, she would drive less than a block before returning home to see whether the door was locked and the stove turned off. I told her I didn’t think these were going to be cleared up in brief therapy with me, nor were they significantly interfering with her life. I considered her a well-integrated person, someone who had an excellent marriage and was dealing with the difficult task of searching for meaning after retirement. She was pleased to hear that I thought she did not need therapy. The following day she emailed me these words:
I just wanted to let you know how much I enjoyed and valued our consultation last Thursday, it meant a great deal to me. I felt your support and validation that I’m doing well, am happy and content with my life and really appreciate your comment I do not need any therapy. And I left your office feeling less anxious and more confident and accepting of myself. I felt that it was a true gift. That’s pretty darn good for just one session!
Later, the same afternoon, a middle-aged South American man, visiting a friend in San Francisco, came for a single consultation. He spent almost the entire hour speaking of his concerns about his sister, who has fought anorexia nearly all her life. After the death of his parents, he was so heavily burdened by the expenses of her medical and psychiatric care that he was never able to marry and have a family. I asked why he, rather than other members of his large family, had taken on the entire burden of her care. Then, with a great deal of anxiety and hesitation, he told me a story he had never before shared with anyone.
He is thirteen years older than his sister, and one day, when she was two and he fifteen, his parents left his sister in his care for several hours while they and his older siblings attended a wedding. During their absence he had a long erotic phone conversation with a girlfriend (whom his parents greatly disliked and had expressly forbidden him to contact). During this conversation his sister crawled out the open front door and fell down several steps, suffering very considerable bruising of her body and face. When his parents returned, he had to confess everything—the worst moment of his life—and, though his sister’s injury was slight and the bruising faded in a few days, he had harbored, all these years, a secret fear and conviction that her anorexia was caused by that fall. Moreover, in the twenty-five years since his sister’s injury, this was the first time he had ever disclosed this experience to anyone.
Using my deepest and most formal voice I told him that I had listened carefully to what he had told me about his sister and, after considering all the evidence, I now pronounced him innocent. I assured him that he had paid his dues for his episode of negligence, and reassured him there was no way in which her fall could have caused anorexia. I also suggested he explore this in therapy when he returned to his country. He wept with relief, declined my suggestion to pursue therapy, and assured me he had gotten precisely what he wanted. He left my office with a much lighter step.
These one-shot consultations, in which I recognize the patient’s efforts and strengths and offer my blessings, owe their success in large part to the power with which the patient imbues me.
Not too long ago a woman recounted one of the saddest events of her life. In her late adolescence, just before leaving home for college, she took a long train ride with her eminent but very distant father. She had so looked forward to time alone with him, but was devastated when he opened his briefcase and spent the entire ride working, without speaking a word to her. I responded that our therapy offered an opportunity to replay that event. She and I (an older prominent man) would take a multi-hour therapy trip, but we would travel differently: she would have full permission, even encouragement, to ask questions, register complaints, and express feelings. And I would make sure to respond and reciprocate fully. She was moved and ultimately helped by such an approach.
And the impact of all this attention and applause upon my own sense of self? At times I fee
CHAPTER FORTY
A NOVICE AT GROWING OLD
As a child, I was always the youngest kid—youngest in my class, on the baseball team, on the tennis team, in my bunk at camp—but now, wherever I go, I am the oldest—oldest at a lecture, a restaurant, a book reading, the cinema, a baseball game. Recently I attended and spoke at a two-day continuing medical education conference for psychiatrists sponsored by the Stanford Department of Psychiatry. When I looked at the audience of colleagues from around the country, I saw only a few gray-haired folks and not one with white hair. I wasn’t just the oldest; I was the oldest by far! Listening to the program of sixteen other lectures and discussions made me even more aware of my age and the changes in the field since I began the practice of medicine in the 1950s. All the current developments—the new psychopharmacology for schizophrenia and bipolar disorders and depression, the new generation of drug trials in progress, high-tech treatments for sleep disorders, eating disorders, and attention deficit disorder—much of this has passed me by. I recalled myself as a promising young faculty member who took great pride in keeping abreast of every new development. Now, I felt lost in many of the presentations, none more so than when listening to a lecture on transcranial magnetic stimulation of the brain, which described methods of stimulating and inhibiting critical centers in the brain far more efficiently and precisely than can be done with medication, and without side effects. Was this to be the future of my field?