Love's Executioner

by Irvin D. Yalom

I MAGINE THIS SCENE: three to four hundred people, strangers to each other, are told to pair up and ask their partner one single question, “What do you want?” over and over and over again. Could anything be simpler? One innocent question and its answer. And yet, time after time, I have seen this group exercise evoke unexpectedly powerful feelings. Often, within minutes, the room rocks with emotion. Men and women—and these are by no means desperate or needy but successful, well-functioning, well-dressed people who glitter as they walk—are stirred to their depths. They call out to those who are forever lost—dead or absent parents, spouses, children, friends: “I want to see you again.” “I want your love.” “I want to know you’re proud of me.” “I want you to know I love you and how sorry I am I never told you.” “I want you back—I am so lonely.” “I want the childhood I never had.” “I want to be healthy—to be young again. I want to be loved, to be respected. I want my life to mean something. I want to accomplish something. I want to matter, to be important, to be remembered.” So much wanting. So much longing. And so much pain, so close to the surface, only minutes deep. Destiny pain. Existence pain. Pain that is always there, whirring continuously just beneath the membrane of life. Pain that is all too easily accessible. Many things—a simple group exercise, a few minutes of deep reflection, a work of art, a sermon, a personal crisis, a loss—remind us that our deepest wants can ne...

anxiety emerges from a person’s endeavors, conscious and unconscious, to cope with the harsh facts of life, the “givens” of existence.* I have found that four givens are particularly relevant to psychotherapy: the inevitability of death for each of us and for those we love; the freedom to make our lives as we will; our ultimate aloneness; and, finally, the absence of any obvious meaning or sense to life.

At one’s core there is an ever-present conflict between the wish to continue to exist and the awareness of inevitable death. To adapt to the reality of death, we are endlessly ingenious in devising ways to deny or escape it. When we are young, we deny death with the help of parental reassurances and secular and religious myths; later, we personify it by transforming it into an entity, a monster, a sandman, a demon. After all, if death is some pursuing entity, then one may yet find a way to elude it; besides, frightening as a death-bearing monster may be, it is less frightening than the truth—that one carries within the spores of one’s own death. Later, children experiment with other ways to attenuate death anxiety: they detoxify death by taunting it, challenge it through daredevilry, or desensitize it by exposing themselves, in the reassuring company of peers and warm buttered popcorn, to ghost stories and horror films. As we grow older, we learn to put death out of mind; we distract ourselves; we transform it into something positive (passing on, going home, rejoining God, peace at last); we deny it with sustaining myths; we strive for immortality through imperishable works, by projecting our seed into the future through our children, or by embracing a religious system that offers spiritual perpetuation.

Many people take issue with this description of death denial. “Nonsense!” they say. “We don’t deny death. Everyone’s going to die. We know that. The facts are obvious. But is there any point to dwelling on it?” The truth is that we know but do not know. We know about death, intellectually we know the facts, but we—that is, the unconscious portion of the mind that protects us from overwhelming anxiety—have split off, or dissociated, the terror associated with death. This dissociative process is unconscious, invisible to us, but we can be convinced of its existence in those rare episodes when the machinery of denial fails and death anxiety breaks through in full force.

the fact, the physicality, of death destroys us, the idea of death may save us.

we are creatures who desire structure, and we are frightened by a concept of freedom which implies that beneath us there is nothing, sheer groundlessness.

“Effort, too, is needed. You have to try, you know. There’s a time for thinking and analyzing but there’s also a time for action.”

It is through willing, the mainspring of action, that our freedom is enacted. I see willing as having two stages: a person initiates through wishing and then enacts through deciding.

John Gardner, in his novel Grendel, tells of a wise man who sums up his meditations on life’s mysteries in two simple but terrible postulates: “Things fade: alternatives exclude.”

“alternatives exclude,” is an important key to understanding why decision is difficult. Decision invariably involves renunciation: for every yes there must be a no, each decision eliminating or killing other options (the

“Even though you’re alone in your boat, it’s always comforting to see the lights of the other boats bobbing nearby.”

The search for meaning, much like the search for pleasure, must be conducted obliquely. Meaning ensues from meaningful activity: the more we deliberately pursue it, the less likely are we to find it; the rational questions one can pose about meaning will always outlast the answers.

the experience of the other is, in the end, unyieldingly private and unknowable.

In choosing to enter fully into each patient’s life, I, the therapist, not only am exposed to the same existential issues as are my patients but must be prepared to examine them with the same rules of inquiry. I must assume that knowing is better than not knowing, venturing than not venturing; and that magic and illusion, however rich, however alluring, ultimately weaken the human spirit. I take with deep seriousness Thomas Hardy’s staunch words “If a way to the Better there be, it exacts a full look at the Worst.”

Since therapists, no less than patients, must confront these givens of existence, the professional posture of disinterested objectivity, so necessary to scientific method, is inappropriate. We psychotherapists simply cannot cluck with sympathy and exhort patients to struggle resolutely with their problems. We cannot say to them you and your problems. Instead, we must speak of us and our problems, because our life, our existence, will always be riveted to death, love to loss, freedom to fear, and growth to separation. We are, all of us, in this together.

I always listen carefully to first statements. They are often preternaturally revealing and foreshadow the type of relationship I will be able to establish with a patient. Words permit one to cross into the life of the other, but Thelma’s tone of voice contained no invitation to come closer.

too many patients badly damaged by therapists using them sexually. It’s always damaging to a patient.

doubted whether it would be possible to separate her from her obsession without first helping her to enrich other realms of her life.

Perhaps the function of the obsession was simply to provide intimacy: it bonded her to another—but not to a real person, to a fantasy.

No real need for my question, since Thelma had been on the verge of describing the resolutions, but I had to have some exchange with her. I was getting plenty of information, but we were not making contact. We might as well have been in separate rooms.

have worked with many people who have truly tried to kill themselves; but usually their experience is in some way transformational, and they ripen into new maturity and new wisdom. A real confrontation with death usually causes one to question with real seriousness the goals and conduct of one’s life up to then. So also with those who confront death through a fatal illness: how many people have lamented, “What a pity I had to wait till now, when my body is riddled with cancer, to know how to live!”

a love obsession drains life of its reality, obliterating new experience, both good and bad—as

So, in my work with Thelma, I stressed to her how her obsession was vitiating her life, and often repeated her earlier comment that she was living her life eight years before. No wonder she hated being alive! Her life was being stifled in an airless, windowless chamber ventilated only by those long-gone twenty-seven days.

“Thelma, this feeling that the only thing that matters is for Matthew to think well of you—tell me everything you know about it.” “It’s hard to put into words. The idea of him hating me is unbearable. He’s the one person who has ever known everything about me. So the fact that he could still love me, despite everything he knew, meant so much.” This, I thought, is precisely the reason therapists should not become emotionally involved with patients. By virtue of their privileged role, their access to deep feelings and secret information, their reactions always assume larger-than-life meanings. It is almost impossible for patients to see therapists as they really are.

I had known that the pure forcefulness of my argument would not penetrate deep enough to effect any change. It almost never does. It’s never worked for me when I’ve been in therapy. Only when one feels an insight in one’s bones does one own it. Only then can one act on it and change. Pop psychologists forever talk about “responsibility assumption,” but it’s all words: it is extraordinarily hard, even terrifying, to own the insight that you and only you construct your own life design. Thus, the problem in therapy is always how to move from an ineffectual intellectual appreciation of a truth about oneself to some emotional experience of it. It is only when therapy enlists deep emotions that it becomes a powerful force for change.

How I long at such junctures for the certainty that orthodoxy offers. Psychoanalysis, to take the most catholic of the psychotherapy ideological schools, always posits such strong convictions about the necessary technical procedures—indeed, analysts seem more certain of everything than I am of anything. How comforting it would be to feel, just once, that I know exactly what I’m doing in my psychotherapeutic work—for example, that I am dutifully traversing, in proper sequence, the precise stages of the therapeutic process. But, of course, it is all illusion. If they are helpful to patients at all, ideological schools with their complex metaphysical edifices succeed because they assuage the therapist’s, not the patient’s, anxiety (and thus permit the therapist to face the anxiety of the therapeutic process). The more the therapist is able to tolerate the anxiety of not knowing, the less need is there for the therapist to embrace orthodoxy. The creative members of an orthodoxy, any orthodoxy, ultimately outgrow their disciplines. Though there is something reassuring about an omniscient therapist who is always in control of every situation, there can be something powerfully engaging about a fumbling therapist, a therapist willing to flounder with the patient until they, together, stumble upon an enabling discovery.

‘the unexamined life is not worth living.’

“You’ve been living and feeling one way for eight years, and now suddenly in twenty-four hours all that is pulled away from you. These next few days are going to feel very disorienting. You’re going to feel lost. But we have to expect that. How could it be otherwise?” I said this because often the best way to prevent a calamitous reaction is to predict it. Another way is help the patient get outside of it and move into the observer role. So I added, “It will be important this week to be an observer and recorder of your own inner state. I’d like you to check in on your internal state every four hours, when you are awake, and jot down your observations. We’ll go over them next week.”

Cervantes asked, “Which will you have: wise madness or foolish sanity?”

In the past I hadn’t tampered with his denial. In general, it’s best not to undermine a defense unless it is creating more problems than solutions, and unless one has something better to offer in its stead.

I was being cruel, yet the option of not being cruel, of simply humoring him, of tacitly acknowledging that he was incapable of seeing reality, was crueler yet.

Sometimes countertransference is dramatic and makes deep therapy impossible: imagine a Jew treating a Nazi, or a woman who has once been sexually assaulted treating a rapist. But, in milder form, countertransference insinuates itself into every course of psychotherapy.

The origins of these sorry feelings? I had never thought to inquire. So deep do they run that I never considered them prejudice.

In the streets, the black attacked me for my whiteness, and in school, the white attacked me for my Jewishness. But there was always fatness, the fat kids, the big asses, the butts of jokes, those last chosen for athletic teams, those unable to run the circle of the athletic track. I needed someone to hate, too. Maybe that was where I learned it.

The first step in all therapeutic change is responsibility assumption. If one feels in no way responsible for one’s predicament, then how can one change it? That was precisely the situation with Betty: she completely externalized the problem. It was not her doing: it was the work transfer, or the sterile California culture, or the absence of cultural events, or the jock social scene, or society’s miserable attitude toward obese people. Despite my best efforts, Betty denied any personal contribution to her unhappy life situation.

The psychotherapist’s single most valuable practical tool is the “process” focus. Think of process as opposed to content. In a conversation, the content consists of the actual words uttered, the substantive issues discussed; the process, however, is how the content is expressed and especially what this mode of expression reveals about the relationship between the participating individuals. What I had to do was to get away from the content—to stop, for example, attempting to provide simplistic solutions to Betty—and to focus on process—on how we were relating to each other. And there was one outstanding characteristic of our relationship—boredom. And that is precisely where countertransference complicates things: I had to be clear about how much of the boredom was my problem, about how bored I would be with any fat woman. So I proceeded cautiously—too cautiously. My negative feelings slowed me down. I was too afraid of making my aversion visible. I would never have waited so long with a patient I liked more. I spurred myself to get moving. If I were going to be helpful to Betty, I had to sort out, to trust, and to act upon my feelings.

couldn’t promise more honesty than I was willing to give.

Psychological “emptiness” is a common concept in the treatment of those with eating disorders.)

Whenever the patient begins to develop symptoms in respect to the relationship with the therapist, therapy has really begun, and inquiry into these symptoms will open the path to the central issues.

There’s no such thing as a lifetime guarantee. It’s like refusing to enjoy watching the sun rise because you hate to see it set.”

“Maybe, but sounds farfetched.” Another good example, I thought, of the pointlessness of the therapist rushing in with an interpretation, even a good one like this. Patients, like everyone else, profit most from a truth they, themselves, discover.

have come to believe that the fear of death is always greatest in those who feel that they have not lived their life fully. A good working formula is: the more unlived life, or unrealized potential, the greater one’s death anxiety.

As we neared our final session, I felt a mounting relief and exhilaration—as though I had gotten away with something. One of the axioms of psychotherapy is that the important feelings one has for another always get communicated through one channel or another—if not verbally, then nonverbally.

if something big in a relationship is not being talked about (by either patient or therapist), then nothing else of importance will be discussed either.

as termination approaches, patients are bound to regress temporarily. (There is an absolute.) Second, issues are never resolved once and for all in therapy. Instead, therapist and patient inevitably return again and again to adjust and to reinforce the learning—indeed, for this very reason, psychotherapy has often been dubbed “cyclotherapy.”

She had that very hour given me a concept that would serve me in good stead in all my future work with the bereaved: if one is to learn to live with the dead, one must first learn to live with the living.

To lose a parent or a lifelong friend is often to lose the past: the person who died may be the only other living witness to golden events of long ago. But to lose a child is to lose the future: what is lost is no less than one’s life project—what one lives for, how one projects oneself into the future, how one may hope to transcend death (indeed, one’s child becomes one’s immortality project). Thus, in professional language, parental loss is “object loss” (the “object” being a figure who has played an instrumental role in the constitution of one’s inner world); whereas child loss is “project loss” (the loss of one’s central organizing life principle, providing not only the why but also the how of life).

The sentiment that one “should have done something more” reflects, it seems to me, an underlying wish to control the uncontrollable. After all, if one is guilty about not having done something that one should have done, then it follows that there is something that could have been done—a comforting thought that decoys us from our pathetic helplessness in the face of death. Encased in an elaborate illusion of unlimited power and progress, each of us subscribes, at least until one’s mid-life crisis, to the belief that existence consists of an eternal, upward spiral of achievement, dependent on will alone. This comforting illusion may be shattered by some urgent, irreversible experience,

the robbery illuminated her ordinariness, her “I never thought it would happen to me” reflecting the loss of belief in her personal specialness. Of course, she was still special in that she had special qualities and gifts, that she had a unique life history, that no one who had ever lived was just like her. That’s the rational side of specialness. But we (some more than others) also have an irrational sense of specialness. It is one of our chief methods of denying death, and the part of our mind whose task it is to mollify death terror generates the irrational belief that we are invulnerable—that unpleasant things like aging and death may be the lot of others but not our lot, that we exist beyond law, beyond human and biological destiny.

In a way no patient had ever done before, she showed me everything. And I had accepted everything and asked for even more.