Momma and the Meaning of Life: Tales From Psychotherapy

by Irvin D. Yalom

By allowing the patient to teach him, Dr. Whitehorn related to the person, rather than the pathology, of that patient. His strategy invariably enhanced both the patient’s self-regard and his or her willingness to be self-revealing.

The horror in learning of one’s sickness unto death, I learned from Paula, is intensified many times over by the withdrawal of others. The isolation of the dying patient is exacerbated by the foolish charade of those who attempt to conceal the approach of death.

More than death, one fears the utter isolation that accompanies it. We try to go through life two by two, but each of us must die alone—no one can die our death with us or for us.

The patient cuts herself off from the living, not wanting to drag family or friends into her horror by revealing her fears or her macabre thoughts. And friends shrink away, feeling helpless, awkward, uncertain of what to say or do, and reluctant to get too close to a preview of their own deaths.

In her final paragraph she reminded him that the lungs in the human fetus do not breathe, nor do its eyes see. Thus, the embryo is being prepared for an existence it cannot yet imagine. “Are we not, too,” Paula suggested to her son, “being prepared for an existence beyond our ken, beyond even our dreams?”

They had learned one lesson particularly well: that life cannot be postponed; it must be lived now, not suspended until the weekend, until vacation, until the children leave for college, until the diminished years of retirement. More than once I heard the lament, “What a pity it is that I had to wait till now, till my body was riddled with cancer, to learn how to live.”

I had broken a fundamental rule of psychotherapy: do not strip away a patient’s defenses if you have nothing better to offer in their stead.

learned long ago that when two people have something big between them and don’t talk about it, they don’t talk of anything else of importance either.

“some individuals refuse the loan of life in order to avoid the debt of death,”

The profit-hungry health care executives and their misguided professional advisers assume that successful therapy is a function of information obtained or dispensed rather than the result of the relationship between patient and therapist. This is a grievous error.

You can’t fling the truth in your patient’s face: the only real truth is the truth we discover for ourselves.

People love themselves if they see a loving image of themselves reflected in the eyes of someone they really care about.”

Whenever therapists have too much ego riding on a patient’s decision, whenever they need a patient to stay in therapy, that’s when they lose their effectiveness: they begin to wheedle, to be seductive, to give patients exactly what they wish—anything to get them to return the following week.