Book Review: Becoming Myself: A psychiatrist’s memoir

I think many of us therapists generally have a story about Yalom, especially in relation to our journey to becoming a therapist. Despite protestations in general that I am not one of the herd, in this case I am no different. In 2013, a friend bought me Staring at the Sun as a present and thought provoker, while I was an inpatient at the Priory due to a chronic desire to kill myself. I found the writing uplifting, confronting and comforting. I worked my way through it in the summer sun on the lawn, trying as much to recover my ability to read and retain information, as to get a grip on whether I wanted to live or not. I have read most of his works by now, with the exception of his more academic textbooks.

It was therefore a wonderful chance to read about the man himself and his life. His biography is divided into forty separate chapters which progress chronologically through the author's life. There is a focus on two main themes as titles and anchors for the chapters – his sabbaticals around the world and the titles of some of his works. As a technique I found this quite helpful to understand his own journey in the context of his writing and potentially useful to try and keep track of his progression in terms of age. The number of chapters keep the reader, or at least this reader, readily engaged, as no chapter was particularly long nor tiresome. The similarities with some of his case studies in previous works are clear, and the book is very much in keeping with his previously published style.

I thought I would feel more of an issue with the subtitle A Psychiatrist's Memoir, given my stance towards psychiatry, and the assumed chapters that would relate to his advertised profession in the book. Quite the opposite was my experience, however. Yalom describes his training and profession in a medical way, but with a softness that is in keeping with what my understanding of the existential approach is. In fact, my only issue is the lack of explicit acknowledgement of the privilege with which he operated, something that was accentuated in Alastair Campbell's latest book where he opens with a description of the comfort with which he finds himself. As an example, Yalom's employer paid for him to go on a sabbatical to Paris, and for his secretary to accompany him, so he could write and give her the initial version that she would type up for the following afternoon. This complaint is born from a resentment, not at the life he has led, but that he has married an ethical concern for his work with an ability to not acknowledge that for his clients, having their therapist disappear for a year may have been inconvenient. My own feelings aside, this is potentially a nod to the psychiatric stance Yalom first trained in and societal expectations at that time.

The saplings of Yalom's preference for the here and now, and for bringing himself into his work, are shown in his attitude towards his own analysis, something he was often late for and describes as where

I was asked to free-associate and her responses were entirely limited to interpretations, very few of them helpful. Her occasional lapses from neutrality were the most important part of the treatment…I think she was the wrong therapist for me – I simply needed someone more interactive. Many times I have had the unkind thought that the main think I learned in my analysis was how not to do psychotherapy.

(96-97)

This resonated on a multitude of levels for me. It is something I struggle with at times, but almost the opposite to his analyst, in that I find myself becoming a blank screen. I was amazed at his reflection, especially when he goes on to state that the cost of his analysis was greater than his salary and he had to do additional work on a Saturday, while having a family, to pay for it. This is a truly committed man, at least in terms of his desire to understand himself and to be a good therapist.

I have a feeling this book would appeal to some existential therapists but not all. What Yalom offers is different to what is taught over here in the UK. Indeed, he offers a critique of the existential psychotherapy training model as a baseline and is clear that it should be an add-on to a more wide-ranging understanding of psychotherapeutic orientations. Yalom, that great existential practitioner, has read Freud widely and attended many psychoanalytic conferences as part of his psychiatric training. It is fair to say I have not, and do not, possess more than a cursory knowledge of Freud. I felt a pang here, potentially one of guilt, possibly annoyance and perhaps even of dereliction of duty.

Yalom's love for his wife is clear throughout and I could not help but wonder as to what he would have written had the book been published now, after her death in late 2019. At one stage, Yalom recounts how his daughter candidly shared on a documentary that she felt he had always put his relationship with his wife/her mother before that with his children. Later he suggests that he has regrets that he did not do as a friend and had alternated Saturdays between the children and spent in-depth time with them. This speaks to me, some nine months into parenthood, about the choices that we each face. It also speaks of Yalom's widespread use of amor fati, a concept that I encountered in his work while I was at the Priory. It spoke to me enough to have the words tattooed onto my forearm despite an intense loathing of needles and blood.

Twice Yalom states that he does not have regrets, but this stands in contrast to that assertion and I wonder if it is part of the difficulty of taking full responsibility for everything in one's life; that while you do not regret the great things, ultimately you could have done things differently. I wonder whether he regrets not getting to the conclusion quicker that his first analyst was not particularly useful so he could have spent more time with his wife and child rather than jumping through an imaginary (perhaps) hoop, or whether he would argue that it is just part of the process. This question points to my desire for more from Yalom at times, a desire for an even greater level of reflection, possibly to justify the esteem with which I view him. Perhaps I am right in wanting that, but I wonder if this is an omission to avoid it becoming an industry publication rather than a contender for the New York Times bestseller list.

Is this book going to change your life or your practice? No. If it does, I would be amazed. Is it a stimulating read? Very much so, as it offers some insights into Yalom's commitment to development and relationships professionally, what is possible to see in the world off the back of undertaking therapy, and how the increasing spectre of death changes his attitude to things. There is some commendable honesty about failures to be sensitive in his younger days, especially towards the client to whom he confessed to feeling appalled by her obesity, and subsequently showing her the chapter – this could be useful to colleagues who write about case material. Ultimately, whether one is a great fan or a grudging acknowledger, Yalom has done more than anybody to move some existential thought into the mainstream. This is a thoroughly good read about his life and experiences.

Ben Scanlan

References

Benjamin, W. (2009). One-way Street and Other Writings. London: Penguin

Campbell, A. (2020). Living Better: How I learned to survive depression. London: John Murray.

Yalom, I. (2011). Staring at the Sun: Being at peace with your own mortality, overcoming the dread of death. London: Piatkus.