Book Review: Creatures Of A Day

Now in his golden years (his description) Yalom has lost none of his touch as a writer, teacher and therapist. I enjoyed this book as much as any of his earlier case-history compilations.

Over 10 chapters consisting mainly of dialogue with occasional, minimal commentary about his private thoughts and concerns, he allows the stories to tell themselves. These all show clients grappling with existential issues that require from the therapist a humanistic, holistic approach and the flexibility to identify and adapt to the client's needs.

There is only a glancing reference to theory in the Afterword, where he says he hopes this book will be helpful to novice therapists in counteracting the prevailing trend toward therapies which consist of 'highly specific techniques addressing discrete diagnostic categories' (p 210). So definitely not a 'one size fits all' or 'how to' manual.

The book is potentially useful to any therapist as well as the lay reader. I certainly found it immediately helpful in suggesting ideas to keep in mind with some of my current clients. Best of all though for me was reading about where he breaks the rules and where he messes up – white-knuckle rides, pratfalls and all.

He illustrates repeatedly that we may never know how we have helped someone and that we must learn to live with the mystery. Being Yalom he also constantly reminds, through modeling in the dialogue sections, the value of using the 'here and now', checking in with the client about the state of their relationship.

Like me he enjoys and encourages a playful relationship with clients and I appreciated his examples showing how this can enliven therapy, making it more real and present, allowing the client to speak truth. For example, at a break in a heavy talk about us all being on the path to death, he asks the client how she's doing and she replies 'a few more healing sessions like this and I'll need to go home by ambulance!' (p 49).

Then there are incidents of rule breaking where I'm thinking 'Oh, no you didn't really do that?!'. Such as pressuring a client named Alvin into agreeing to a home visit in order to discover what was preventing him from allowing people into his life. This was decades before reality TV shows about extreme hoarders and what Yalom found there shocked him. Alvin stopped therapy abruptly and Yalom was sure he had messed up badly. Then 30 years later they met (Alvin now happily married with a grown-up family) at the funeral of a woman called Molly, a household organiser. Yalom had forgotten that after the final session he had phoned to suggest contacting Molly to sort out the mess. Now he was told, by a very grateful Alvin, that their sessions and Molly's ministrations had turned his life around. Yalom was left with his mind swirling with thoughts 'about the impossibility of ever learning how psychotherapy works' (p 80). Yes, indeed!

The book title comes from The Meditations of Marcus Aurelius, a second century Roman emperor, who dictated daily his reflections on how to live a virtuous life. During a session Yalom quoted from this book and suggested the client might read it, while muttering to himself that he knows such suggestions are seldom helpful and often a bad idea. It did nearly backfire with this client who liked to retreat from the difficulty of the matters in hand by engaging in theoretical dialogue. But finally he did become inspired by The Meditations and resolved to make changes, saying 'every morning he [Marcus Aurelius] took himself more seriously than I have ever done any morning in my entire life' (p 204).