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Friday, August 28, 2015

Creatures of a Day: And Other Tales of Psychotherapy

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Creatures of a Day

“All of us are creatures of a day; the rememberer and the remembered alike,” the Roman emperor Marcus Aurelius wrote in Meditations. “All is ephemeral — both memory and the object of memory. The time is at hand when you will have forgotten everything; and the time is at hand when all will have forgotten you. Always reflect that soon you will be no one, and nowhere.” I first encountered this passage when Meditations was required reading in my freshman honors course in college. At the time, the quote had no particular resonance, no more than the hundreds of other pithy phrases in the book. As a college freshman, death remained comfortably distant and abstract and there was so much doing and being that there was no time to think of the eventual forgetting.

Now, having just completed the intern year of my medical training, death has come to the forefront, each day a reminder that we are all no more but also no less than creatures of a day. In doing my rounds, the very ephemeral nature of life is writ large with each patient I see. I’m sorry. It’s cancer, I say. I’m sorry. We’re keeping her as comfortable as possible. I’m sorry. He didn’t make it. I watch their faces, offer a hand. And as I see my patients grapple with their mortality, I come to better appreciate my own. Which makes psychiatrist and author Irvin Yalom’s most recent book, Creatures of a Day: And Other Tales of Psychotherapy, an especially timely read.

As he does in one of his previous books, Love’s Executioner, Yalom gives us in Creatures of a Day a series of patient stories, allowing us into the drama of their lives from within the sanctity of the therapist’s office. This time, though, the focus is squarely on life’s final stanza. Each individual in the book grapples with the inevitability of death and reflects back on the meaning of his or her life thus far.

Yalom introduces us to Andrew, a man who asks for only a single therapy session, then spends most of it having Yalom read over his mentor’s correspondence from years back. He introduces us Natasha, a former ballerina sidelined by gout who searches the National Gallery for the lover of her youth. And there is Rick, a retired business executive who longs for spontaneity and feels imprisoned by his retirement community.

At times these patients can feel like a cast of characters — a Russian ballerina? Really? They sometimes seem a bit too extreme to be real. And yet it is this slight distance between us and Yalom’s patients that may help us see elements of ourselves in their stories.

As I read, I found that something in each person’s life resonated with me. In one essay we meet Alvin, a skilled radiologist who also happens to be a hoarder and who leaves therapy early — unwilling, it seems, to take the next step. I could empathize easily with his holding back, standing on the ledge of change and refusing to jump.

Then there is Charles, a man whose sadness over the sudden death of his dear friend and mentor turns tortured when he learns the friend committed suicide. “All those times he was giving me support, giving me loving advice,” Charles says to Yalom, “at the same time he must have been contemplating killing himself. You see what I mean? Those wonderful blissful times when he and I sat talking, those intimate moments we shared — well, now I know those times didn’t exist.

The story makes us realize: How well can we really ever know another person? Charles’s story brings to light the difficult role of the rememberer combined with the impossibility of knowing a friend or loved one completely.

Yalom is also masterful at the interplay between psychiatrist and patient. Any clinician would be envious of his swift deductions and graceful repartee with his patients (though, admittedly, as he writes it all down, he does have the power of the revisionist’s pen).

But while Yalom’s skill is apparent, both as storyteller and as clinician, it is also clear that he is profoundly human. His patients may be lucky to receive his astute analysis, but we as readers get to be privy to his internal dialogue.

Throughout the book, Yalom attempts to better understand the complexity of the older individuals who have sought his counsel while also simultaneously considering his own mortality. And as he has us consider the words of Marcus Aurelius nearly two centuries after the ancient Roman died, one has to wonder if this new book isn’t an attempt to thwart the inevitable forgetting.

Creatures of a Day: And Other Tales of Psychotherapy
Basic Books, February 2015
Hardcover, 224 pages
$24.99



from Psych Central http://ift.tt/1hlJirG

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