Several years ago, after emerging from many years of clinical formation and advanced training and consultation in EMDR, a fellow clinician in recovery made a potent recommendation to me:  Read The Gift of Therapy by Irving Yalom (2001).

“Yalom?” I questioned, “Isn’t he the guy who wrote the thousand-page text on group therapy?”

“Yes,” responded my colleague, “But The Gift of Therapy is different. It’s written by a much older Yalom who has learned from his mistakes, declaring that despite all of his years writing about techniques, it really is the relationship that matters most.”

Intrigued, I logged on to Amazon and ordered myself a copy. To say that the book changed my clinical life is an understatement. Written in very readable prose, the book’s essential premise is that therapy should not be theory driven, but relationship driven. In this and many of his other writings, Yalom contends that a heightened sensibility to existential issues deeply influences the nature of the therapeutic relationship and the therapy itself. Moreover, in Yalom’s view, a therapist has no place forcing solutions, a piece of guidance I have found extremely helpful in doing EMDR work with the complex client. When I began applying many of Yalom’s principles to my own clinical work (principles he clearly traces back to Carl Rogers), I noticed that my own effectiveness with EMDR improved tremendously, and the improvement was reflected in my client outcomes.

Yalom elucidated that my view of a therapy session may be drastically different from a client’s view. When I started doing EMDR, I often felt elated when I saw a client go through the “textbook” protocol. The distress levels would come down to zero and the validity of cognition levels would rise significantly. Then one day, after such a textbook session, a client told me, “Just getting all that out and telling another human being I trust seems like it took a huge weight off of my shoulders.” This phenomenon reminds me of another famous work of Yalom’s, Every Day Gets a Little Closer: A Twice-Told Therapy (Yalom & Elkin, 1974). This book chronicled a year Yalom spent doing therapy with one particular client. After each session, Yalom would write his reflections of the session down, and the client would do the same. Yalom’s reflections were focused on technique and all of the “brilliant” things he said and did in the session. For the client, the impact of the session was all in the relationship.

Although these relational ideas of Yalom’s may be too flowery and non-directional for some, the research literature backs them up. Several scholar-practitioners at the forefront of investigating what works in psychotherapy have recently published massive meta-analyses (studies that statistically analyze the results of several studies) and literature reviews that confirm what people who think like Irving Yalom have believed all along: It’s the relationship that heals.

(c) Jamie Marich, 2011