Becoming Myself: A Psychiatrist's Memoir

  BECOMING MYSELF

  PHOTOGRAPH BY REID YALOM

  IRVIN D. YALOM is an emeritus professor of psychiatry at Stanford University and practices psychiatry in San Francisco and Palo Alto. He is the author of many books, including Love’s Executioner, The Gift of Therapy, When Nietzsche Wept, and The Schopenhauer Cure. He and his wife, the author Marilyn Yalom, have four children and seven grandchildren. They live in Palo Alto, California.

  Scribe Publications

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  2 John Street, Clerkenwell, London, WC1N 2ES, United Kingdom

  This edition published by arrangement with Basic Books, an imprint of Perseus Books, LLC, a subsidiary of Hachette Book Group, Inc.

  Published by Scribe 2017

  Copyright © Irvin D. Yalom 2017

  All rights reserved. Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of the publishers of this book.

  The moral right of the author has been asserted.

  All names, identifying characteristics, and other details of the case material in this book have been greatly altered to protect doctor-patient confidentiality.

  The publisher is not responsible for websites (or their content) that are not owned by the publisher.

  9781925322385 (paperback edition)

  9781925548457 (e-book)

  A CiP record for this title is available from the National Library of Australia.

  scribepublications.com.au

  scribepublications.co.uk

  To the memory of my parents, Ruth and Benjamin Yalom, and my sister, Jean Rose.

  CONTENTS

  CHAPTER ONE: The Birth of Empathy

  CHAPTER TWO: Searching for a Mentor

  CHAPTER THREE: I Want Her Gone

  CHAPTER FOUR: Circling Back

  CHAPTER FIVE: The Library, A–Z

  CHAPTER SIX: The Religious War

  CHAPTER SEVEN: A Gambling Lad

  CHAPTER EIGHT: A Brief History of Anger

  CHAPTER NINE: The Red Table

  CHAPTER TEN: Meeting Marilyn

  CHAPTER ELEVEN: College Days

  CHAPTER TWELVE: Marrying Marilyn

  CHAPTER THIRTEEN: My First Psychiatric Patient

  CHAPTER FOURTEEN: Internship: The Mysterious Dr. Blackwood

  CHAPTER FIFTEEN: The Johns Hopkins Years

  CHAPTER SIXTEEN: Assigned to Paradise

  CHAPTER SEVENTEEN: Coming Ashore

  CHAPTER EIGHTEEN: A Year in London

  CHAPTER NINETEEN: The Brief, Turbulent Life of Encounter Groups

  CHAPTER TWENTY: Sojourn in Vienna

  CHAPTER TWENTY-ONE: Every Day Gets a Little Closer

  CHAPTER TWENTY-TWO: Oxford and the Enchanted Coins of Mr. Sfica

  CHAPTER TWENTY-THREE: Existential Therapy

  CHAPTER TWENTY-FOUR: Confronting Death with Rollo May

  CHAPTER TWENTY-FIVE: Death, Freedom, Isolation, and Meaning

  CHAPTER TWENTY-SIX: Inpatient Groups and Paris

  CHAPTER TWENTY-SEVEN: Passage to India

  CHAPTER TWENTY-EIGHT: Japan, China, Bali, and Love’s Executioner

  CHAPTER TWENTY-NINE: When Nietzsche Wept

  CHAPTER THIRTY: Lying on the Couch

  CHAPTER THIRTY-ONE: Momma and the Meaning of Life

  CHAPTER THIRTY-TWO: On Becoming Greek

  CHAPTER THIRTY-THREE: The Gift of Therapy

  CHAPTER THIRTY-FOUR: Two Years with Schopenhauer

  CHAPTER THIRTY-FIVE: Staring at the Sun

  CHAPTER THIRTY-SIX: Final Works

  CHAPTER THIRTY-SEVEN: Yikes! Text Therapy

  CHAPTER THIRTY-EIGHT: My Life in Groups

  CHAPTER THIRTY-NINE: On Idealization

  CHAPTER FORTY: A Novice at Growing Old

  ACKNOWLEDGMENTS

  CHAPTER ONE

  THE BIRTH OF EMPATHY

  I awake from my dream at 3 a.m., weeping into my pillow. Moving quietly, so as not to disturb Marilyn, I slip out of bed and into the bathroom, dry my eyes, and follow the directions I have given to my patients for fifty years: close your eyes, replay your dream in your mind, and write down what you have seen.

  I am about ten, perhaps eleven. I am biking down a long hill only a short distance from home. I see a girl named Alice sitting on her front porch. She seems a bit older than me and is attractive even though her face is covered with red spots. I call out to her as I bike by, “Hello, Measles.”

  Suddenly a man, exceedingly large and frightening, stands in front of my bicycle and brings me to a stop by grabbing my handlebars. Somehow I know that this is Alice’s father.

  He calls out to me: “Hey, you, whatever your name is. Think for a minute—if you can think—and answer this question. Think about what you just said to my daughter and tell me one thing: How did that make Alice feel?”

  I am too terrified to answer.

  “Cummon, answer me. You’re Bloomingdale’s kid [My father’s grocery store was named Bloomingdale Market and many customers thought our name was Bloomingdale] and I bet you’re a smart Jew. So go ahead, guess what Alice feels when you say that.”

  I tremble. I am speechless with fear.

  “All right, all right. Calm down. I’ll make it simple. Just tell me this: Do your words to Alice make her feel good about herself or bad about herself?”

  All I can do is mumble, “I dunno.”

  “Can’t think straight, eh? Well, I’m gonna help you think. Suppose I looked at you and picked some bad feature about you and comment on it every time I see you?” He peers at me very closely. “A little snot in your nose, eh? How about ‘snotty’? Your left ear is bigger than your right. Supposed I say, ‘Hey, “fat ear”’ every time I see you? Or how about ‘Jew Boy’? Yeah, how about that? How would you like that?”

  I realize in the dream that this is not the first time I have biked by this house, that I’ve been doing this same thing day after day, riding by and calling out to Alice with the same words, trying to initiate a conversation, trying to make friends. And each time I shouted, “Hey, Measles,” I was hurting her, insulting her. I am horrified—at the harm I’ve done, all these times, and at the fact that I could’ve been so blind to it.

  When her father finishes with me, Alice walks down the porch stairs and says in a soft voice, “Do you want to come up and play?” She glances at her father. He nods.

  “I feel so awful,” I answer. “I feel ashamed, so ashamed. I can’t, I can’t, I can’t . . . ”

  Since early adolescence, I’ve always read myself to sleep, and for the past two weeks I have been reading a book called Our Better Angels by Steven Pinker. Tonight, before the dream, I had read a chapter on the rise of empathy during the Enlightenment, and how the rise of the novel, particularly British epistolary novels like Clarissa and Pamela, may have played a role in decreasing violence and cruelty by helping us to experience the world from another’s viewpoint. I turned out the lights about midnight, and a few hours later I awoke from my nightmare about Alice.

  After calming myself, I return to bed, but lie awake for a long time thinking how remarkable it was that this primeval abscess, this sealed pocket of guilt now seventy-three years old, has suddenly burst. In my waking life, I recall now, I had indeed bicycled past Alice
’s house as a twelve-year-old, calling out “Hey, Measles,” in some brutish, painfully unempathic effort to get her attention. Her father had never confronted me, but as I lie here in bed at age eighty-five, recovering from this nightmare, I can imagine how it must have felt to her, and the damage I might have done. Forgive me, Alice.

  CHAPTER TWO

  SEARCHING FOR A MENTOR

  Michael, a sixty-five-year-old physicist, is my last patient of the day. I saw him for therapy twenty years ago, for about two years, and I had not heard from him since until a few days ago when he emailed to say, “I need to see you—this attached article has ignited a lot of things, both good and bad.” The link led to an article in the New York Times describing how he had recently won a major international science prize.

  As he takes his seat in my office, I am the first to speak.

  “Michael, I got your note saying you needed help. I’m sorry you’re distressed but I also want to say it’s good to see you and wonderful to learn of your award. I’ve often wondered how you’ve been doing.”

  “Thank you for saying that.” Michael looks around the office—he is wiry, alert, nearly bald, about six feet tall, and his gleaming brown eyes radiate competence and confidence. “You’ve redone your office? These chairs used to be over there? Right?”

  “Yep, I redecorate every quarter-century.”

  He chuckles. “Well, you saw the article?”

  I nod.

  “You can probably guess what happened to me next: a flush of pride, all too brief, and then wave after wave of anxious self-doubting. Same old stuff—down deep I’m shallow.”

  “Let’s go right into it.”

  We spend the rest of the session reviewing old material: his uneducated Irish immigrant parents, his life in the New York tenements, his poor primary education, the lack of any significant mentor. He spoke at length of how much he envied people who were taken in hand and nourished by an elder, whereas he had to work endlessly and get the absolute highest grades simply to be noticed. He had had to create himself.

  “Yes,” I say. “Creating yourself is a source of great pride, but it also leads to a feeling of having no foundations. I’ve known many gifted children of immigrants who have a sense of being lilies growing in a swamp—beautiful flowers but no deep roots.”

  He remembers my saying this to him years ago, and says he’s glad to be reminded of it. We make plans to meet again for a couple of sessions and he tells me he feels better already.

  I had always worked well with Michael. We connected from our very first meeting, and he had told me at points that he felt I was the only one who truly understood him. In our first year of therapy he talked a lot about his confused identity. Was he really the sterling student who left everyone behind? Or was he the bum who spent his spare time in the poolroom or shooting crap?

  Once, while he lamented his confused identity, I told him a story about my graduation from Roosevelt High School in Washington, DC. On the one hand, I had been notified that I would be receiving the Roosevelt High School Citizenship Award at graduation. Yet, in my senior year, I had been conducting a small bookie venture handling bets on baseball: I was giving 10–1 odds that any three selected players on a given day would not get six hits between them. The odds were in my favor. I had been doing famously well and always had money to buy gardenia corsages for Marilyn Koenick, my steady girlfriend. However, a few days before graduation I lost my bookie notebook. Where was it? I was in a frenzy and searched everywhere up to the very moment of graduation. Even when I heard my name called and started to stride across the stage, I trembled, wondering: Would I be honored as a sterling citizen of the Roosevelt High School 1949 class or expelled from the school for gambling?

  When I told Michael that story, he guffawed and muttered, “A shrink after my own heart.”

  After writing notes on our session, I change into casual clothes and tennis shoes and take my bike out of the garage. At eighty-four, tennis and jogging are long behind me, but almost every day I ride on a bike path near my home. I start by pedaling through a park full of strollers and Frisbees and children climbing ultramodern structures, and then cross a rude wooden bridge over Matadero Creek and climb a small hill that grows steeper every year. At the crest I relax as I begin the long downhill glide. I love coasting with the rush of warm air streaming in my face. Only at these moments can I begin to understand my Buddhist friends who speak of emptying the mind and luxuriating in the sensation of simply being. But the calm is always short-lived, and today, in the wings of my mind, I sense the rustling of a daydream readying to go onstage. It is a daydream that I’ve imagined scores, perhaps hundreds, of times over my long life. It had been dormant for several weeks, but Michael’s lament about the lack of mentors stirs it awake.

  A man, carrying a briefcase and dressed in a seersucker suit, straw hat, white shirt, and necktie, enters my father’s small, shoddy grocery store. I’m not in the scene: I see it all as if I’m hovering near the ceiling. I don’t recognize the visitor but I know that he is influential. Perhaps he is the principal of my elementary school. It is a hot, steamy Washington, DC, June day and he takes out his handkerchief to wipe his brow before turning to address my father. “I have some important things to discuss with you concerning your son, Irvin.” My father is startled and anxious; he has never before encountered such a thing. Never having assimilated into the American culture, my father and my mother were at ease only with kinsmen, other Jews who had emigrated with them from Russia.

  Though there are customers in the store demanding attention, my father knows that this is a man not to be kept waiting. He phones my mother—we live in a small flat above the store—and, out of earshot of the stranger, tells her in Yiddish to rush downstairs. She appears a few minutes later and efficiently waits on the customers while my father leads the stranger into the tiny storage room in the back of the store. They sit down on cases of empty beer bottles and talk. Mercifully no rats or roaches make an appearance. My father is obviously uncomfortable. He would have much preferred for my mother to do the talking, but it would be unseemly to acknowledge publicly that it was she, not he, who ran things, who made all the important family decisions.

  The man in the suit tells my father remarkable things. “The teachers in my school say that your son, Irvin, is an extraordinary student and has the potential to make an outstanding contribution to our society. But that would happen if, and only if, he were provided a good education.” My father seems frozen, his handsome, penetrating eyes fixed on the stranger, who continues, “Now the Washington, DC, school system is well run and is quite satisfactory for the average student but it is not the place for your son, for a very gifted student.” He opens his briefcase and hands my father a list of several private DC schools and proclaims, “I urge you to send him to one of these schools for the rest of his education.” He takes a card out of his wallet and hands it to my father. “If you contact me, I’ll do all I can to help him obtain a scholarship.”

  Upon seeing my father’s bewilderment, he explains, “I’ll try to get some help to pay his tuition—these schools are not free like the public schools. Please, for your son’s sake, give this your highest priority.”

  Cut! The daydream always ends at this point. My imagination balks at completing the scene. I never see my father’s response, or his ensuing discussion with my mother. The daydream expresses my longing to be rescued. When I was a child I didn’t like my life, my neighborhood, my school, my playmates—I wanted to be rescued and in this fantasy I am, for the first time, recognized as special by a significant emissary of the outside world, the world beyond the cultural ghetto in which I was raised.

  I look back now and see this fantasy of rescue and elevation throughout my writing. In the third chapter of my novel The Spinoza Problem, Spinoza, while strolling to the home of his teacher, Franciscus van den Enden, loses himself in a daydream that recounts their first meeting a f
ew months earlier. Van den Enden, an ex-Jesuit classics teacher who operated a private academy, had wandered into Spinoza’s shop to buy some wine and raisins and had become astonished at the depth and breadth of Spinoza’s mind. He had urged Spinoza to enter his private academy so as to be introduced to the non-Jewish world of philosophy and literature. Though the novel is, of course, fiction, I attempted as much as possible to stay close to historical accuracy. But not in this passage: Baruch Spinoza never worked in his family store. There was no family store: his family had an export-import business but no retail outlet. I was the one who worked in the family grocery store.

  This fantasy of being recognized and rescued abides within me in many forms. Recently I attended a performance of the play Venus in Fur by David Ives. The curtain opens on a backstage scene showing us a weary director at the end of a long day of auditioning actresses for a lead role. Exhausted and highly dissatisfied with all the actresses he has seen, he is preparing to leave when a brash, highly flustered actress enters. She is an hour late. He tells her he is finished for the day, but she begs and wheedles for an audition. Aware that she is obviously unsophisticated, profane, uneducated, and entirely inappropriate for the role, he refuses. But she is an excellent wheedler; she is savvy and persistent and finally, to get rid of her, he gives in and grants her a brief audition in which they begin to read the script together. As she reads, she is transformed, her accent changes, her speech matures, she speaks like an angel. He is stunned; he is overwhelmed. She is what he has been looking for. She is more than he could have dreamed of. Could this be the bedraggled, vulgar woman he met only thirty minutes earlier? They continue to read the script. They do not stop until they have brilliantly performed the entire play.

  I loved everything about the performance, but that first few minutes, when he appreciates her true quality, resonated most deeply with me: my daydream of being recognized was enacted upon the stage and I could not contain the tears streaming down my face, as I rose, the first one in the theater, to applaud the actors.