What Would Yalom Do? Wisdom for Counselors

During the winter of 2014, I bedded down for a long deserved rest.

As a counselor educator, I basked in the idea that after posting final grades, the university would be closed for the holiday season. I made myself a cup of Jasmine tea, started a fire in the fireplace and pulled my new Christmas throw over my tired shoulders.

Inhaling the scent of Jasmine mixed with the musty pages of the selected paperback, I immersed myself in the titillating experience of Dr. Yalom’s literary masterpiece entitled “When Nietzsche Wept” and I swore my allegiance to his wisdom.

For within this teaching novel, Yalom brilliantly intertwined the lives of the successful Dr. Josef Breuer, the neophyte Sigmund Freud, the despairing Frederick Nietzsche and the seductive Lou Salome’. The encounter that ensued captured the essence of the sacred-yet-murky therapeutic relationship and the courtship that occurs between healer and healing.

I reflected on my role as a counselor educator, a midwife to second year clinicians-in –training who (as they experience the final stage of their birthing) make one final attempt to remain safe in the womb of graduate school.

“There must be more to this therapy-thing? Surely I do not know what I am doing! Teach me your tricks. Offer me your magic wand!” they implored as they faced their launching into the professional community.

I assured them that they will remain in the shelter of supervision and community as they continue their journey as helpers. I commented on the vast amount of continued work they will do both professionally and personally. I reminded them that the most important element of the therapeutic relationship is…the relationship.

Yet, I wanted to be supportive. I wanted to offer an elixir to relieve their discomfort. I pondered the unrest of the neophyte counselors and inquired “What would Yalom do?” It is to this question that I defer to the work of Dr. Yalom and I provide my learners with final lessons as interpreted by me and borrowed from “When Nietzsche Wept”:

1. Symptoms are Messengers
Yalom’s Nietzsche suggests:

“Perhaps symptoms are messengers of a meaning and will vanish only when their message is comprehended.”

The DSM-5 has provided all of us with a new manual for categorizing and labeling sets of symptoms. For many counselors, in particular new counselors, the responsibility of diagnoses can be daunting. Many of my students chide me as I refer to the “patterns of behavior” a client manifests versus a specific diagnosis.

Yalom further challenges that all behavior is purposive and serves the host. Therefore, discovering how these patterns or symptoms serve the client may provide insight into deeper meaning.

2. Cultivate Meaning
Viktor Frankl, psychiatrist and author of the groundbreaking book, “Man’s Search for Meaning,” describes meaning construction as paramount to the human condition. He notes,

“You can take everything from a man, accept his attitude about his circumstance.”

Yalom concurs that the cultivation of understanding is key for a client’s wellness. Therefore, I am inclined to assess what meaning is ascribed by the client to a particular symptom or patterns of symptoms?

For example, I had a client who presented with concerns over discovering that her husband had a fetish for wearing women’s lingerie. Initially, I thought her discomfort was related to possible concerns about his sexuality. However, upon further exploration, this client’s real discomfort was related to her own body image. She found her husband to be more comfortable wearing his pink nightie than she, and this resulted in her envy and resentment.

3. Model Honesty
To truly be honest one necessarily experiences risk–risk of rejection, risk of betrayal. Yet, vulnerability can offer great rewards in relationship. As clinicians, we ask our clients to be truthful and often negatively refer to those who withhold information as “resistant.”

However, do we ask the same of ourselves? Do we allow ourselves, as Yalom suggests, to model this behavior so that our clients can “learn there is no horror in openness and honesty between people?”

Brene’ Brown, the author of the 2012 #1 New York Times Bestseller entitled “Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead,” writes,

“Vulnerability sounds like truth and feels like courage. Truth and courage aren’t always comfortable, but they’re never weakness.”

4. Healer and Healed are In Courtship
Yalom poignantly reminds us that the secret to the therapeutic alliance is the unconscious dance that occurs between the healer and the healed. This intricate pattern between transference and counter transference may resemble a perfectly executed waltz or a more random quick step.

Rarely understood outside the counseling community, it is within this complex relationship that healing occurs. Furthermore, the healer is often equally touched by the experience of being in relationship with the client.

Hermann Hesse’s novel “Magister Ludi” expresses this best where two great healers discover one another. In desperation, the young student seeks the help of the great teacher and remains in service to him until his dying days. However, it is during the final scene as the sage healer is dying that he confesses that he too had sought out the care of the younger healer and that both were served by the relationship.

5. Isolation Exists Only in Isolation
Nietzsche’s emotional release results in a profound understanding by Breuer,

“Isolation exists only in isolation. Once shared, it evaporates.”

The importance of social supports is well documented in the research and the therapeutic relationship provides an intimate and significant relationship for many of our clients. For some, it may be the first time that they have told their stories. This is powerful. Up to that moment of disclosure, it has remained a secret that has anchored the client to the experience and the emotional turmoil that is attached to the experience.

6. Choose your Fate. Love your Fate
Yalom’s Nietzsche confronts Dr. Breuer about agency in one’s life offering that we make choices in our life that contribute to our experiences. He further contends

“…The spirit of a man is constructed out of his choices!”

So often our clients present to counseling feeling stuck in a life that they feel has happened to them. They do not feel that they have agency in their life. It can be powerful to simply offer that they possess the ability to choose much of their experiences in life and they always have the ability to choose how they wish to respond to their circumstance.

7. Take Time to Chimney Sweep
Chimney sweep is a term in the text that is synonymous to brainstorming and relative to the technique free association. It refers to the free flowing of thoughts around a topic or idea as a means to access meaning.

This process, however, requires us to unplug and put aside all other activities that may distract us from this housekeeping of sorts. Additionally, chimney sweeping requires adequate time to empty our cluttered thoughts, turn our attention and eventually meditate on, the topic of interest. As a result, a purging of thoughts, ideas and meanings tangled within the threads of the subject matter takes place. It adds to clarity of mind and peace of body.

8. Be more Generous to Your Own Humanity
Yalom’s Nietzsche declared a granite sentence of the human experience to be to “Become who you are.” He continued,

“That means not only to perfect yourself but also not to fall prey to another’s designs for you.”

Dr. Kristin Neff, associate professor of human development and culture in the educational psychology department at the University of Texas at Austin, and author of the book entitled “Self-Compassion” writes in her online blog dated June 25, 2011:

Instead of endlessly chasing self-esteem as if it were the pot of gold at the end of the
rainbow, therefore, I would argue that we should encourage the development of
self-compassion. That way, whether we’re on top of the world or at the bottom of
the heap, we can embrace ourselves with a sense a kindness, connectedness and
emotional balance. We can provide the emotional safety needed to see ourselves
clearly and make whatever changes are necessary to address our suffering. We can
learn to feel good about ourselves not because we’re special and above average, but
because we’re human beings intrinsically worthy of respect.

9. Die at the Right Time
Yalom’s Nietzsche and Breuer agonized over mortality and Nietzsche proposed,

“Die at the right time. Live when you live! Death loses its terror if one dies when one has consummated one’s life? If one does not live in the right time, then one can never die at the right time.”

Consummating one’s life necessarily requires the shunning of distractions of the past and concerns for the future. It requires us to be fully present in the moment. It commands courage to take risks in life and love. This results in vulnerability (there it is, again!). However, to live fully means to embrace all aspects of the human experience. Pain, suffering, joy, and ecstasy are all shared experiences of humanity. Would I give up one aspect for another?

Now armed with several, though certainly not all, of the nuggets of wisdom provided by the brilliant Dr. Irvin Yalom, I leave you with one final thought from my humble experience as a counselor:

10. We are People, Not Pathologies.
We are human beings seeking relationship, wanting to belong in community. We want to love and be loved. As counselors we have the greatest privilege in being asked to enter into the most vulnerable spaces with others and to be in relationship. That is a sacred gift and the secret to therapy.

Insightful book photo available from Shutterstock

What Would Yalom Do? Wisdom for Counselors

Cheryl Fisher, PhD.,NCC, LCPC

Dr. Fisher is a Licensed Clinical Professional Counselor in private practice in Annapolis, Maryland. She is a visiting full-time faculty member at Loyola University Maryland in the Pastoral Counseling Department. Her current research examines sexuality and spirituality in young women with advanced breast cancer. She is currently working on a book titled, “Homegrown Psychotherapy: Scientifically-Based Organic Practices” of which this article is an excerpt. She may be contacted at [email protected]


APA Reference
Fisher, C. (2015). What Would Yalom Do? Wisdom for Counselors. Psych Central. Retrieved on May 25, 2020, from


Scientifically Reviewed
Last updated: 26 Jul 2015
Last reviewed: By John M. Grohol, Psy.D. on 26 Jul 2015
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