Interview with Irv Yalom, M.D.

by Bob Edelstein on April 1, 2007

Over the last half century, Irvin D. Yalom, M.D. has been one of the pioneers and leaders in developing existential psychotherapy, group psychotherapy, and psychotherapy based literature. He has authored numerous books and articles, both non-fiction and fiction, including The Theory and Practice of Group Psychotherapy and Existential Psychotherapy, both main sourcebooks in their field. He has also written three novels, the most recent being The Schopenhauer Cure. He is currently writing a novel about death anxiety.

EDELSTEIN: As I understand it, a core of your existential psychotherapy is the need for human beings to deal with the conflicts that grow from the individual’s confrontation with the four ultimate concerns that are the givens of existence — death, freedom, isolation, and meaninglessness. How did you choose these four concerns? Can there be other ultimate concerns?

YALOM: How I arrived at those I’m not even sure as I wrote Existential Psychotherapy 25 years ago. I used Paul Tillich’s term, ultimate concerns. There are lots of other ways to slice these things and I simply selected concerns that seemed to be germane to my practice at the time. I don’t know of any other significant concerns that enter into the literature. Of the four, probably death is the overarching one; it’s a hallmark of the existential approach, and we really have to focus on how we come to terms with mortality.  The concern of meaning is somewhat independent of death, and at the same time very much related. Because if everything is going to vanish and we’re going to vanish, then what purpose can there be in life? Again, my sense is that death is the major concern. I’m writing a book now about death anxiety, so in a sense it’s expanding that part of the existential psychotherapy book.

EDELSTEIN: I am interested about your own death anxiety. Given that you are in the latter part of your life, what gets evoked for you?

YALOM: In this new book I do have a long personal memoir of my own issues. I have myself interviewing myself, and in fact that’s one of the questions I ask myself. Is it any coincidence that I’m returning to these issues at this time in my life? I used to write about other issues, the sexual ones or the prestige ones. I’ve been struggling with death anxiety for a long time. My protagonist in Lying On The Couch is writing a book on death and psychotherapy. In The Schopenhauer Cure the protagonist is dealing with a malignant disease, a melanoma. I think exploring death anxiety is the most important question we can ask. I think it’s present in our clinical practice far more than we think, if only we have the vision to look for it.

EDELSTEIN: I believe you have a Jewish heritage?

YALOM: I have a Jewish heritage stapled over an atheistic world view.

EDELSTEIN: Do you think your Jewish heritage has something to do with your passion for exploring death anxiety, given the cultural history of the Jewish people?

YALOM: No, I don’t think so. In my house, as is pretty common in Jewish families, the children aren’t given any kind of education about death. They never go to funerals. At least no one in our family had children go to funerals. Death was never talked about. I left the religious way of thinking very early, immediately after age 13. There is really very little that the Jews say in regard to death.

EDELSTEIN: I’m thinking there hasn’t been much of a direct dealing with death anxiety in terms of World War II and the genocide.

YALOM: My father’s response to World War II and the Holocaust was, “How could you possibly believe in God given the Holocaust?” He really lost his belief after that.

EDELSTEIN: Can existential psychotherapy coexist with spirituality and religion? I was a clinical supervisor of chemical dependency treatment agencies early in my career. In those agencies, the 12-Step approach was utilized, which included a strong emphasis on surrendering to a higher power. I’m aware of how much you emphasize the importance of using personal will effectively. Can using personal will effectively coexist with surrendering to a higher power?

YALOM: It’s a hard question. I think, on quite a theoretical basis, that religion is something that makes good men do evil things and that it will do us all in, eventually. It’s hard to look at what’s happening in the world today without thinking about that very question. I think we’d be far better off without religion. As Dawkins put it in The God Delusion, what would a world without religion be? There wouldn’t be a 9/11, there wouldn’t be any Near Eastern struggle, there wouldn’t be an Irish civil war, there wouldn’t be a Hindu-Moslem struggle.

When I work clinically my major priority is the care of the patient. So, if the patient has religious beliefs and they have served him or her in good stead, it would be unthinkable for me to try to strip those beliefs away, even if I could. Rather, I would want to try to reinforce them. If a person had a great deal of faith and got a great deal out of it, I’m much more likely to wonder why he is not doing that now or what stopped him from getting this kind of comfort.

I will move patients into using whatever has been useful to them. Certainly the 12-Step belief in a higher power is very useful for a lot of people if they are in a state where that’s what they have to use. Secretly, I feel like maybe it’s a kind of an infantilization, maybe it is enhancing delusion because God is a delusion, but that’s what they need at this stage of their life. The 12-Step programs are immensely valuable to a lot of people.  I know some people would get more out of 12-Step groups if they weren’t turned off by the religious aspect. They search for meetings where there is a de-emphasis on religion, and generally find meetings that have more highly educated people. There is a very direct relationship between the level of education and the level of disbelief.

EDELSTEIN: Do you see any difference between religion and spirituality?

YALOM: I have a lot of trouble with the concept of spirituality, and every time someone uses the term I can’t discuss it with them until I find out exactly what they are thinking. Everybody talks about something very different. Some people talk about a sense of awe and magic in the universe, looking at the skies and the cosmos, their sense of smallness, and the glory of the heavens. You don’t need religion to have that. So I want to find out exactly what spiritualism is for that person. It comes in a rainbow of flavors, so I need to find out what they mean.

EDELSTEIN: This would fit with the phenomenological base of existentialism, getting to the lived experience of what the person is talking about.

YALOM: Exactly. Thinking about deeper issues may be looked at as a kind of spirituality. I had a lot of contact with the therapist and good friend of mine, Rollo May. He said my book Existential Psychotherapy is a very religious book. I think he got very annoyed at me for not seeing it that way. I believe he meant the same thing that the American Psychiatric Association did when it gave me the Pfister Award for contributions to religion and psychiatry a few years ago. I was amazed that they did this, and I told them how odd it is that you gave this award to a card-carrying atheist. Their response was no, you’re asking religious questions. I think questions about being and death, what it means to be facing death, and what it means to be thrown into the world and leave the world alone are existential questions. Even though religious people tend to examine these same things, I don’t think of them as religious questions.

EDELSTEIN: I think existentialism is sometimes viewed as pessimistic. It deals with issues that are really hard for people to face – death, freedom, isolation, and meaninglessness. On the other hand, I experience your work as being optimistic in that it engages these critical issues.

YALOM: It’s a big error for people to think that an existential perch is pessimistic and leading to despair. I think it is exactly the opposite. I feel if you face these issues clearly, if you face and confront death very openly, you can enrich your life. There is a 2,500 year line of philosophers who have said very much the same thing.

When you have a confrontation with death, it can wake you up and move you out of your everyday state to a more ontological state. That’s Heidegger’s term, it’s used in philosophical literature. Death makes you wonder more about the world, the creation of the world, and where our place is. Psychological literature used to call it a boundary experience, but I don’t like that term – it gets mixed up with boundaries and it doesn’t mean that. I’m using a new phrase. I’m calling it the awakening experience. I feel that confronting death can enrich life, not deplete it. Constantly denying death, compartmentalizing it, not thinking about it, or being frightened by it all the time is a way of diminishing yourself.

EDELSTEIN: So would you look at your nature as optimistic?

YALOM: I would certainly look at it this way. Optimistic for how you can live this life in this world, which is the only life you’ve got. Otherwise there is a big inferential leap without a scrap of evidence.

EDELSTEIN: One way that I’ve heard spirituality defined is making heaven on earth, embracing what we have right here right now, not looking for the afterlife for salvation. Would that fit with what you’re saying?

YALOM: That’s right. The error of devaluing this current life started back with Plato and Socrates, who were convinced that there was a better life after this one and you need to direct your energies toward that life. That’s why Nietzsche hated Socrates so much. He thought Socrates was leading everybody in the wrong direction. Ultimately the teachings of Plato were incorporated in the Neo-Platonists which became the foundation for the Christian belief in the afterlife. I much prefer Nietzsche to Plato in that regard.

EDELSTEIN: It seems like you hold your contributions to group psychotherapy and interpersonal process as separate and distinct from your contributions to existential psychotherapy and the ultimate concerns of being human.

YALOM: I do. I have two separate parallel streams of interest. One has been group therapy, which is based very much on interpersonal theory. And then there is another stream, an existential approach which has its greatest fruition in individual therapy. I don’t know what an existential therapy group would be, so I need groups which are interpersonally based and work on the here-and-now interactions, trying to help people alter the way they relate to other people. I led groups of cancer patients that dealt with issues around death for many years, but these were support groups with occasional forays into looking more directly at death.

EDELSTEIN: It seems to me that one could tie together your contributions to group therapy and interpersonal process with existential psychotherapy and the ultimate concerns of being human. Interpersonal process deals directly with the ultimate concern of isolation, and remedies that by allowing the client to move into genuine and meaningful relationship. Group psychotherapy seems to be a methodology to explore this ultimate concern, and in that process the client can also explore the other ultimate concerns of death, meaninglessness, and freedom.

YALOM: I think it’s true in groups that there is a real effort to diminish interpersonal isolation, which is loneliness and not having meaningful relationships with others.

But that is not the same kind of isolation that I’m talking about in Existential Psychotherapy. I’m talking about something else entirely. I’m talking about existential isolation: we are thrown alone into the world, and we die alone in the world, and there is a separation between us and the world, and when we die our world disappears too – the world that we built. Every person is a constituting entity. Reality is a very relative thing. We’ve known that since Kant. That’s what Heidegger was talking about when he talked about dasein, the person who is there, but also creates the world about him. You don’t see existential isolation very much in life. When you really see it is when you have to confront death.

A lot of my patients in the cancer group had a lot of interpersonal isolation issues; people didn’t know how to talk to them and avoided them sometimes. But existential isolation – the awareness that the whole world is going to disappear, the world that you’ve created, you take that whole world with you – that’s the kind of separation I don’t think is really bridgeable by any kind of relationship. It can be eased and comforted, but that gap isn’t bridgeable.

EDELSTEIN: How is that isolation dealt with? Is that an individual confrontation?

YALOM: Yes, it’s an individual confrontation. I think it’s dealt with primarily through recognizing it, being with the comfort we get from other people who are dealing with the same issues, and being aware of how much of our lives we constitute ourselves.

EDELSTEIN: What moves me about what you’re saying about death and death anxiety is the importance of constituting as rich a life as I can, even if it’s going to disappear. Or even more so because I know it’s going to disappear.

YALOM: Yes, because it is going to disappear. This idea is frightening. One can lose meaning because it’s all going to disappear. But I think it’s preferable to take just the opposite view – because life is going to disappear, it makes it all the more poignant and all the more beautiful and all the more meaningful. There won’t be an afterlife, where you go into another world, so we have to create this world as richly as we can. Enjoy the moment. Don’t be so distracted by things. Appreciate what’s going on around you. Appreciate the really important things in life. That’s what a lot of my patients learned as a result of confronting their own cancer. They made some significant changes.

EDELSTEIN: I’m thinking there is choice. For instance, being nihilistic would go in the other direction . . . why bother?

YALOM: Right, that would be nihilistic and there would be no particular rational view for that idea. Of course, everything is going to disappear. The solar system will disappear, it will lie in ruins one day.

EDELSTEIN: Which goes back to the existential humanistic perspective’s emphasis of being in the present moment, because that’s what we have.

YALOM: Yes, I agree.

EDELSTEIN: I’ve been impacted tremendously by Jim Bugental and his work in existential humanistic psychotherapy. As I see it, his lens focuses on the exploration of the lived experience of the client in the here-and-now. I think of this as a process orientation, wherein we are focusing on how the client is present with him or herself in the moment. As I see it, your lens focuses on the four ultimate concerns of being human, which I think of as more of a content orientation. There is an emphasis on these four themes that we continually confront throughout our lives. I’m curious about how you see it. Are these two ways of viewing existential psychotherapy? And, if so, how do they relate to each other and fit together as a whole?

YALOM: I can’t tell you that I’m crystal clear about the major differences between Jim and myself. I’ve worked with a lot of Jim’s students and I know he does a lot more inner integration as parts of the self than I do, and I’m doing much more interpersonal work.

EDELSTEIN: You do so much with the interpersonal, and Jim does so much with the intra-psychic. I’m fascinated by this, because they are both effective and powerful ways to support human beings to grow, and yet they are clearly different approaches. Will you talk more about that?

YALOM: I want to use myself as fully as possible with the patient. I want to examine everything that goes on between the patient and myself in the hour with microscopic detail. I’m doing a great deal of work on our relationship, which means that I strive to have an authentic relationship with the patient, where I’m as genuine as possible. I’m self-disclosing. I’m not hiding behind my degrees, or any other subterfuges. I don’t deny that I am facing many of the same exigencies in life, because I am facing the same destiny that they are. So we are together on that. Those are my emphases during each therapy hour, during each therapy hour I’ve had today. I work with dreams very much in that way, too.

EDELSTEIN: What do you see as the primary component of healing? Is it the relationship between client and therapist, the therapist’s authenticity including self disclosure, the client’s receptivity to his or her own subjectivity, or something else?

YALOM: I do a lot of work on how clients relate to me and what does it mean, and what are the thoughts they have about me, and in which ways do they think, as many of them do, that I might be critical of them for some reason, or judging them. I try to look at that. I ask if there are any questions they want to ask me, and I try to be very open about my answers. So if I do that fully and thoroughly, I’m really changing the person’s way of relating to other people. That’s often the process of what I do. I’m examining the way that we’re relating.

But from a standpoint of existential content, there may be many hours that go by without talking about any of the ultimate concerns. The process of what goes on between me and the patient is an existential view, meaning that I am a fellow traveler. I’m facing the same things. I have to be genuine. I have to be authentic. I’m not an authority figure. I’m simply taking this path along with you and it goes with every single hour that I see a patient. I don’t know if that answers your question, but that’s a difference that I make.

EDELSTEIN: Is being a fellow traveler separate from being a fellow sufferer?

YALOM: Schopenhauer says fellow sufferer. That’s putting it a little too darkly. Everyone suffers. Everyone has panics and anxiety, some more than others. Schopenhauer had it in spades.

EDELSTEIN: Is there a danger that you can lose your professional objectivity, if there is even such a thing, by identifying too much with your client as a fellow traveler?

YALOM: It’s never happened to me. I don’t quite know how that would happen. You do have to go inside yourself and reach the parts of yourself that are troubling the patient. You have to find that in yourself. For some therapists, it gets to be very anxiety provoking, which is why the therapist has to be in therapy and has to do as much work as he can with himself or herself. But no, it doesn’t cause me to lose my equilibrium at all. When I first started working with patients who were facing death it sure did. It got me very anxious. I went back into therapy for a long time because of that, even though I had a very long analysis during my training. Many years later, when I was working with a lot of cancer patients, I grew anxious once again, which led me to work on things in therapy that I’d never touched before.

EDELSTEIN: Do you look at clients as having resistances? If so, how do you therapeutically engage and work through client resistances?

YALOM: Oh, yes, all the time. I have a patient who is married to an alcoholic wife and I met with him several times before I even learned she was alcoholic. He has a lot of resistances to talking about that, because number one he is too ashamed that he has been in this relationship for so long. And number two, he’s afraid that if he talks about it that I might break up the marriage. So there is terrible resistance in that he is settling for a lesser state of being by staying in this relationship, feeling shamed all the time, not being able to talk about it to anyone, and feeling he is not fulfilling himself at all. That’s certainly the patient with whom I’m dealing with the most resistance right now. I have another patient who feels that he needs to be perfect and he thinks I’m constantly grading him on not doing this process correctly. He gets more and more uptight about being with me and he searches for ways to divert my attention. Resistances are a pleasure when you can move the client through them, and they’re not a pleasure when that is not happening quite as much.

EDELSTEIN: What do you see as your strengths and your vulnerabilities as an existential psychotherapist?

YALOM: Well, I think that I am a vastly better therapist than I was in the past. Now I feel like I can do things and talk about things I could not have done before. I have a very small practice, I’m just working quarter time. I see a smaller number of patients, so naturally I select my patients very carefully. I’m at the age where I want to work with people who are pretty well motivated. At my age, I think I would probably become very impatient with people who need to be taught the ABCs of how you relate, how you identify feelings, that kind of thing. So, I have to do some screening of patients, even on the phone before I see them in the first session. Also, at my age I’m not going to be undertaking therapy which I know is going to be five years in duration. I need to make sure that I can be useful to them in a relatively short period of time. I will generally say to patients when I see them that I am going to make a one year commitment to be with them and see what we can do in that one year.

EDELSTEIN: How do you feel about the state of existential psychotherapy and depth psychotherapy in terms of the political and cultural climate?

YALOM: Well, it’s ghastly. I’d rather speak of depth psychology because I don’t know where the enclave of existential psychotherapy is. I work very much in isolation, I don’t have a lot of contact with other therapists. This is the just the way I’ve always worked.

I’m appalled at what’s going on in the field. When I work with psychiatrists at Stanford, they are graduating with extremely little knowledge of psychotherapy. It’s really stunning to me. I can hardly do much with them if I see them in their last year and try to supervise them in some way. I ask them, “Why not ask patients this type of question or that question about their inner life.” Their answer stuns me: “We don’t know what to do with the answers when we get get them.” I’m getting equally concerned about the education of psychologists who are finishing up years of training and having nothing but a cognitive behavioral approach and they know very little about what it means to offer a deeper psychotherapy to patients.  That’s one of the motives for why I keep on working.

I feel group therapy is totally misused in the country today.  Managed care has finally understood that groups might actually save a little bit of money. But, they are rushing in and offering groups to everyone without any kind of preparation, and all of the groups are lecture groups or psycho-educational groups. So, I have been trying to demonstrate how therapy can be useful and show what you can do with it. That has been a big motivation in my work. In a sense the answer to your question is, I’m so concerned about it that I’m really writing far past the age I should be writing.

EDELSTEIN: I think depth psychotherapy is so needed because there is too often a lack of depth in our culture and our political climate generally.

YALOM: I agree entirely.

EDELSTEIN: In terms of group psychotherapy, existential psychotherapy, and psychotherapy-based literature, do you have a mentor in each of these categories? If so, how have they impacted you?

YALOM: I think we have a tendency, a wish, a need to have some wise person in our life. I feel sometimes we exaggerate how much we owe to our mentors. That’s backhand for my answer.

But I think I owe a lot to Jerry Frank, who was my teacher at John Hopkins.  He was the one who introduced me to group therapy. I learned a lot from Jerry. I knew him for the next 30 years; he died about two years ago, in his nineties. As for existential therapy, I think the person who really opened that possibility for me was Rollo May, when I was a student resident in Baltimore. I was very dissatisfied with both the analytic approach and the biological approach, which were the two wings of the Hopkin’s system. Rollo’s book, Existence, came out. It’s a very good book, at least his part of the book – the first three or four chapters, were eye-opening. That got me thinking, well there is another way. Here’s a way that somehow literature can come into play. So many philosophers have turned to writing fiction. I think at that point, in my second year at Hopkins, I really decided I better undertake an education in philosophy and started taking courses, which I continue to the present day. As for a mentor in fiction, nobody alive. Just writers. I’ve been a voracious reader of fiction ever since I can remember. I didn’t have any mentor or teacher in writing.

EDELSTEIN: I want to switch gears and ask you about your psychotherapy based literature, your novels. Are all the characters you, or some aspect of you? If so, how does it feel to expose yourself so deeply and vulnerably to your readers?

YALOM: At this time I don’t have a lot of concerns about exposing myself. I’m so old now that I’m not going to be meeting older therapists who are going to criticize me in some way. People treat me with a lot of respect.

In my early novels, for example Lying on the Couch, my wife thought I sometimes was showing too much of myself. But I have no concerns about it really. In novels, your characters do come from within. Lots of my characters have pieces of myself in them, and those are the characters that I think I write about most truly.

EDELSTEIN: Is it a reflection of your comfort with yourself?

YALOM: I think so. I have more comfort and more tranquility in my life now than I had when I was younger.

EDELSTEIN: In your novels it seems to me there’s an emphasis on addressing the value of both existential psychotherapy and group psychotherapy. For instance, in The Schopenhauer Cure, the book opens with a psychiatrist, Julius, finding out he is dying of cancer. A large part of the book describes the group psychotherapy process led by Julius. It powerfully impacts all members of the group – most dramatically, Phillip, a major character in the book. I’m curious about what you wanted to reveal about existential and group psychotherapy in this novel.

YALOM: I wanted to show how both approaches play out. So, I very deliberately decided to write a book on group therapy, because I was getting more and more appalled at the extremely inaccurate ways groups were depicted in our literature. They’re awful. Any of the groups in mass media and movies – they’re so terrible. The Bob Newhart Show was a total catastrophe. And there is one new one now, The Ted Danson Show. Maybe it’s good for entertainment, but they are a total distortion of what the group therapy process is. There was a book, The Group, published a few years ago that was a New York Times bestseller – but it was totally inaccurate. So I thought I would write a book that could convey to therapists and also to the general public how a group really does work. I also wanted to convey the power that gets generated in a hard-working therapy group. That’s why I started writing the group in The Schopenhauer Cure.

And then the other theme in that book was to take a look at the whole question of how you face mortality. I wondered what would happen to a therapist who decided that he really wanted to continue seeing patients as long as he could in some way enrich his work as a result of his facing death. There are some therapists who do this. I’ve known therapists who, as soon as they get a diagnosis, totally quit their practice. On the other hand, there are therapists who work right through it and deal with it with their patients, and maybe teach them a deeper lesson than they might have gotten anywhere else.

I had the psychiatrist, Julius, being helped by Nietzsche’s idea of the eternal return – how would he like to live this life if he had to live the same life that he’s living now throughout all eternity? How would he feel about that? I had Julius decide that he was comfortable with it. He thought he was living a good life, that he was spreading a lot of good, helping a lot of people, so he decided that he would spend his last year doing exactly what he had been doing.

Philip, the primary client character, is a clone of Schopenhauer. I constructed him deliberately to take on all the characteristics of Schopenhauer. Philip had done major bibliotherapy, where he had really assimilated Schopenhauer’s ideas. I wanted to get Phillip in a therapy group and I wanted to point out how he might have been affected by a powerful therapy group led by someone who he had come to respect. I wanted to point out that psychotherapy is more than ideas. Psychotherapy is the synergy of relationships plus ideas. So I wanted to have Philip be able to relate and have other people matter to him. The title, The Schopenhauer Cure, is a double entendre, a double meaning. It means Schopenhauer’s cure, but there is also a cure for Schopenhauer. Schopenhauer offers a cure, but also Schopenhauer, like Philip, needs a cure.

EDELSTEIN: I read The Schopenhauer Cure and was really touched by the transformation of Philip. I was so taken by his character that I cried. It was beautiful.

YALOM: Thank you. A lot of people told me that towards the very end, something in that last chapter, really moves them. I’m very glad about that. I don’t think there’s ever been a book which combines a novel and a psychological biography of a writer. I spent a lot of time doing research to get the psychobiography right. I think I’m contributing something on Schopenhauer. So, I’ve got two things – I’ve got a novel and a psychobiography.

EDELSTEIN: In reading both your nonfiction and your fiction, your combination of head and heart impresses me. You are very lucid and clear in your mind, and very heartfelt in your feelings and in the importance of relationships. In terms of head and heart, I’m wondering if you struggle more with one than the other and if you lead with one more than the other.

YALOM: I can’t answer that. I don’t really know if I struggle or lead with one more than the other. I try to combine them. I try to say, ‘Let’s figure this out’ but I’m also conveying an implicit, ‘Look, I’m with you and I’m going to be with you and I’m not going to abandon you and I’m going to stay with you until we work this out.’ I can’t really separate them.

EDELSTEIN: Your book Loves Executioner and Other Tales of Psychotherapy made the New York Times Bestseller list. I believe there have been very few case study books that have made it to this list – Oliver Sachs and yours are the only ones I know of. I’m curious about your thoughts as to why this case study book was so well received.

YALOM: I think they’re good stories. It also offers people – patients, would-be patients, and people who have been in therapy – an opportunity to eavesdrop into the process and see what it’s like. But maybe it is also because of my skills as a storyteller.  That’s my major talent. I recognize my limitations as a writer, but by and large I can tell a story.

EDELSTEIN: And also because of your own self-disclosing process?

YALOM: That’s right. I try to make myself the character. I am the same doctor in the stories so the stories are all interconnected. They’ve all got the same protagonist.

EDELSTEIN: What are the differences and similarities for you between writing fiction and nonfiction? What do you like or dislike about each of the genres?

YALOM: I think that I like writing fiction better. It really gives me free reign to work in that I don’t need to use any kind of outline. The books are extremely organic; I have no idea where the next chapter is going to go or can go. Some people write fiction and want to outline the whole book first. For me that would be a terrible mistake. It’s much fresher if I just let things develop. For example, I had no idea where the book, When Nietzsche Wept, was going to end.

There’s a movie of When Nietzsche Wept. I just saw it on DVD. It’s neat. It is a small budget movie, not in the theatres yet, but its being shown at Sundance and other festivals.

EDELSTEIN: Congratulations. In wrapping up, I want to ask you how would you like to be remembered by the world?

YALOM: I’ve been thinking about this in the book I’m writing. This may seem a little unbelievable, but it really doesn’t matter much to me. So maybe the next generation will know my name. So what? You know the following one won’t. To make that a major motif in your life, that doesn’t matter. I hope that the things I write about or do will influence some people, who will then influence others. I hope I have started some ripples that will be useful. I am writing a lot about the concept of rippling in this new book.

EDELSTEIN: Will you elaborate about rippling?

YALOM: It’s the idea that you’re passing on bits of yourself to others. Not necessarily your personal identity, but the acts you do, the acts of helping people explore themselves or acts of charity or virtue that get passed on from person to person. We all know that certain patients we treat are highly influential. For example, we treat school teachers who change something in school and then look what that can do for so many other generations.

EDELSTEIN: You say it doesn’t matter much how people remember you. It seems to me that would fit in with what you’ve been talking about – that the most important things are how you feel about your life and how you’re living it.

YALOM: Right. When you’re dead, you’re dead. I don’t know how other people will look at me or think about me in the future. It doesn’t matter. I just try to do the best I can and the thing that I feel best about myself is probably that I’m a writer, I’m a storyteller.

EDELSTEIN: Thank you very much for this interview.


(c) Bob Edelstein. This interview was published in the April/May 2007 edition of the AHP Perspective.