The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients

Yalom instructs therapists to carefully phrase their observations of their clients, making sure to be tactful and sensitive. Rather than labeling the patient’s behavior, he suggests that therapists can discuss how the behavior makes them feel. For example, rather than saying that a client is boring or difficult, a therapist can say that they feel shut out or disconnected.

Yalom recommends acknowledging incidents when patients become particularly emotional or vulnerable and soliciting their feelings about what happened. It is most useful to do this in retrospect. For instance, if a patient breaks down in tears during one session, they could be asked to reflect on it in the following session. Other incidents can arise in therapy, including errors or misunderstandings, and these are also “grist for the mill” or potentially useful opportunities for discussion (82).

Yalom argues that therapists should check in with their patients about their relationship during each session, even if it seems positive and productive. He advises therapists to frame their initial sessions as “two-way interviews” and encourage the patient to ask them questions, too. This tactic has helped him develop a trusting relationship with his patients, and it also normalizes giving and receiving feedback.