Becoming Myself: A Psychiatrist’s Memoir

Becoming Myself: A Psychiatrist’s Memoir

by Irvin Yalom
After decades of writing about his patients' lives as they journey with him through therapy, Irvin Yalom finally puts himself on the couch in this touching memoir—his final book. 
Filed Under: Irvin Yalom


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Editor's Note: The following is excerpted from Becoming Myself: A Psychiatrist's Memoir by Irvin Yalom. Published by Basic Books © 2017. Reprinted by permission of the publisher.

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.”

"Think about what you just said to my daughter and tell me one thing: How did that make Alice feel?”
“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 Three, I want Her Gone

I have a patient, Rose, who lately had been talking mostly about her relationship with her adolescent daughter, her only child. Rose was close to giving up on her daughter, who had enthusiasm only for alcohol, sex, and the company of other dissipated teenagers.

In the past Rose had explored her own failings as a mother and wife, her many infidelities, her abandoning the family several years ago for another man and then returning a couple of years later when the affair had run its course. Rose had been a heavy smoker and had developed crippling advanced emphysema, but, even so, she had for the past several years tried hard to atone for her behavior and devoted herself anew to her daughter. Yet nothing worked. I strongly advocated family therapy, but the daughter refused, and now Rose had reached her breaking point: every coughing fit and every visit to her pulmonary doctor reminded her that her days were limited. She wanted only relief: “I want her gone,” she told me. She was counting the days until her daughter would graduate from high school and leave home—for college, a job, anything. She no longer cared which path her daughter would take. Over and again she whispered to herself and to me: “I want her gone.”

My relationship with my mother was an open sore all my life, and yet, paradoxically, it is her image that passes through my mind almost every day.
I do all I can in my practice to bring families together, to heal rifts between siblings and between children and parents. But I had grown fatigued in my work with Rose and lost all hope for this family. In past sessions I had tried to anticipate her future if she cut her daughter off. Would she not feel guilty and lonely? But that was all to no avail, and now time was running out: I knew that Rose did not have long to live. After referring her daughter to an excellent therapist, I now attended only to Rose and felt entirely on her side. More than once she said, “Three more months till she graduates from high school. And then she is out. I want her gone. I want her gone.” I began to hope she would get her wish.

As I took my bicycle ride later that day, I silently repeated Rose’s words—“I want her gone. I want her gone”—and before long I was thinking of my mother, seeing the world through her eyes, perhaps for the very first time. I imagined her thinking and saying similar words about me. And now that I thought about it, I recalled no maternal dirges when I finally and permanently left home for medical school in Boston. I recalled the farewell scene: my mother on the front step of the house waving goodbye as I drove away in my fully packed Chevrolet, and then, when I vanished from view, stepping inside. I imagine her closing the front door and exhaling deeply. Then, two or three minutes later, she stands erect, smiles broadly, and invites my father to join her in a jubilant “Hava Nagila” dance.

Yes, my mother had good reason to feel relieved when I, at twenty-two, left home for good. I was a disturber of the peace. She never had a positive word for me, and I returned the favor. As I coast down a long hill on my bicycle, my mind drifts back to the night when I was fourteen and my father, then age forty-six, awoke in the night with severe chest pain. In those days, doctors made home visits, and my mother quickly called our family doctor, Dr. Manchester. In the quiet of the night, we three—my father, my mother, and I—waited anxiously for the doctor to arrive. (My sister, Jean, seven years older, had already left home for college.)

Whenever my mother was distraught, she reverted to primitive thinking: if something bad happened, there must be someone to blame. And that someone was me. More than once that evening, as my father writhed with pain, she screamed at me, “You—you killed him!” She let me know that my unruliness, my disrespect, my disruption of the household—all of this—had done him in.

Years later, when on the analytic couch, my description of this event resulted in a rare, momentary outburst of tenderness from Olive Smith, my ultraorthodox psychoanalyst. She clucked her tongue, tsk, tsk, leaned toward me, and said, “How awful. How terrible that must have been for you.” She was a rigid training analyst in a rigid institute that valued interpretation as the singular effective action of the analyst. Of her thoughtful, dense, and carefully worded interpretations, I remember not a one. But her reaching out to me at that time, in that warm manner—that I cherish even now, almost sixty years later.

“You killed him, you killed him.” I can still hear my mother’s shrill voice. I remember cowering, paralyzed with fear and with fury. I wanted to scream back, “He’s not dead! Shut up, you idiot.” She kept wiping my father’s brow and kissing his head as I sat on the floor curled up in a corner until, finally, finally, about 3 a.m., I heard Dr. Manchester’s big Buick crunching the autumn leaves in the street and I flew downstairs, three steps at a time, to open the door. I liked Dr. Manchester very much, and the familiar sight of his large round smiling face dissolved my panic. He put his hand on my head, tousled my hair, reassured my mother, gave my father an injection (probably morphine), held his stethoscope to my father’s chest, and then let me listen as he said, “See, Sonny, it’s ticking away, strong and regular as a clock. Not to worry. He’s going to be all right.”

That night I witnessed my father drawing close to death, felt, as never before, my mother’s volcanic rage, and made a self-protective decision to shut the door on her. I had to get out of this family. For the next two to three years I barely spoke to her—we lived like strangers in the same house. And, most of all, I recall my deep, expansive relief at Dr. Manchester’s entrance into our home. No one had ever given me such a gift. Then and there I decided to be like him. I would be a doctor and pass on to others the comfort he had offered me.

My father gradually recovered, and though he had chest pain thereafter with almost any exertion, even walking a single block, and immediately reached for his nitroglycerin and swallowed a tablet, he lived another twenty-three years. My father was a gentle, generous man whose only fault, I believed, was his lack of courage in standing up to my mother. My relationship with my mother was an open sore all my life, and yet, paradoxically, it is her image that passes through my mind almost every day. I see her face: she is never at peace, never smiling, never happy. She was an intelligent woman, and though she worked hard every day of her life, she was entirely unfulfilled and rarely uttered a pleasant, positive thought. But today, on my bicycle rides, I think about her in a different way: I think of how little pleasure I must have given her while we lived together. I am grateful I became a kinder son in later years.

Excerpted from Becoming Myself: A Psychiatrist's Memoir by Irvin D. Yalom © 2017. Available from Basic Books, an imprint of Perseus Books, a division of PBG Publishing, LLC, a subsidiary of Hachette Book Group, Inc.
Irvin Yalom Psychiatrist and author Irvin Yalom, MD has been a major figure in the field of psychotherapy since he first wrote The Theory and Practice of Group Psychotherapy in 1970 (now in it's 5th edition). Other significant contributions have included Existential Psychotherapy, and NY Times Bestseller Loves Executioner and Other Tales of Psychotherapy. He has written four novels on psychotherapy: When Nietzsche Wept, Lying on the Couch, The Schopenhauer Cure, and The Spinoza Problem.  His works, translated into over 20 languages, have been widely read by therapists and non-therapists alike. Visit Dr. Yalom's website.

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