A Psychotherapist Returning from Vacation By Victor Yalom, PhD on 8/30/10 - 10:52 PM

It’s been twenty-plus years now of returning from some sort of summer vacation to resume seeing clients.  I wake up this morning, still unsettled from my dream life, reminded that my own anxiety, seemingly under wraps, is not too far from the surface. As I mentally ready myself to go back to work, images and memories seep in from prior years: early in my career nervously wondering whether any clients would return; other times eagerly anticipating seeing a specific client or two, looking forward to continuing our work; and now, a sinking feeling as I recall the years surrounding my divorce, wondering how I could possibly be useful when my whole world was a jumble.  In the San Francisco climate, where the summer fog is the strongest reminder of the changing seasons, August vacations serve as a marker of years passing.

My mind races back to my first clients: I was just starting out, not yet licensed, and had a small office at 20 Van Ness St., above Bull’s Restaurant.  The restaurant’s long gone, my office perhaps now occupied by a CPA or web designer, or vacant in this economy.  And my clients, where are they now?  How are they now?  Raza, or was it Rasha . . . a beautiful young Iranian woman telling me angrily yet excitedly that we had just launched Operation Desert Storm. This was pre-internet, and some information was still passed on via word of mouth.  Or Michael, still aching from his mother’s death, and trying to come to grips with being gay. I was pleased to discover that I could really empathize with his struggles, even though they were so foreign to my own. Or Joanne, whom I shepherded through memories of sexual abuse into a better relationship, and eventual marriage. When her memories first started emerging, we were both stung, confused, taken off guard.  But we both hung in there and plowed through somehow.  It was new territory for both of us, though I’m fairly certain she benefitted from our meetings. But how many of my clients did I really help?  The experience I brought to those sessions as a therapist and as a human being seems so limited as I look back now.  But perhaps that was partially compensated by my enthusiasm?  I would like to think so, to give myself the benefit of the doubt.

My dreamlife and the wisps of anxiety that remain if I allow myself to linger in bed suggest that I am still the same person as I was 20 years ago, and perhaps 20 years before that.  But I do know a few more things about myself, and about life, and that translates into being a better therapist….at least for most of my clients.  I know that significant change is really possible:  I’ve seen it; I’ve experienced it.  And yet I’m also humbled by the hardships that life can throw at us, that no amount of positive psychology or cognitive restructuring can easily neutralize.

This summer’s vacation has been broken into a few blocks.  This past weekend my wife and I had a quick getaway to the Delta region, just two hours away in current time, yet another world apart. We passed through “islands” surrounded by levees, pear orchards and vineyards below sea level, and the only surviving Chinese quasi-ghost town paying tribute to the first generation of farmers and miners who experienced hardships and loneliness unimaginable to most of the worried well of today.  No therapy couches to provide comfort; gambling parlors and liquor had to suffice as a distraction. 

But the morning’s coffee, nytimes.com, and the megabytes of emails provide a sharp transition back to life-as-usual.  Clients are calling.  Appointments need to be juggled. This is what I do.  I don’t grow pears, which in itself is no easy task, and subject to the uncertainties of nature . . . but hopefully I can help my clients grow.

File under: The Art of Psychotherapy, Musings and Reflections