Irvin D. Yalom - Every Day Gets a Little Closer

IT IS TRUE that the literature of psychotherapy already numbers many works which recount the saga of recovery. Since the turn of the century, psychiatrists have increasingly elected to publish illustrative and exceptional case histories, and, not to be outdone, patients have increasingly presented their own retrospective versions. This book is unique in that it simultaneously traces the course of treatment from the vantage points of both patient and doctor, as they evolve a delicate and difficult relationship which has personal meaning for both of them.

The book is an outgrowth of an experiment undertaken by my husband, Dr. Irvin Yalom of Stanford University, and one of his patients, henceforth known as Ginny. In the fall of 1970 my husband decided that it would be inadvisable for Ginny to continue with him and a co-therapist in group therapy, since she had made virtually no progress in that format for a year and a half, and he suggested that they subsequently meet in individual therapy. Because Ginnys problems included that of a writers block (a serious complaint for an aspiring novelist), Dr. Yalom stipulated that she pay for treatment in the form of post-session reports, which would provide an obvious stimulus to her writing. At the same time Dr. Yalom decided that he too would prepare a separate account of their weekly meetings, with the understanding that he and Ginny would exchange these reports at six months intervals, in the hope of therapeutic benefit. For two years thereafter doctor and patient recorded his and her recollections of the hour they had shared together, frequently adding afterthoughts, interpretations, emotions and associations which hadnt been voiced during the session.

Although my husband almost never discusses his patients with me, I was privy to some of his reflections on Ginny as he considered this method of encouraging her writing. Since I am a professor of literature, he knew this project would be of real interest to me. I suggested that he carefully preserve both sets of reports until the end of therapy and then decide whether they merited a wider audience. Privately I wondered if the post-session reports might not constitute a publishable piece of literature, with two distinct characters and two recognizable literary styles, not unlike an epistolary novel.

It was, thus, with an especial interest that I read the manuscript for the first time two years later. My enthusiastic evaluation, and that of less biased judges, succeeded in persuading the authors to publish it. Although changes were necessary to conceal the identity of the patient and to adapt the doctors tapescripts for a reading public, the words are essentially those of the original texts. No supplemental thoughts or fictive events have been added to the symbiotic drama of psychotherapy. In the case of the doctors accounts, not one significant reflection has been added or omittedexcept for a few tapes which were, unfortunately, mislaid and lost for good. Aside from very minor stylistic corrections, Ginnys reports are virtually unaltered.

At the suggestion of several readers who found the manuscript difficult to approach without some explanatory material, and others who were eager to know what became of Ginny after therapy, Dr. Yalom and Ginny each wrote a Foreword and an Afterword composed a year and a half after their last therapeutic meeting together. These do add considerable information and clarification of both a personal and theoretical nature. Still, it is my belief that the central portion can be read like a novel, as the story of two human beings who met in the intimacy of the psychiatric tte--tte and now permit you to know them as they knew each other.

Marilyn Yalom
February 20, 1974