In Therapy

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Yalom On the Here-and-Now

Here-and-now, where and when?

Perhaps the most powerful yet simple tool in psychotherapy is the here-and-now: sharing the raw, honest thoughts and feelings about what's happening in the moment. The concept has been around forever, but no one champions its clinical use quite like Irvin Yalom.

I was honored to sit down with Dr. Yalom for an hour to discuss life, death, therapy and his book Staring at the Sun. The therapy segment of the interview was included in the Seven Questions Project, where I asked prominent authors, theorists and policymakers their thoughts on psychotherapy. The life and death portion was published this month in the Psychotherapy Networker Magazine (online article here). What I have for you today is the special bonus footage.

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Here-and-now is based on the idea that the client's interpersonal issues will eventually emerge in the therapeutic relationship. A woman who feels betrayed by all her friends and family will probably feel betrayed by her therapist at some time. A man with anger issues will eventually feel angry in therapy. Addressing the material that emerges in the room becomes the focus. Therapy becomes less talking about issues and more working with them as they happen, in the here-and-now.

Yalom encourages therapists and patients alike to take the vulnerable risk of discussing what's happening in the moment, a noticeable shift that often bears fruit. But, as you'll see below, here-and-now is not exclusive to the therapy office:

RH: I supervise young clinicians and share with them your ideas of the "here-and-now" from the Gift of Therapy, and it's also a central message in Staring at the Sun. Does this also apply to public speaking: the best speaking comes from being present in the moment?

IY: Absolutely. I gave a talk in China following the [2008 Sichuan] earthquake, and I didn't like it very much. I thought we were very distant from each other. I was trying to talk a little bit about the here-and-now, but they started off asking me questions like, "Will you please teach us how to run groups for all these earthquake victims we have?" There were a couple questions like that, and I frankly didn't have a lot to offer them. I haven't done a group for trauma victims before or anything like that. As I was talking about the here-and-now someone popped up - the Chinese are quite wonderful about this more than many countries, really - "Well, what is the experience for you like here-and-now?" I just love that question. So I said, "Why, I'm feeling a little troubled now. I'm feeling you all have great needs and I'm not offering you very much about these earthquake victims, I'm feeling a little unhappy about that, I wish there were more I could say." I was saying things like that and it just changed the whole talk, it got so much more lively with people jumping in with questions and we had a great discussion. I could have paid that person who asked that question.

RH: So how are you here-and-now?

IY: Right here today?

RH: Yeah.

IY: Yeah, well so far I think this is going pretty good. I'm enjoying it. When you first started to say "Well, we're going to talk about this book" I had a certain sort of a groan in me, I feel like I've talked about it so much, you know. Every author does, this is not idiosyncratic by any means. You send out this little baby into the world and you've got to nurture it, help it swim and that sort of thing, so I know I have to do that with this book.

RH: Of course, I really appreciate that. Sure, you've talked about it a lot, you hear a lot of the same questions. I can understand that groan.

IY: Well, you're doing well. You're asking me unusual questions which is just fine...

 

For more unusual questions with Yalom, take a look at his responses to the Seven Questions or the Psychotherapy Networker interview Embracing Life, Facing Death.

 

Ryan Howes, Ph.D., is a clinical psychologist, writer, musician and professor at Fuller Graduate School of Psychology in Pasadena, California.

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