Thursday, September 18, 2008

Irvin Yalom, Staring at the Sun (Review)

Irvin D. Yalom, Staring at the Sun: Overcoming the Terror of Death.
SanFrancisco: Jossey-Bass, 2007.

H. Talat Halman
Assistant Professor, Religion
Central Michigan University

Irvin Yalom, M.D. (Professor Emeritus of Psychiatry, Stanford University School of Medicine) has authored a dozen books, including the classic textbook Existential Psychotherapy. Yalom has also written the best-selling and widely-translated novel, When Nietzsche Wept (now a movie directed by Pinchas Perry, 2007, 105m, starring Ben Cross). Writing across genres, Yalom maintains a consistent clarity, warmth and compassion. In Staring at the Sun, Yalom presents an intimate memoir and manual for transitioning into death. Combining erudite insight with spell-binding storytelling, Yalom shows how he, his patients and others have transmuted their awareness of death into a vital force for fulfilling and consummating their lives. Yalom demonstrates how -- whether believer or atheist -- we can fulfill of our lives and leave traces of "immortality" – or “rippling” as he calls it – by how we positively affect others.

At the start Yalom introduces his distinctive aphorism, “Death anxiety is the mother of all religions.” (p.5) As the dynamic title of Yalom’s book suggests, he intends to engage us in a heart-to-heart talk about an ultimate human concern: “the wound of mortality.” We suffer over death and even more, the foreknowledge of its inevitability staring at us. Yalom guides us to creatively harvest the fruits of our foreknowledge of death: “Though the physicality of death destroys us, the idea of death can save us.” (p. 33) Yalom encourages us to consummate our lives (amor fati – love your fate, as he quotes Nietzsche) and avoid the regret of an unlived life. Presenting aphorisms from Epicurus, Nietzsche and himself – “mighty thoughts” as he calls them, --Yalom hopes these ideas will quell death’s terror. Consummation of our lives is vital, for as Yalom writes, “…[T]he more unlived your life, the greater your death anxiety. (p. 49)
Yalom invokes aphorisms from Nietzsche: “consummate your life,” “be who you are,” and “die at the right time,” and Zorba the Greek: “Leave death nothing but a burned out candle. (p. 50) These aphorisms and stories of his own clients serve as examples of how “staring into the face of death” can be transforming: “…[a] confrontation with death arouses anxiety but also has the potential of vastly enriching life.” (p. 75) Accepting the reality of transiency, Yalom refers to thinkers who have deeply explored the question of transiency, especially Stoics, Buddhists and Nietzsche (pp. 91-92).

In Staring At the Sun Yalom especially draws on his own personal and professional experience, the Stoics (Epicurus [especially his concept of ataraxia, tranquility], Cicero, Seneca, Zeno and Marcus Auralius). Because Yalom devotes much of the book to actual therapy sessions readers can vicariously experience the therapeutic encounter – or at least its ambiance.

In his first chapter, Yalom critiques Freud’s sexually-centered psychology and argues that death anxiety is our central and ubiquitous concern. In chapter two, Yalom shows us how to look behind our masks and recognize the undercurrent of death anxiety.

In chapter three, Yalom emphasizes that confronting death can lead to an awakening. Yalom discusses life-changes that arise after “awakening experiences” -- turning points such as the death of a relative or friend, school reunions, major illness, divorce, job loss, birthdays and anniversaries, and dreams. Yalom then encourages us to ground these otherwise potentially ephemeral awakenings into our being. One might acknowledge such moments of awakening, but, to provide lasting value and power, they must be rooted in our being.
In chapter four Yalom, introduces “mighty thoughts [that] can jolt [one] out of a familiar or static mode of being.” (p. 92) Yalom highlights Epicurus’s conclusion that philosophy’s role is to relieve human misery and the root cause of human misery is “our omnipresent fear of death.” (p. 77) He proceeds to expand on three of Epicurus’s ideas he has found powerful in therapy: (1) The mortality of the soul (i.e., the soul perishes); (2) The ultimate nothingness of death (i.e., death is unperceived); and, (3) the argument of symmetry (i.e., the afterlife parallels our pre-birth state.). An idea Yalom finds comforting is Epicurus’s idea of the “symmetry” of our non-being: “after death is the same state as we were in before our birth.” (p. 81)

An idea Yalom has found “singularly powerful” is “rippling,” a metaphor of ripples in a pond. Each of us exists in “concentric circles of influence” (p. 83) that affect people, even if the person who created the ripple never receives acclaim or acknowledgement. Rippling, Yalom writes, means “leaving behind something from your life experience; some trait; some piece of wisdom, guidance, virtue, comfort that passes on to others known and unknown.” (pp. 83-84) Introducing, Nietzsche’s idea of the “eternal recurrence,” Yalom offers another exercise in “existential shock therapy: a thought exercise of imagining living one’s life exactly the same way repeatedly and asking how that would change you or what changes you would make. In an everyday sense this exercise is designed to extricate regret over failing to “consummate your life.” As Yalom quotes Rank: “Some refuse the loan of life to avoid the debt of death.” (p. 109)
Finally, Yalom introduces Nietzsche’s two “granite” sentences: “Become who you are” (related to Nietzsche’s ideals of “Consummate your life” and “Die at the right time”) and “That which does not kill me makes me stronger” -- an aphorism in which Nietzsche alludes to the way that weathered trees grow deeper roots and rise in strength.) In discussing Otto Rank’s model of the tension between “life anxiety” (the loneliness and vulnerability of individuation) and “death anxiety” (taking refuge in merging and fusing with another), Yalom makes his one explicit reference to Becker. (pp. 110-111)

In chapter five, Yalom emphasizes that the “mighty thoughts” must be planted in the soil of our “intimate connection to others.” In distinguishing “everyday” and “existential” lonelinesses, Yalom explains that the first involves our fear of intimacy or feelings of rejection or shame, or being unlovable;” the second, arises from our unique world of experience: “each of us inhabits a world fully know only to ourselves.” Yalom writes that for some who ar4 experiencing death anxiety or fatal illness what one can most beneficially offer is the power of “sheer presence.” Narrating specific examples, Yalom demonstrates how we may learn to practice presence. Referring to the medieval play of Everyman, Yalom, replaces the play’s Christian moral that one can only take one’s Good Deeds on the journey to heaven, by offering his trope of “rippling” as a secular equivalent. Borrowing from Martin Seligman, Yalom suggests we undertake an exercise in gratitude as a way to experience completion and closure before death: write a letter of gratitude to someone and pay a “gratitude visit” to that person. One touching example Yalom recounts is that among various group therapy communities, terminal cancer patients welcome, rather than begrudge, observers, because they feel they have a gift to share in showing a way to die with dignity and grace.

In chapter six, building on the previous chapter’s “mighty thoughts,” Yalom discusses the power of personal connections, friendships, family, and relationships in mitigating fear and anxiety over death. As he summarizes, “it is the synergy of ‘ideas-plus-relationship’ that creates real therapeutic power.” (p. 204, author’s italics) Here Yalom provides an intimate memoir of his own struggles with death anxiety and recounts the experience of watching his father die. A telling clue about death anxiety appears in the detail that Yalom’s brother-in-law, a physician of 30 years, also present when Yalom’s father died, had never before witnessed a person die.

Yalom pays tribute to his mentors Jerome Frank, John Whitehorn, and Rollo May and shares his experiences of their deaths. However he psychoanalytically critiques people’s need for spiritual mentors as a “lust for submission.” Here Yalom echoes Becker, though Yalom seems less inclined than Becker to admit the constructive qualities of transference. Yalom acknowledges his respect for persons of faith, even as much as he makes clear that he himself does not share the need to hold onto such “railings” on the journey. Some of his most captivating story-telling involves the sessions with true believers. Why study death as Yalom does? Because, Yalom asserts, it makes us treasure and love life more.

Chapter seven features instruction to therapists, reviewing the problems and opportunities of such work, since most professional schools rarely provide training in an existential approach toward death-anxiety. Yalom encourages a more liberal attitude toward self-disclosure by therapists and emphasizes working in the “here-and-now in therapy” (p. 221ff.) to build a “positive therapeutic alliance (p. 229). Yalom’s underlying principle is that the therapeutic encounter stands as a microcosm of the patient’s world and relationships, and most importantly the here-and-now is a shared event, not merely the patient’s account of events the therapist has not also witnessed. Yalom’s discussion of ‘existential’ (and de-mystified) dream interpretation (p. 264) is refreshingly pragmatic.

A comforting warmth and generosity of spirit pervades Yalom's writing combining simplicity and elegance. Although Yalom writes from the viewpoint of an atheist, he affirms his respect for the faith of believers. The sacred undertone of Yalom’s dedication to "caring for the patient" (p. 192) involves too genuine a spiritual commitment to merely dismiss his perspective as literal atheism.
His synthesis of personal reflection, examples of people he counseled in therapy, mighty thoughts from Epicurus, Buddha and Nietzsche, and personal advice to therapists presents a model more than a method. Through this range of approaches and perspectives, Yalom avoids the symplegedies of simplistic answers and obtuse abstractions.

In relation to Becker's work, Yalom helps connects what Nietsche and Becker share in the
way that Becker did more explicitly with Kierkegaard. Yalom also offers a
succinct review of Ranks's ideas of life-anxiety and death-anxiety (Yalom pp,
110-111) where he cites Becker’s, Denial of Death (See the useful treatment of this topic in Dan
Liechty's Transference and Transcendence, p. 90-91)

Yalom presents a vision of heroism that resonates with Kierkegaard's call
to reach beyond the “philistinism”of mediocrity, and Nietzsche's call to
"consummate your life." In the same way that Becker illuminated Kierkegaard's thought,
Yalom has clarified some of Nietzsche's key ideas.

For some people this might be one of the most accessible non-theistic introductions to
work similar to Becker's. If one can call this an introduction to Ernest Becker's ideas, it is due to the
book's convergence with the Stoics, Existential Psychoanalysts, and his own personal synthesis and application of the ideas of many thinkers. Though Becker is only mentioned once (p. 111) anyone who has read Becker’s last two books, will feel the undercurrent in Yalom's

A more theistic and also friendly and clear introduction to applications of Becker’s thought to therapy, is Daniel Liechty's Transference and Transcendence. As a writer, not only does Yalom raise important questions and ideas, but he also writes with sensitivity, beauty and directness.