In the book “Love’s executioner and other tales of psychotherapy”, Irvin compiles ten of his documented cases with approval from his patients and changes names of the patients for confidentiality purposes. He writes about various patient’s problems, such as obesity, dealing with grief, low self-esteem, loneliness, the trauma of being looked down upon, fear of death and of being by oneself and various issues regarding cancer, especially the fear of being susceptible. In Chapter three Yalom takes a case presented in an easily readable form and relates the problem that led the patient to seek his help. He chronicles his methods, why he used the methods and relationship between a client and a therapist. On the front cover of the book, there is a small notation beneath the title that reads: “for anyone who has been on the other side of the couch”. Dr. Yalom stresses that it is not the Psychiatrist’s job to make the patient better but rather the patient himself.
Brief summary and critical assessment
Yalom chose to present some of his extraordinary cases in this book. Chapter three is about a fat lady who is struggling with obesity and other related issues such as death, low self esteem and self control.
In the third chapter Yalom majorly focuses on freedom. The chapter is entitled “Fat Lady”. The patient, Betty, had gone to seek help from Yalom about her eating disorder. She is almost 250 pounds, 5 foot and 2 inches. The reader may find this case study as a typical case of a depressed, lonely and obese woman.
The issue that makes the case a little bit different is the way Dr. Yalom says how he is disgusted by the patient as she walks in to the room, he says that he is repelled by fat ladies. In this chapter we base our study by looking how Betty who is a fat lady feel so depressed with the kind of life she is going through in terms of health matters. The chapter takes a different turn when it reveals the true feelings, frank opinions and thoughts of the therapist, Dr. Yalom. Yalom not only shows us that what he believes is that therapy is a mutual learning process of both the client and the therapist himself but also feelings and issues of all humans, including those of therapists. In this case we learn that Dr.Yalom in many cases in his career, he handles wider number of issues that affect human being. Yalom is a bit discriminative and profiling in this chapter as he finds himself repelled and disgusted with the sight of fat and big women, a rather questionable feeling for a therapist.
He goes ahead and comforts himself that these are “sorry” feelings but does not stop at that, he goes ahead to write hateful words and feelings of how he would tell a fat woman to stop stuffing herself. The fat woman has found it hard to reduce her weight since in the process of reducing the weight he has faced many challenges that makes her feel like dead is not far away. The patient, Betty, had been overweight her whole life. Indeed she has tried to shade off and reduce some weight, but her efforts are always cut short by pain which is revealed in her body. This experience then brings fear, that fear that she witnessed when her father died due to cancer, the fear of death. She feels that the only good idea is to find some health solutions from Dr.Yalom about the status of her health,(Yalom, 2011).
Betty is scared of losing weight because she is scared of being exposed to cancer and that will be the beginning of a traumatizing path. She tries to get answers from Dr. Yalom as she asks him how one knows that death is around the corner. The patient tells the doctor that she had just been binged before coming to see him and will do so again after leaving his office; the client gives up her freedom and wants the doctor to assume control over her. Yalom uses a powerful technique that allowed the patient to see how she creates her own problems.
In this chapter, the reader has to be skeptical in order to get sides, the psychiatrist- narrator’s side as well as the patient’s side. It is interesting as it is reflected how Dr. Yalom overcame his biasness when dealing with the patient. The chapter contains a self congratulatory sub text paving its way throughout the chapter. It examines more extensively the female body frame, it also questions whether the psychiatrist overcame is biasness and his ethical position towards treating a patient he did not like at first sight by overcoming his biasness and treating the patient with utter respect just like any other patient he saw.
Dr. Yalom uses an existential approach when treating Betty, by doing so he penetrates and are assesses the anxiety that is brought by the fear the patient has regarding death. He circumvents her fears and forces her to face them. He goes ahead to make her realize that in this life we have freedom to choose how we live and it’s upon the us to decide how to live our own life. Through this, Betty is faced with a predicament of having to be responsible and take charge of her life and being in control always. Dr. Yalom makes the patient aware of the responsibilities that befall her I her everyday life to take care of herself. He goes ahead to make Betty come to terms with her fears of failure as she fears she might not lose as much weight if she tried.
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Through this existential approach, he is able to make the patient overcome her fears and strive to be a healthy human being.
He narrates how the patient became engrossed in therapy that she never wanted to miss any session and if she did, she felt bad. Here, we see how doctor patient relationship develops gradually and eventually it becomes part and parcel of one’s life. Dr. Yalom also demonstrates how therapy does not just end the moment the therapy sessions are over but rather creates a continuous process that must be adhered to so as to ensure full recovery and healing of the patient.
The chapter reveals that the doctor has his failures too as he stresses his personal feelings that others may find very insulting the chapter also lets the reader see that Dr. Yalom is also human and acts like any other person in the way he responded to Betty at first site. He reveals that just like any other human, he himself has psychological issues from controlling fat women in his own family hence his prejudice. At the end of the chapter however, the two get closer and develop a strong patient and doctor relationship.
Freedom and responsibility of Dr. Yalom
In administering help to Betty, the patient, Dr. Yalom centers around four givens: death is inevitable. At this point Dr. Yalom was putting across very important information that in life, one cannot predict his or her death since dying is inevitable. Another issue that Dr. Yalom makes it clear to Betty is about freedom. He enables her to realize the importance of freedom in her daily life and furthermore explains that the same freedom she enjoys sometimes it may lead to suffering if we give other people to take control of our freedom. In his discussion with the patient, he distinguishes the difference between freedom and responsibility.
He uses these techniques to suggest to her that one cannot live without these two concepts in life. By referring to responsibility he explains the importance of being responsible with the amount of freedom one is given for a better future.
Finally he suggests that there is need for freedom and responsibility in order to be in charge of our own lives. Loneliness and absence of meaning in life comes with the inability to identify the kind of freedom one uses and the responsibility one takes in their life. Using these four givens, he helps Betty to come to terms with her problems and move forward to a more productive life and to be in charge of her own life, (Loise. W. 2010).
Through his approach, Dr. Yalom manages to overcome his biasness against “fat” ladies and how gets disgusted by them into treating this patient with care and diligence. He manages to help the patient to see the other side of the coin in dealing with her father’s death to managing and controlling her eating disorder and finally manages to lose 100 pounds. It is a success story in the making as the therapy helps both the patient and Doctor in dealing with their prevailing issues.