Introduction
In this analysis, one will delve into the excerpts from the thought-provoking book Every Day Gets a Little Closer: A Twice-Told Therapy and examine their connection to psychological theories and approaches. The case of Ginny Elkin and her therapy with Dr. Irvin Yalom presents a compelling exploration of therapeutic dynamics. However, Yalom’s unorthodox and sometimes unprofessional approach raises concerns about therapeutic boundaries. Examining this case prompts a reevaluation of ethical principles and the centrality of professional boundaries.
Excerpt Summary
In the excerpts, the readers are introduced to Ginny Elkin. She is a young woman suffering from writer’s block who seeks therapy with Dr. Irvin Yalom (Yalom & Etkin, 1974). Timid and self-deprecating, Ginny exhibits nightmares and blurred ego boundaries (Yalom & Etkin, 1974). She also has panic episodes, dissociative tendencies, and social anxiety. Yalom provides her with free individual counseling, on the condition that she submit a report after each session. Yalom sees the reports as a tool to access the unsaid sentiments and thoughts that surface during treatment.
Throughout the excerpts, Yalom and Ginny have unorthodox treatment sessions. For instance, he provides her with techniques for orgasming with her lover and advice on masturbation and sexual encounters (Yalom & Etkin, 1974). Ginny believes Yalom is trying to win her over, since she is aware of his attraction to her.
As their therapy progresses, it becomes more challenging for Ginny and Yalom to form a therapeutic bond. Ginny does not turn in a report for one session, which is stressful for both (Yalom & Etkin, 1974). Ginny has mixed thoughts about Yalom’s approach, but still thinks their therapy is helpful.
Discussion of Readings
Yalom’s treatment approach might be characterized as an eclectic amalgam of techniques drawn from numerous therapeutic modalities. Although cognitive-behavioral therapy is not explicitly mentioned, Yalom’s emphasis on recognizing and addressing unhelpful behavioral patterns is consistent with the fundamental ideas of the method as described by Calkins et al. (2016). Yalom’s open interventions can be seen as attempts to modify Ginny’s dysfunctional beliefs and behaviors.
In addition, positive psychology is another method to note. According to Wallis (2005), positive psychology examines the unique qualities and abilities of the individual. Yalom, recognizing Ginny’s gift as a writer, incorporates her passion into the therapeutic process. As such, Ginny can explore her creativity and overcome writer’s block. This way, Yalom consistently promotes constructive interventions that may increase Ginny’s happiness.
The demand for written reports facilitated introspection and self-reflection, much as the process of transference and the examination of dreams and associations do in traditional psychoanalysis. According to Luborsky et al. (2008), dream analysis, a core psychoanalytic approach, aims to reveal unconscious desires, conflicts, and thoughts that shape a person’s behavior. In one of the sessions, Yalom explores Ginny’s dream in which she saw a “silver-cigar penis” (Yalom & Etkin, 1974, p. 17). Nevertheless, Yalom does not go into great depth about Ginny’s early life, nor does he attempt to uncover any information about her youth. Contrarily, Yalom’s conviction that the consultation room is the most effective place for therapy can be considered a departure from standard psychoanalytic practice.
Despite the benefits of therapy, one could argue that Yalom and Ginny do not have an effective therapeutic relationship. Trust, empathy, and collaboration between the therapist and the client are qualities of an effective therapeutic relationship in which clients feel free to explore their thoughts and emotions (Hackney & Cormier, 1996). In particular, the power dynamic between Ginny and Yalom hinders the therapeutic relationship’s efficacy.
Yalom admits he was taken with Ginny and found her cute and charming (Yalom & Etkin, 1974). The attraction introduces a potential bias and agenda into the therapy partnership, as does Yalom’s determination to save Ginny, despite other specialists’ failures. This power dynamic could jeopardize the required equality and trust.
Finally, in analyzing the case, it is crucial to consider the ethical principles of autonomy, beneficence, nonmaleficence, justice, fidelity, and veracity. Hill (2009) states that autonomy is the fundamental principle, upholding a person’s freedom to choose their course of action in medical care. Ginny had some control over her therapy, taking an active role and making choices such as joining group therapy (Yalom & Etkin, 1974). However, there have been times when Ginny’s independence may have been in jeopardy. Even though Ginny might have sometimes encouraged provocative conversations, questions remain concerning the therapeutic relationship’s limits.
Future Implications
I cannot avoid facing the significant implications of Ginny’s therapy with Yalom. While reading, I struggled with the ethical conundrums and complexity that emerged, forcing me to reconsider my position as a helper and the obligations that come with it. The excerpts demonstrate the importance of professional boundaries when dealing with people seeking assistance.
Yalom’s method disparages the distinction between a therapist and a confidant. In my future practice, I must be aware of the potential risks associated with crossing boundaries to protect the integrity of the therapeutic relationship. The delicate power dynamics that support the helper-helped dynamic can be quickly undermined, requiring clear expectations and the utmost caution to safeguard the well-being of those receiving therapy.
Conclusion
Analyzing the excerpts from Every Day Gets a Little Closer provides a critical examination of the practice of therapy and the obligations of helpers. The account serves as a reminder of the value of upholding professional boundaries and vigilantly protecting the confidentiality of the therapeutic alliance. Yalom’s approach poses moral questions and jeopardizes the delicate power dynamics that support the therapeutic relationship. This new knowledge has shaped how I assist others and strengthened my commitment to continually improving my skills as a helper.
References
Calkins, A. W., Park, J. M., Wilhelm, S., & Sprich, S. (2016). Basic principles and practice of cognitive behavioraltherapy. In T. J. Petersen, S. E. Sprich, & S. Wilhelm(Eds.), The Massachusetts general hospital handbook of cognitive behavioral therapy (pp. 5–14). Springer.
Hackney, H., & Cormier, L. S. (1996). The professional counselor: A process guide to helping (3rd ed.). Allyn & Bacon.
Hill, C. E. (2009). Helping skills: Facilitating, exploration, insight, and action (3rd ed.). American Psychological Association.
Luborsky, E., O’Reilly-Landry, M., & Arlow, J. A. (2008). Psychoanalysis. In R. J. Corsini, & D. Wedding (Eds.), Current psychotherapies (pp. 46-47). Cengage.
Wallis, C. (2005). The new science of happiness. Time.
Yalom, I. D., & Etkin, G. (1974). Every day gets a little closer: A twice-told therapy. Basic Books.