Existential Psychotherapy, Irvin D. Yalom

What’s the meaning of life? It’s one of the existential questions life sometimes throws our way. Psychotherapy doesn’t just help in dealing with the difficulties of life, but it can also help with the question of ‘why?’ – Why me? Why NOT me? 

Yalom is one of the more famous existential therapists out there. He is very good at making sense of the questions that living brings up in us. He organised the topics of existential therapy into the following four themes:

  1. Death and Limitations
  2. Freedom vs Responsibility
  3. Isolation vs Connection
  4. Meaning vs Meaninglessness

Meaning is our own creation

Irvin D. Yalom quote

Nothing in the world has significance except by virtue of one’s own creation. There are no rules, no ethical systems, no values; there is no external referent whatsoever; there is no grand design in the universe…

To experience existence in this manner is a dizzying sensation. Nothing is as it seemed. The very ground beneath one seems to open up. Indeed groundlessness is a commonly used term for a subjective experience of responsibility awareness.

Existential Psychotherapy, p. 221

Perhaps it should be a comfort: just when we feel that groundlessness most deeply, is when we are also most aware of our own responsibility in life. 

Responsibility and Determinism

(Existential Psychotherapy, p. 268) ‘Many therapists are professional advocates of responsibility but secretly, in their own hearts and in their own belief systems, are environmental determinists.’

In other words: even therapists who get payed to help people take responsibility for their lives often don’t believe we can… The cynic in me ads that these same therapists are in fact financially dependent on people NOT taking responsibility for their own lives. Or from a more friendly perspective: therapists get to see people who have experienced a lot of negative things in their life for which they were not responsible. And yet they have to learn to take responsibility for the rest of their lives lives. Facing up to all that people do to each other, is a bit depressing after all.

And in each case they have to try and help them take responsibility, yet they see examples of the opposite so often it’s hard to keep believing it’s possible to change. Especially since people who do change always get out of their lives.

This paradox is partly solved these days by therapeutic journeys usually having a fixed length these days: the client knows in advance that the therapy will end so they WILL have to take responsibility at some point.

What taking responsibility really means

Yalom quotes the ancient philosopher Epictetus who said: (Existential Psychotherapy, p. 272)

I must die. I must be imprisoned. I must suffer exile. But must I die groaning? Must I whine as well? Can anyone hinder me from going into exile with a smile? The master threatens to chain me: what say you? Chain me? My leg you will chain – yes, but not my will – no, not even Zeus can conquer that.

Yalom adds: “One’s attitude towards one’s situation is the very crux of being human.” (Existential Psychotherapy, p. 272)

And that’s as good a way to close this review as any. 

  • 51V9Ibf1+NL._SY344_BO1,204,203,200_Existential Psychotherapy
  • Irvin D. Yalom, M.D.
  • Hardcover: 544 pages
  • Publisher: Basic Books; 1 edition (December 8, 1980)
  • Language: English
  • ISBN-10: 0465021476
  • ISBN-13: 978-0465021475
  • Product Dimensions: 6.2 x 1.7 x 9.7 inches


This is dedicated to my mom. She’s a humanistic psychotherapist and Irvin D. Yalom is one of her heroes. The smile on her face when I picked out this book from the bookcase is one I’m sure I’ll never forget…I’m afraid some part of her is partly hoping I’ll be converted or something.

Well, in a way I am. I do think Yalom is a genius who portrays the human condition with an expert touch.

A reader…

I read this book in grad school. They assigned us a book by him on group psychotherapy, which I loved so much that I found his other books and this was wonderful. He also did a book with a patient where they both wrote, separately about what they thought was going on in the treatment.


I first wrote this review in 2012. Slightly adapted for republication on this site in 2016. 

More psychology and neurology book recommendations.

Posted on Categories Books, Smart People