Hour of the Heart

Irvin Yalom is well into his nineties, still writing and until relatively recently, still practising as a therapist. Hour of the Heart was published in 2024 with the assistance of his son Ben, who has a background in theatre but has now also trained as a therapist. Hour of the Heart was written after the death of Irvin's beloved wife Marilyn; he realised that with his unreliable memory and lowered energy levels, it was no longer possible for him to offer long term therapy to patients, but instead decided to try single sessions with a new client each day, often over Zoom. 

Hour of the Heart presents a score of stories from these sessions, which involved clients from all over the world (interestingly, there were a few from Melbourne, perhaps reflecting the high anxiety and distress caused by prolonged Covid lockdowns here). Yalom is upfront about the limitations of offering a single therapeutic session, just one hour, but he also recognises that with his vast experience and established authority, he can cut through more quickly than other therapists might. Sometimes this backfires, as patients are over-awed by his reputation or project father difficulties onto Irv and become tongue-tied, but Yalom finds some tricks to accelerate insights -- he reveals more of his weaknesses and fears to establish a quick rapport, and he turns the tables and invites clients to ask him questions. This techniques can produce some surprising results.

But finally, sadly, Dr Irv finds himself in a confronting conversation with a doctor who has begun to suffer the effects of dementia. To his horror, when he comes to write up the session, Yalom finds he has completely blanked out what they said to each other, perhaps because this subject matter brushed so close to his own anxieties about getting old and becoming incompetent. According to son Ben, this was the last session Yalom ever held with a patient. It's a sad ending to an extraordinary and generous career, but Hour of the Heart is also a wonderful testament to Yalom's willingness to keep learning and experimenting for as long as he possibly could (and apparently yet another book is in the works, this time the final, final work).