Jarod entered my office and trudged straight to his chair without greeting me. I braced myself.

While staring out the window at strands of fleecy wisteria, he said, ‘Irv, I have a confession to make.’ He hesitated and then suddenly turned to face me directly to say, ‘This woman, Alicia... you remember my talking about her?’

‘Alicia? We’ve spoken a great deal about Marie, of course, but no, I don’t remember Alicia. Refresh my memory.’

‘Well, there is this other woman, Alicia, and the thing is... uh... Alicia also thinks I’m going to marry her.’

‘Whoa, I’m lost. Jarod, back up, and fill me in.’

‘Well, yesterday afternoon, when Marie and I met for our couples therapy session with your Patricia, the shit hit the fan. Marie began by opening her bag, pulling out a sheaf – a very large sheaf – of emails, highly incriminating emails, in which Alicia and I discussed marriage. So I decided I’d better fess up here today. I’d rather you hear this from me than from Patricia. Unless you’ve already talked to her.’

I was stunned. In the year I had been meeting with Jarod, a 32-year-old dermatologist, we had been focusing heavily on his relationship with Marie, his live-in partner for the last nine months. Though he claimed to love Marie, he balked at commitment. ‘Why should I,’ he said more than once, ‘offer up my one and only life?’

Up to now I had been under the impression that therapy was proceeding slowly but steadily. Jarod had been a philosophy major in college and had originally sought me out because he had read some of my philosophical novels and felt certain I would be the right therapist for him. In the first months of our work together he often resisted therapy through attempts to engage me in abstract philosophical discussions. However, in recent weeks, I saw less of that, and he seemed to have grown more serious and shared more and more of his inner self. Even so, Jarod’s most pressing issue, his problematic relationship with Marie, remained unchanged. Knowing that it was futile to attempt couples work in an individual therapy setting, I had suggested a few weeks earlier that he and Marie see an excellent couples therapist, Dr Patricia Johnson, whom today, out of the blue, he referred to as ‘my Patricia’.

How to respond to Jarod’s confession? Several directions beckoned: his crisis with Marie, his having led two women to believe he would marry them, his reaction to Marie’s breaking into his email account, or his comment about ‘my Patricia’ and the fantasies that underlay that. But all these things would have to wait a bit. I considered that my primary task just then was to attend to our therapeutic relationship. That always takes precedence.

‘Jarod, let’s go back and explore your very first comment: your statement about needing to make a confession. Obviously you’ve withheld some important things from our work, things that you speak of today only because you believe I’ll hear about them from Patricia. From “my Patricia”.’

Dammit, I shouldn’t have added that last bit. I knew it would divert us, but it just popped out.

‘Right, sorry about that Patricia crack. I don’t know where it came from.’

‘Any hunches?’

‘Not sure. I think it’s just that you seemed so keen on her and so effusive in your praise of her ability. Plus she is drop-dead gorgeous.’

‘And so you thought there was something going on between Patricia and me?’

‘Well, not really. I mean, for one thing, there is a big age difference. You said she was a student of yours about 30 years ago. I did some internet research and learned she’s married to a psychiatrist, another ex-student of yours... so... I mean... uh... tell you the truth, Irv, I don’t know why I said that.’

‘Perhaps you may have wished it, wished that you and I were in collusion, that I, like you, was engaged in a problematic affair?’



‘Preposterous but...’ Jarod nodded to himself a few times. ‘Preposterous, but probably true. I admit that when I walked in today, I felt exposed and alone, flapping in the breeze.’

‘So you wanted company? Wanted us to be co-conspirators?’

‘I guess so. Makes sense. That is, it makes sense if you’re psychotic. God, this is embarrassing. I feel like I’m about 10 years old.’

‘I know this is uncomfortable, Jarod, but try to stay with it. I’m struck by your word “confession”. What does it say about you and me?’

‘Well, it says something about guilt. About something I’ve done that I hate to admit. I avoid telling you anything that would tarnish your view of me. I have a lot of respect for you... you know that... and I very much want you to continue to have a certain... uh... a certain image of me.’

‘What kind of image? What do you want Irv Yalom to think about Jarod Halsey? Take a moment and conjure up a scene in which I am attentive to your image.’

‘What? I can’t.’ Jarod grimaced and shook his head as though to rid himself of a bad taste. ‘And anyway what are we doing now? This all seems off the mark. Why aren’t we talking about the important stuff – my tight spot with Alicia and Marie?’

‘That, too. Shortly. But humor me for a moment. Continue with our discussion of my image of you.’

‘Boy, I can really feel my unwillingness. This what you call “resistance”?’

‘In spades. I know this feels risky, but do you remember my telling you at our first meeting that it was important to take a risk each session? Now’s the time! Try to risk it.’

Jarod closed his eyes and turned his face toward the ceiling. ‘Okay, here goes... I see you in this office sitting there,’ he turned and, with eyes still shut, pointed in the direction of my desk at the opposite end of my office. ‘You’re busy writing, and for some reason my image drifts into your mind. This what you mean?’

‘Exactly. Don’t stop.’

‘You close your eyes; you see my face in your mind and take a good long look at it.’

‘Good. Keep going. And now imagine my thoughts as I look at your face.’

‘You think, Ah, there’s Jarod. I see him...’ He seemed more relaxed as he sank into the fantasy task. ‘Yes, that Jarod, what a fine fellow. So smart, so knowledgeable. A young man of unlimited promise. And so deep, so philosophically inclined.’

‘Keep going. What else am I thinking?’

‘You’re thinking, What character he has, what integrity... One of the best and brightest men I’ve ever seen... a man to be remembered. That kind of stuff.’

‘Say more about how important it is that I have this image of you.’

‘Of paramount importance.’

‘It seems like it’s more important for me to have this image of you than for me to help you change, which, after all, is the purpose of your consulting with me.’

Jarod shook his head, resigned. ‘After what’s gone down today, it’s damned hard to refute that.’

‘Yes, if you withhold crucial information from me, like your relationship to Alicia, it must be so.’

‘Point taken. Believe me, the absurdity of my position is all too evident.’

Jarod slumped in his chair, and we sat briefly in silence.

‘Share what’s passing through your mind.’

‘Shame. Mainly shame. I was ashamed to admit to you that I might not marry Marie when you... we... put in all that hard work together after Marie’s cancer diagnosis and mastectomy.’

‘Keep going.’

‘I mean, what kind of a prick leaves a woman who has cancer? What kind of man betrays and abandons a woman because she has lost one of her tits? Shame. A lot of shame. And to make it worse, I’m a doctor: I’m supposed to care about people.’

I began to feel some real sorrow for Jarod and spotted an impulse bubbling up in me to protect him from the wrath of his self-accusations. I wanted to remind him that his relationship to Marie was troubled long before she was diagnosed with cancer, but he was now in such decisional crisis that I feared saying anything he might interpret as advice. I have known too many patients in such a state who provoke others, including their therapist, to make their decision for them. In fact, it seemed likely to me that Jarod was covertly prodding Marie to make the decision to break off their relationship. After all, how did she discover those email messages? He must have unconsciously colluded with her; otherwise why hadn’t he trashed and deleted that correspondence?

‘And Alicia?’ I asked. ‘Can you fill me in about you and her?’

‘I’ve known her a few months. Met her at the gym.’


‘Been seeing her a couple of times a week in the daytime.’

‘Oh, can you give me a little less information?’

Perplexed, Jarod looked up at me, noted my grin, and smiled. ‘I know, I know...’

‘You must feel jammed up. This is an awkward and painful predicament. You come to me for help, but you’re reluctant to speak openly.’

‘“Reluctant” is putting it delicately. I absolutely hate talking about this.’

‘Because of influencing the image I’ll have of you in my mind?’

‘Yes, because of that image.’

I pondered Jarod’s words for a few moments and then decided on an unorthodox strategy – one that I had rarely ever used in a course of therapy.

‘Jarod, I happen to have been reading Marcus Aurelius recently, and I’d like to read you a few of his passages that seem pertinent to our discussion. Do you know his work?’

Jarod’s eyes immediately filled with interest. He welcomed this respite. ‘Used to. I read his Meditations in a college course. I was a classics major for a while. But I haven’t read him since.’

I walked over to my desk to fetch my copy of The Meditations of Marcus Aurelius and started flipping through the pages. For the past few days I had been reading and highlighting passages because of an unusual interaction with another patient, Andrew. At our session the previous week Andrew had expressed, as he had done so many times before, his anguish at spending his life in a meaningless vocation. He worked as a high-salaried advertising executive and hated such meaningless goals as selling Rolls Royce sedans to women wearing Galliano evening gowns. But he felt he had no choice: with advanced emphysema likely to shorten his productive work years, he needed the income to pay for his four children’s college tuition and to care for his ailing parents.

I surprised myself when I suggested to Andrew that he read The Meditations of Marcus Aurelius. I hadn’t read Marcus Aurelius for many years, but I did recall that he and Andrew had something in common: Marcus Aurelius, too, had been forced into a vocation not of his own choosing. He would have preferred to be a philosopher, but he was the adopted son of a Roman emperor and was ultimately chosen to succeed his father. So, instead of a life of thought and learning, he spent most of his adult years as an emperor fighting wars to protect the Roman empire’s borders. However, in order to maintain his own equanimity, he dictated, in Greek, his philosophical meditations to a Greek slave, who entered them into a daily journal meant only for the emperor’s eyes.

After that session, it occurred to me that Andrew was so diligent he would, without doubt, do a close reading of Marcus Aurelius. Hence, I had to reacquaint myself immediately with The Meditations, and I spent much of my spare time in the previous week savouring that second-century Roman emperor’s powerful, poignant words and preparing myself for the next session with Andrew, whom I was to see shortly after Jarod.

This was all in the back of my mind when I met with Jarod and, as he spoke of longing for his image to flicker forever in my brain, I grew persuaded that he, too, might be transformed by some of the ideas of Marcus Aurelius. At the same time I doubted my own inclinations: I had on many occasions observed that, whenever I read any of the great life philosophers, I invariably sensed their relevance to many of the patients I was currently seeing and couldn’t help citing some ideas or passages I had just stumbled on. Sometimes it was useful, but often not.

While Jarod waited, somewhat impatiently, I scanned the passages I had highlighted. ‘This will take just a few minutes, Jarod. I’m certain there are passages here that will be of value to you. Ah, here’s one: “Soon you will have forgotten all things: soon all things will have forgotten you.”

‘And here’s the one I was thinking of.’ I read aloud while Jarod closed his eyes, apparently in deep concentration. ‘All of us are creatures of a day; the rememberer and the remembered alike. All is ephemeral – both memory and the object of memory. The time is at hand when you will have forgotten everything; and the time is at hand when all will have forgotten you. Always reflect that soon you will be no one, and nowhere.’

‘And this one too: “Swiftly the remembrance of all things is buried in the gulf of eternity.”’

I put down the book. ‘Any of these hit home?’

‘What’s the one starting with “All of us are creatures of a day”?’

I reopened the book and read again:

‘All of us are creatures of a day; the rememberer and the remembered alike. All is ephemeral – both memory and the object of memory. The time is at hand when you will have forgotten everything; and the time is at hand when all will have forgotten you. Always reflect that soon you will be no one, and nowhere.’

‘Not sure why, but that one sent some shivers down my back,’ Jarod said.

BINGO! I was delighted. Just what I had hoped for. Maybe this was an inspired intervention after all. ‘Jarod, put other thoughts aside, and focus on that shiver. Give it a voice.’

Jarod closed his eyes and appeared to sink into a reverie. After a few moments of silence, I again prodded him.

‘Reflect on this thought: All of us are creatures of a day: the rememberer and the remembered alike.’

Slowly Jarod, eyes still closed, responded. ‘Right now I have a crystal-clear memory of my first contact with Marcus Aurelius... I was in Professor Jonathan Hall’s class in my sophomore year at Dartmouth. He asked me for my reactions to Part 1 of The Meditations, and I posed a question that surprised and interested him. I asked, “Who was the intended audience of Marcus Aurelius?” It is said that he never intended for others to read his words and that his words expressed things he knew already, so to whom exactly was he writing? I recall my question launching a long, interesting class discussion.’

How annoying. How very annoying. How typical of Jarod to attempt to involve me in an interesting but distracting discussion. He was still trying to embellish my image of him. But over my year of work with him I had learned that it was best not to challenge him at times like this but, instead, to address his question directly and then gently guide him back to the issue.

‘As far as I know, the scholars have felt that Marcus Aurelius was repeating these phrases to himself primarily as a daily exercise to bolster his resolve and to exhort himself to live a good life.’

Jarod nodded. His body language signified satisfaction, and I continued, ‘But let’s return to the particular passages I cited. You said you were moved by the one that began: “All of us are creatures of a day; the rememberer and the remembered alike.”’

‘Did I say I was moved? Perhaps I did, but for some reason it leaves me cold now. Honestly, right now, tell you the truth, I don’t know how it applies to me.’

‘Maybe I can help by recalling the context for you. Let’s see, 10, 15 minutes ago, when you described the importance of my having a certain image of you, it occurred to me that certain Marcus Aurelius statements might be illuminating for you.’

‘But how?’

How irritating! Jarod seemed oddly obtuse today – ordinarily he had such a nimble mind. I considered commenting on his resistance but ruled that out because I had no doubt he would have a clever rebuttal and it would slow us down even more. I continued to plod along. ‘You place great importance on my image of you, so let me read the beginning of this one again: “All of us are creatures of a day: the rememberer and the remembered alike.”’

Jarod shook his head. ‘I know you’re trying to be helpful, but these stately pronouncements seem so off the mark. And so bleak and nihilistic. Yes, of course we are but creatures of a day. Of course everything passes in an instant. Of course we vanish without a trace. That’s all pretty obvious. Who can deny it? But where’s the help in that?’

‘Try this, Jarod: keep in mind that phrase “The time is at hand when all will have forgotten you,” and juxtapose that to the vast importance you place upon the persistence of your image in my mind, my very mortal, evanescent, 81-year-old mind.’

‘But Irv, with all respect, you’re not offering a coherent argument...’

I could see Jarod’s eyes sparkling with the prospect of an intellectual debate. He was in his element as he continued, ‘Look, I’m not arguing with you: I accept all is ephemeral. I have no pretence of being special or immortal. I know, like Marcus Aurelius, that eons of time have passed before I existed and that eons will go on after I cease to be. But how does that possibly bear on my wish for someone I respect, in other words, you, to think well of me during my brief time in the sun?’

Yikes! What a blunder to have tried this. I could hear the minutes clicking by. This discussion was eating up the whole session, and I felt pressed to salvage some part of our hour together. I always teach my students that, when you’re in trouble in a session, you can always bail yourself out by calling on your ever-reliable tool, the ‘process check’ – you halt the action and explore the relationship between you and the patient. I heeded my own advice.

‘Jarod, can we stop for a moment and turn our attention to what’s going on between you and me? How do you feel about the last 15 minutes?’

‘I think we’re doing great. This is the most interesting session we’ve had for ages.’

‘You and I do share a delight in intellectual debate, but I have grave doubts that I’m being helpful to you today. I had hoped that some of these meditations would shed light on the importance of your desire for me to have a positive image of you in my mind, but I now agree with you that this was a hare-brained notion. I suggest we just drop it and use what little time remains today to address the crisis you’re facing with Marie and Alicia.’

‘I don’t agree it was hare-brained. I think you were right on. I’m just too rattled now to think straight.’

‘Even so, let’s go back to how things stand right now with you and Marie.’

‘I’m not sure what Marie is going to do. All this just happened this morning, and right after the session she had to get back to a research meeting in her lab. Or at least that’s what she claims. Sometimes I think she fabricates excuses not to talk.’

‘But tell me this: What do you want to happen between the two of you?’

‘I don’t think it’s up to me. After what’s just happened, it’s her call right now.’

‘Perhaps you don’t want it to be your call. Here’s a thought experiment: tell me, if it were up to you, what would you want to happen?’

‘That’s just it. I don’t know.’

Jarod shook his head slowly, and we sat in silence for the last minutes of the hour.

As we prepared to end, I commented, ‘I want to underscore these last few moments. Keep them in mind. My question is: What does it mean that you don’t know what you want for yourself? Let’s start from that question next session. And, Jarod, here’s one more thought to ponder during the week: I’ve got a hunch there’s a connection, maybe a powerful connection, between your not knowing what you want and your powerful craving for your image to persist in my mind.’

As Jarod stood to leave, I added, ‘You have a lot going on now, Jarod, and I’m not sure I’ve been helpful. If you’re feeling pressed, call me, and we’ll find a time to meet again this week.’

I was not pleased with myself. In a sense, Jarod’s confusion was understandable. He came to see me in extremis, and I responded by becoming professorial and pompous and reading him arcane passages from a second-century philosopher. What an amateurish error! What was I expecting? That simply reading Marcus Aurelius’ words would, presto, magically enlighten and change him? That he would immediately realize that it was his own image of himself, his own self-love, that mattered, not my image of him? What was I thinking? I was embarrassed for myself and certain he left my office far more confused than when he had entered.

Irvin D Yalom is an emeritus professor of psychiatry at Stanford University and a psychiatrist in private practice in San Francisco. He is the author of many books, including Love’s Executioner, The Gift of Therapy and Staring at the Sun.

Copyright © 2015 by Irvin D Yalom. Extracted from Creatures of a Day: and other tales of psychotherapy by Irvin D Yalom, published by Piatkus