Living a life without regrets: Dr. Irvin Yalom on love, death and meaning

Legendary psychotherapist Dr. Irvin Yalom talks with Joyce Carol Oates at the upcoming Bay Area Book Festival about issues explored in his new memoir, “A Matter of Life and Death.”

Bay Area Book Festival logo 2021This story is brought to you by the Bay Area Book Festival. Legendary psychotherapist and author Dr. Irvin Yalom talks with Joyce Carol Oates at the upcoming Bay Area Book Festival about love, marriage, loss and grief as explored in his new memoir, “A Matter of Death and Life.” Special Mother’s Day live, online event, Sunday, May 9, 1 p.m. Tickets are $7.50-$15, or covered under a festival pass. Festival donors can sign up for an intimate, online “Afterparty” with Dr. Yalom. See baybookfest.org.

Dr. Irvin Yalom. Credit: Bay Area Book Festival

Dr. Irvin Yalom, the “therapist’s therapist,” emeritus professor at Stanford and world-renowned psychiatrist — who has penned numerous bestselling books of nonfiction and fiction on psychotherapy, death anxiety, grief and a meaningful life — has recently faced grief of his own: the death from cancer of his beloved wife of 65 years, Marilyn.

Marilyn, also an author (a well-known scholar of comparative literature and doyenne of a long-running literary salon in Palo Alto), had suggested that she and “Irv” both write about the experience of her final months after her cancer diagnosis. The wrenching, beautiful memoir, A Matter of Death and Life, is told in alternating sections until her death, after which Dr. Yalom revisits his decades’ worth of writings as a way to cope with his own grief. His books include Love’s Executioner, When Nietszche Wept, The Theory and Practice of Group Psychotherapy (a classic on helping clients face death anxiety, now in its fifth edition), and 2017’s Becoming Myself, which he had announced would be his last book. 

Now 90 years old, he spoke with festival director Cherilyn Parsons in advance of his live, online event—on Mother’s Day, May 9—in conversation with Joyce Carol Oates, herself twice widowed and author of more than 100 books, many of which explore grief, love and marriage, including her recent poetry collection, American Melancholy. Toward the end of this article, we reprint a poem that evokes the Berkeley streets and landmarks Oates saw while rushing to Alta Bates hospital to see her ailing husband, who died in April 2019. This interview has been edited and condensed.

There’s a lovely epigraph that opens A Matter of Death and Life: “Mourning is the price we pay for having the courage to love others.” It’s not a quotation, just a statement, not attributed to anyone. Can you tell us where it came from?

I have no idea: Who said it, Marilyn or me? But the phrase is perfect. I hope I wrote it; I love every single word of it. Maybe the more we love others or the longer we love others, the longer the grief. That’s happening with me right now.

How is your grief changing from where you left off in the book, a few months after Marilyn’s death?

It’s less intense, but it’s still there. I miss her terribly. I have not made progress in some ways. I still can’t look at her picture. It hurts too much when I do that. The cemetery’s only a 20-minute walk away, but I haven’t gone there. Maybe it’s because I don’t want to see her tomb. Maybe I don’t want to see the spot next to her that’s going to be for me. My daughter keeps urging me, inviting me to go, but I just don’t want to do it. I’m having enough pain as it is. I think of her a great deal. I’ve known her since I was 14. 

The book was published quickly. What have you been doing since then?

I went right into another book that I had in mind, and that’s been a real lifesaver. I’ve always been a writer, and all I do now is to write and see patients, but very few, just one a day, in one-session consultations. The book I’m writing is teaching stories that emerge from these consultations. But I have no intention of finishing the book because I don’t know what I’ll do with myself if I’m not writing. So I’ll just keep doing this for a while. I’m kind of enjoying it.

So no more saying that the current book will be your last! Why do you think writing is such a solace for you?

My friendship with Marilyn, my love with her, started with a book, and it’s ended with a book. The first time I went out with her, she told me she’d been missing school because she’d been reading a book all night long. Well, that was all I had to hear, because I’d never met anyone who loved books as much as I did. I read them out of almost necessity because I grew up in a terribly dangerous neighborhood and spent all my childhood indoors reading or going to the library. We immediately joined with our love for books. Our house is quite spectacularly full of books.

About your novels: Someone described When Nietzsche Wept in this way, “Only through facing his own inner demons can the gifted healer begin to help his patient.” You’ve always been the gifted healer, but after Marilyn’s death you’ve become the patient, in the sense of working through a major life transition. How would Dr. Yalom treat a patient named Irv who just lost his beloved wife of 65 years?

I’ve been in therapy many times in my life. I’m in therapy now, seeing someone who works like me. She’s open, talks about herself, relates to me. I say to my students all the time, “The most important part of your training is your own therapy.” In fact, I started a group of other therapists, a leaderless group, when I was at Stanford, and we met for 30 years at least. Another group I had started consisted of patients who were all dying of metastatic breast cancer. It generated so much anxiety in me that eventually I thought, “I’d better go see a therapist now myself to deal with that.” So I selected a well-known therapist who had just moved to California named Rollo May. We became good friends. I was at his side when he died.

What do you feel you’re getting out of your therapeutic experience now?

She said something the other day that I liked very much. I don’t think it’s totally original; she was quoting someone else and I’ve forgotten who. But the idea is that grief is like an amputation. You don’t get over it. You just learn to live with it. That hit home. I’m living in the same house we lived in, and I’m sure I won’t move from here. I have our children all around me. We had four children, and three of them are right here in this area, so I see them all the time.

At the very end of the book, you talk about how, despite being a confirmed skeptic and not holding spiritual beliefs about an afterlife, you now understand the drive people have toward that. Has that continued?

I came to understand the solace they get from religion, from the idea of rejoining loved ones. My feelings had to do with this idea of joining Marilyn. In fact, it started before her death. Marilyn had done a book with my son, who’s a photographer, on cemeteries in the United States, American Resting Place. I asked her at one point, “We’ve been together all our lives. Why don’t we be buried in the same coffin? Can you get a coffin for two?” She said, “I can tell you there’s no such thing as a coffin for two.” But, even so, I have this notion in my head that I’ll be joining Marilyn, and yet my brain tells me that’s nonsense. Marilyn isn’t anywhere. I’m not joining Marilyn. But the idea of joining Marilyn offers me comfort, and I know that every religion since the beginning of time has offered that kind of comfort. I have to respect what people do get from this religious belief.

So many people have lost loved ones during the COVID pandemic, and we’ve all lost a way of life, at least for a while. Fear and isolation have become our experience. What advice would you have for people struggling with these situations, given your recent experience?

Stay close to the enduring friends that you have. I’m in touch with many people in that way, and I think I’d be going crazy if I weren’t. I have a cousin I grew up with; we’re two years apart. We’ve spoken every day on the phone for years. Now I have a lot of people I’ve known, many of them my ex-students, come over. Today, one’s coming over for a walk. But I’m gradually getting used to the idea that I don’t have any peers because I’m so old. It’s a strange feeling.

Is it loneliness? Anxiety?

No. It’s funny, I don’t have any anxiety about death. I have in the past, but don’t now. It’s quite remarkable. The relief from this anxiety began when I started rereading my own books, all the novels and all the books of stories. I was really proud of what I had done. So now when I work with people who have death anxiety, I tie this in with regrets in life. The more regrets you have about the way you lived your life, the more death anxiety you suffer. I feel that formula’s really strong. It has meaning to the many patients who come to me with death anxiety. And I think that’s why I have so little of it now, because I have very, very few regrets about my life. If anything, it’s turned out so much better than I ever thought it would when I was a teenager. That, of course, is so much due to Marilyn and knowing her. 

What did you love most about her, if you could even say?

Everybody loved Marilyn. She was a tiny little woman, hardly five feet tall. She had incredible social skills, so we rarely had a bad time in our marriage, except when she left for a while. Then there was the time she got so caught up in her position as the head of the Stanford Center for Research on Women that I had to confront her, “I’m not getting much out of this marriage anymore. I’m wondering why we’re still together.” I said this when we were at a restaurant in San Francisco. Her response—it was unbelievable—was to wail loudly. So, anyway, that was the end of that.

Wow. That’s good advice. Wail when you need to.

Everybody in the restaurant was turning around looking at her.

It seems that now at last, despite the pandemic and losses of the last year for everyone, we might be moving in a “new normal,” whatever that means. What would you advise people as we try to come back to life and connection? Would you change what’s called the “normal”? What do you think people need to be and do to live the kind of full life you’ve experienced?

The issue is, what does living a full life mean to you? I work with the issue of regret so often now with patients I see. Even though they’re single sessions, I take a look at that because it opens up all kinds of important things. What are the things you’re disappointed with, and what can we do about changing that now? That’ll be so important for you later on in life.

It’s like the last year has been an opportunity for a reset. People have been thrown off what they used to be.

Yes. Very few people, at least among many I know, want to go back to the kind of work they used to do or want to go back to an office.

Anything else you want to say just about this book that you’ve published or your experience of love and grief?

Writing that book, right until she died, was so important to me and to Marilyn. The book is a matter of death, her death, and life, my life afterwards, so it’s got these two distinct parts as I try to figure out how to live without her and how to deal with my grief. Writing it gave me some kind of purpose. 

Joyce Carol Oates. Credit: Dustin Cohen

As noted above, Dr. Yalom will talk with author Joyce Carol Oates at the festival. Oates’ own memoir, “A Widow’s Story” (2011), depicts her struggles after the loss of her husband of 47 years. Both of her latest books, the poetry collection “American Melancholy” and short story collection “The (Other) You,” explore how circumstances and choices indelibly shape how we live and find meaning. The following poem from American Melancholy is reprinted with her permission. 


The Tunnel

Early April, descending
the long broken hill
behind Panoramic Way.

Morning radioactive-bright.
The hill a puzzle of concrete outcroppings
broken and discontinuous as the aphorisms of Nietzsche.

And the Tunnel not (yet) visible
though its peristalsis begins
to pull, squeeze, tug.

In the dazzling distance,
San Francisco Bay.
As you descend the hill

the glittering Bay retreats
like a memory of happiness
but still

the palette is wide, seemingly random
in sunshine like spangled coins
the curious uneven descent

like a drunk
staggering
and the Tunnel not (yet)

defined as in a canvas
of Magritte where it’s the absence of
depth that assures

This is art, not life.
This will not hurt you.

And now passing
the abandoned house
gigantic, stucco

strangely surrounded by chain-link fencing,
razor wire absurd in swagger
protecting what no one wants.
And still you descend the hill,
bravely, boldly
blinding seeing now

the deserted playing field,
deserted playground.
Stilled swings, rusted slide

O where has life gone?—
abandoning these places
abruptly at Warring Street,

and then to Derby
more rapidly now
the Tunnel narrows

at Stuart, College, Russell, too
swiftly passing way-stations
of ordinary life

you would clutch at, in
your descent
except sucked by peristalsis

tugged past, breathless
and now the sky lowered
like a sound-proofed ceiling

unremitting, no mercy
at Ashby Avenue
rudely tugged as a teat

made to turn right onto Ashby,
as the morning shudders
visibly, you can feel shrinkage

as out of pastel treetops
the Hospital emerges
grim in efficiency

the “boundless” sky
has vanished, at the Hospital
driveway in the grip
of peristalsis tugged
through the automatic doors
in whose glass a frightened face

appears, disappears
and into the twilit foyer
and to the double elevators

rising inexorably to the sixth floor
to room 765
where your life awaits you

sleeping, a tube in his bruised nose
clasped hands on the distended belly
breathing in random gusts

like the lone wind at shore,
and a sickle moon above.

Oh Love—where will you abide when our frail bodies are no more?


The festival is offering a discount on tickets to the Mother’s Day conversation between Dr. Irvin Yalom and Joyce Carol Oates as a way to highlight the universal power of caring. Anyone who is a mother, a professional caretaker, an essential worker — or who has just now decided to tell loved ones afresh how much they mean to you — can use the code CARE in checkout to get 50% off the $15 ticket price. This event also is included in any of the festival’s three passes. You can purchase A Matter of Life and Death, American Melancholy, and The (Other) You in checkout. 

Special opportunity: Afterparty with Dr. Yalom

With a tax-deductible donation of $100 to the nonprofit Bay Area Book Festival, you can get a special invitation to an afterparty on Zoom for a casual, warm conversation with maximum 10 guests. Hurry before the party is full! Bay Area Book Festival logo 2021

This story was brought to you by the Bay Area Book Festival. This year this Festival takes place virtually May 1-9, with eleven programs for adults and eight for young readers. Visit the BABF website for full details. Berkeleyside is a media sponsor of the Bay Area Book Festival.