Thread by @ToanTruongGTX

This man heals what therapists can't:

Irvin Yalom.

He spent years facing his inner demons until one realization...

Now, by unlocking the "4 Ultimate Concerns", he has cured millions from anxiety, guilt, and overthinking.

Here's his philosophy: 🧵

Before his breakthrough, Yalom was trapped in his own existential crisis.

Despite being a successful psychiatrist at Stanford, he was plagued by death anxiety and the meaninglessness of traditional therapy.

He'd help patients for years just symptom management.

Then in the 1970s, something shifted.

While treating a terminal cancer patient, Yalom witnessed something profound...

As she faced death directly, her lifelong anxieties disappeared.

Yalom discovered that all psychological suffering stems from avoiding 4 ultimate concerns.

This insight later became "Existential Psychotherapy"—a method that addresses the root of human anxiety, not just its symptoms.

His approach operates on a simple principle:

Anxiety is the dizziness of freedom.

When we avoid life's ultimate truths, we create elaborate defenses that become our disorders.

Face these truths directly, and the defenses dissolve.

The 4 Ultimate Concerns that underlie all suffering:

1. The first ultimate concern: DEATH

Yalom noticed that his most anxious patients never talked about dying.

They worried about promotions, relationships, money—everything except the obvious.

When he helped them face mortality directly, their petty anxieties disappeared.

Try this:

• Write your own obituary
• Visit a cemetery monthly
• Ask: "What would I regret not doing?"

This is on the same line as Jeff Bezos Regret Minization Framework: ↓

2. The second ultimate concern: FREEDOM

Most people say "I have to go to work" or "I can't leave this relationship."

Yalom's response? "No, you're choosing to."

This isn't motivational fluff. It's terrifying responsibility that we avoid through victimhood.

Practice:

• Replace "I have to" with "I choose to"
• List 10 things you could change tomorrow
• Own one decision you've been blaming on others

3. The third ultimate concern: ISOLATION

Yalom discovered lonely people do something backwards:

They hide their real selves to avoid rejection, creating the very isolation they fear.

Harvard's 80+ years research on happiness and fulfillment back it up:

Start small:

• Tell someone one real fear this week
• Stop pretending you're fine when you're not
• Admit when you don't understand something

4. The fourth ultimate concern: MEANINGLESSNESS

A CEO patient told Yalom: "I've achieved everything and feel empty."

Yalom: "Good. Now you can stop looking for meaning and start creating it."

The man left business. Started teaching kids. Found purpose.

Your turn:

• Help someone who can't repay you
• Create something unnecessary but beautiful
• Do one thing daily just because it matters to you

The genius of Yalom's approach is its directness.

• How do you escape your freedom?
• What are you avoiding about death?
• Where do you deny your aloneness?
• What meaning are you failing to create?

The concerns are universal—every human faces them.

Contrary to criticism that existential therapy is depressing, it's liberating.

By accepting life's limitations, you discover freedom within them.

As Yalom says:

"Though the physicality of death destroys us, the idea of death saves us."

That's a wrap!

Follow @ToanTruongGTX for more fascinating stories about human psychology and historical events that changed how we see the world.

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