Reflections on Yalom, Grief, and the Sacred Space of Psychotherapy

By Nicole Rizkallah, LMFT

Death is often the room we try not to enter—the silent hallway we pass with quickened steps. Yet in the therapy room, it waits patiently for our attention. In my own work as a therapist, particularly in recent months, I’ve sat with several clients grieving the death of a parent. Some have come with a sense of closure. Others are still tangled in unfinished conversations, aching for words never spoken.

In these sacred moments, I often find myself returning to the work of Irvin Yalom, the existential psychiatrist who’s spent decades helping us look directly at death—not to despair, but to live more honestly because of it.

Why Death Belongs in the Therapy Room

Yalom writes: “Though the physicality of death destroys us, the idea of death saves us.” In his view, it’s not death itself that haunts us—it’s our avoidance of it. And when that avoidance takes hold, it shows up everywhere: anxiety, disconnection, compulsive busyness, even depression.

For therapists, Yalom’s message is clear: we must be willing to sit with our clients in the face of the ultimate unknown. Not to pathologize death anxiety, but to welcome it as a teacher. Yalom challenges us to go beyond the symptom—to witness the soul work. He invites us to speak of death not with clinical neutrality, but with human warmth and depth. Not every session will revolve around death, but when it comes near, we can meet it without flinching.

For clients, especially those facing loss, the invitation is to name what has been feared or silenced—and in doing so, to become more fully alive. It’s okay if your grief is complicated. It’s okay if you feel angry, numb, grateful, or all three. Therapy can offer a space to explore these contradictions—not to fix them, but to companion them.

Two Paths to Grief: What Clients Have Taught Me

In my recent work, I’ve seen how different the grief journey can look—especially when it comes to the loss of a parent.

Some clients come in holding a sense of completion. They were able to say goodbye, to express love, to receive it back. Their grief is still deep, but it is not fragmented. It carries an integrity that supports the healing process. With them, the work is often about honoring the legacy, integrating the loss, and giving space to continued connection in symbolic ways.

Others come with unfinished stories. Estrangement. Complicated relationships. Words unsaid. With these clients, grief is often laced with guilt, resentment, or confusion. Sometimes the parent was emotionally absent even in life—and their death reawakens the child inside who still wanted to be seen.

Both kinds of clients are teaching me something profound: closure is not always about what happened in the relationship. It’s about how we choose to relate to it now.

What Yalom Offers in These Moments

Yalom’s existential framework provides grounding for both clinician and client. He reminds us that death anxiety isn’t something to “treat”—it’s something to make meaning from. He believes that clients who come to terms with mortality often experience a deepened sense of gratitude and vitality, reduced anxiety and avoidance, greater alignment with their authentic self, and more intentional, meaningful decision-making.

His work encourages us to ask big questions, not with clinical detachment, but with reverence:

• What legacy did this person leave behind?
• What am I afraid to say or feel?
• How does facing this loss help me see my own life more clearly?
• What does it mean to me to live a meaningful life?

He introduces the idea of "rippling"—the notion that our impact continues after we’re gone through the memories, values, and love we’ve shared. This concept often brings comfort, and it reframes death from being the end to being a transition into influence.

Final Thoughts: Letting Death Awaken Life

In my own practice, I’ve found that when we allow space for conversations about mortality, something sacred happens. Clients often walk away not weighed down by the fear of death, but lifted by the clarity of what matters. They reconnect with their values. They say what they’ve been afraid to say. They begin, slowly, to live more fully. As Yalom puts it: “The best way to prepare for death is to live life to its fullest.”

So perhaps the real work isn’t about fearing death less—it’s about loving more, risking more, and being more present with the time we’re given.