Nietzsche once said: “He who has a why to live can bear almost any how.”

By Jane Sonnenschein · July 4, 2026

Over the past couple of days, I came across several posts on Xiaohongshu (a Chinese lifestyle and social-media platform, often compared loosely to a mix of Instagram and Pinterest) about Irvin Yalom and his son.

Yalom is one of the most important figures in modern existential psychotherapy. In Existential Psychotherapy, he wrote about several ultimate concerns that human beings cannot escape: death, freedom, isolation, and meaninglessness. Put simply, we will all die; we have to take responsibility for our choices; at some level, each of us ultimately faces existence alone; and life does not arrive with a meaning already written for us. Meaning is something we gradually create through living, relationships, creation, and responsibility.

In psychological writing, Yalom’s “four ultimate concerns” are also commonly described as death, freedom, existential isolation, and meaninglessness.

But what many people have been discussing recently is not Yalom’s theory itself. It is the death of his son, Victor Yalom.

Public information has described Victor Yalom as a psychotherapist who also worked for many years in psychotherapy and professional training. Reports and information shared publicly by his family have said that he lived with serious mental illness for a long time and eventually died by suicide.

For many people, this was deeply unsettling.

There is an assumption that the son of a major figure in existential psychotherapy—someone who was himself a psychotherapist—should somehow not have reached this point. And so people begin to ask: if even the family of a psychotherapy master, and even therapists themselves, cannot escape severe psychological suffering, then what is psychology actually good for? Can any of these theories really save a person?

I think that question is understandable. But behind it lies a fairly large misunderstanding.

We tend to imagine that if someone understands psychology, they should no longer be troubled by psychological problems. If someone has studied the meaning of life, they should not fall into a sense of meaninglessness. If someone knows how to help other people understand trauma, then surely their own trauma must already have been resolved.

But human beings do not work that way.

A doctor knows how illness develops, but that does not mean a doctor cannot become ill. A nutritionist understands healthy eating, but that does not guarantee a body will never have problems. A marriage counselor may understand intimate relationships extremely well, but that does not mean their own marriage will always be happy.

Psychotherapists are no different. They are not people who stand outside suffering. They simply know its structure better.

Knowledge can shine a light on pain, but it cannot make someone immune to it.

In fact, knowing more does not always make life easier.

Someone who feels vaguely unhappy may still be able to move through life with busyness, routine, numbness, and a little self-deception. But once a person begins taking that pain apart layer by layer—seeing the influence of their family of origin, patterns of trauma, attachment, self-worth, fear of death, existential loneliness, and the sheer contingency of life—they do not necessarily feel better immediately.

Sometimes seeing clearly is not a painkiller.

It is more like a scalpel.

It can cut the wound open and show you what is inside. But once the wound has been opened, healing may still take a very long time.

That is also why I have come to feel more and more strongly that psychology is not theology, and psychotherapists are not gods.

Psychology can give pain a name.

It can help someone realize: perhaps I am not endlessly overthinking for no reason. Perhaps I am so sensitive to other people’s judgment because I learned very early to tie “what other people think of me” to “whether I deserve to be loved.”

Perhaps I am not simply lazy. Perhaps after years of doubting myself, my brain developed avoidance as a way to protect me from the possibility of failure.

Perhaps it is not that I do not understand what I should do. Perhaps my nervous system, my body memory, and my trauma responses simply move more slowly than my rational mind.

But naming something is not the same as healing it.

Knowing why you hurt does not mean you will not hurt the next time.

Knowing that other people’s judgments should not control you does not mean your body suddenly stops caring.

Knowing where childhood wounds came from does not mean you can immediately make peace with the past.

For many people, this is exactly where the deepest frustration lies:

It is not that I don’t know.

I know, and I still can’t do it.

That sentence sounds very ordinary, but it explains a great deal of human difficulty.

Some forms of pain do not live only at the level of thought. They are carried in the body, in the nervous system, and in patterns of relationship.

Someone who has lived for years with a deep sense of insecurity may rationally know, “I am safe now,” while their body remains constantly on alert.

Someone who learned as a child that approval had to be earned through performance may understand perfectly well that “my worth should not depend on what other people think,” and still collapse after one harsh rejection.

Someone who has repeatedly been abandoned, ignored, or humiliated may read countless books on psychology and still struggle to believe, in any stable way, that they are worthy of love.

So between knowing and being able to live differently lies far more than a few pieces of advice.

There lies a person’s entire life experience.

And those life experiences are exactly what psychotherapists encounter every day.

From the outside, people sometimes imagine that being a therapist simply means sitting in a room and listening to someone talk. The fee for an hour may be high, and from a distance it can look almost easy.

But if you think about what therapists actually hear every day, it is not ordinary storytelling.

They hear about trauma, fear, depression, shame, anger, loss, domestic violence, childhood abuse, broken relationships, and the despair of people who no longer feel able to keep living.

If a therapist simply sits there mechanically, of course they cannot truly help the person in front of them. But if they genuinely enter that person’s world, they also have to absorb a great deal of painful human experience.

That is heavy emotional work.

The mental-health field has terms such as vicarious trauma, compassion fatigue, and professional burnout. In plain language, when someone spends a long time in close contact with other people’s suffering, they can be affected even when none of those events happened directly to them.

A mature therapist is not someone who feels nothing.

It is someone who can say, in effect: I understand you, but I am not drowned by you. I can come close to your pain, and still find my way back to myself.

That ability is not easy to develop. It requires training, supervision, personal therapy, and also rest and recovery.

So I do not find it shocking at all that psychotherapists can have psychological problems of their own.

In fact, I sometimes think that many people are drawn to psychology and therapeutic work precisely because they themselves have known pain.

They are not necessarily studying water because they have always stood safely on the shore. Some of them became interested in water because they once struggled not to drown. They wanted to understand why people drown—and whether there is a way to pull someone else back to land.

But a person who helps others out of the water can become exhausted too.

They can be injured.

And one day, they may simply have no strength left.

That does not prove psychology is useless. It only proves that psychology should not be treated as something all-powerful.

We would not say medicine is useless because a doctor becomes ill. In the same way, the suffering of a psychologist or psychotherapist does not make psychology meaningless.

What really needs to disappear is our illusion about professionals.

Knowledge, theory, experience, and a professional identity do not remove someone from ordinary human vulnerability.

And existential psychology, perhaps more than most fields, deals with questions that were never meant to be “solved” once and for all.

Death, freedom, loneliness, meaninglessness—these are not mathematical problems with a formula at the end.

A person may find meaning during one period of life and lose it again in another. They may believe deeply in creativity, love, and responsibility when they are young, then later be struck by illness, physical decline, loneliness, and loss.

Meaning is not a certificate you earn once and keep forever.

It is more like a lamp that needs oil again and again.

Sometimes the lamp burns brightly. Sometimes it grows dim. Sometimes the wind is so strong that a person simply does not have the strength to shield the flame.

So when I see people asking, “If even the son of a great psychotherapist ended up like this, doesn’t that prove the theory is useless?”, I feel the question arrives at its conclusion too quickly.

Theory is not a protective charm.

Theory cannot endure illness on someone’s behalf. It cannot carry a person through endless nights. It cannot give someone a stable nervous system, enough love and support, or automatically create the strength to stay alive.

At most, theory can offer a little language in the darkness, a little direction, and perhaps a way to see oneself more clearly.

But whether a person can ultimately be held and supported depends on much more than theory. It depends on relationships, the body, the environment, medical care, social support, and many very concrete things—some of them also shaped by chance.

That is why I have become increasingly reluctant to judge another person’s suffering too easily.

Some people are already using almost everything they have simply to stay alive.

From the outside, we may see their profession, identity, achievements, theories, and reputation. What we do not see is how they face themselves alone at night. We do not see the thoughts that return again and again, slowly wearing away their capacity to keep going. Nor do we see how someone can understand so many things and still be unable to make their body believe:

I am safe.

I am worthy.

I can keep going.

Human suffering can sometimes run deeper than knowledge.

Someone can understand psychology and still be unable to save themselves.

Someone who studies the meaning of life can still be swallowed by meaninglessness.

Someone who helps others through darkness may one day lose sight of their own path.

That is not the failure of psychology.

It is the complexity of being human.

A mature understanding does not place psychology on an altar, but neither does it throw psychology away because of one tragedy.

It simply allows us to admit that psychology is useful, but not all-powerful. Understanding matters, but understanding is not the end. Knowing the cause is a first step, but learning how to live differently after knowing it can take far longer.

If psychology gives us anything, perhaps it is not the promise that we will become invulnerable.

Perhaps it teaches us to have a little more respect for human fragility.

Not to say too easily, “But you understand all of this—how can you still be like this?”

Not to say, “You studied psychology. How can you still not save yourself?”

And not to turn one person’s collapse into a joke about an entire theory.

Because people do not suffer simply because they understand too little.

Sometimes the hardest thing is exactly the opposite:

They understand a great deal, and still cannot find a way out of their own life.

And perhaps that is one of the deepest difficulties of being human.

This essay is also available in other languages:

Chinese version: 懂心理学的人，也不一定能救自己

German version: Auch Menschen, die Psychologie verstehen, können sich nicht immer selbst retten