Marvin, a 64-year-old accountant referred by a neurologist for newly developed migraines, arrives at his first session with a color-coded chart linking each headache to an episode of impotence or premature ejaculation. Yalom finds Marvin controlling and abrasive—their session is derailed first by a protracted exchange about eyeglass frames and then by Marvin insisting Yalom study his chart—and he is relieved when the hour ends.

At their second session, Yalom identifies what he believes is the pivotal event: Six months ago, when Marvin’s symptoms began, he had decided to retire and sell his firm. To Yalom, retirement is a major marker of finitude and approaching death, but Marvin consistently deflects every attempt to explore that dimension. Background history reveals that Marvin was briefly considered a math prodigy as a child, spent six unhappy years as a high school teacher before building a lucrative accounting and real estate career, and has been married to his wife, Phyllis, for 41 years. They have no children—a source of quiet grief. Marvin describes Phyllis as his emotional anchor; her physical attention during anxious episodes dissolves his distress entirely. Their sex life was active until Marvin’s recent impotence, which has left Phyllis increasingly irritable.

Marvin recounts four disturbing yet imaginative dreams that feature images linking sex and death. Yalom is startled by their power and sophistication. He recommends couples therapy, but Phyllis refuses to see any therapist and rarely leaves the house. Yalom therefore agrees to individual therapy, motivated largely by his desire to reach the hidden “dreamer” beneath Marvin’s emotionless facade.

Marvin’s migraines nearly vanish once treatment begins. Yalom proceeds carefully, exploring his client’s marriage and retirement without pushing too deep. In parallel, the dreamer sends a continuous stream of striking dreams that Yalom interprets as messages: Early images suggest hope and the discovery of an unexplored interior life; later images warn Yalom that he is too emotionally detached. Taking the hint, Yalom devotes sessions to Marvin’s childhood. He learns of a traumatic family secret—likely infidelity or compulsive gambling by Marvin’s father—that caused the father’s permanent banishment from the marital bedroom and eventual disappearance from the family. As the youngest son, Marvin became his mother’s social escort for years. Yalom identifies a direct parallel in Marvin’s marriage: just as his mother used sexual withdrawal as control, so does Phyllis.

Marvin eventually discloses a private experiment he once conducted alone: He attempted to conjure final conversations with his deceased parents and found he could produce no emotion whatsoever—a revelation that taught him he had spent his life emotionally deadened. He weeps in session, and Yalom feels genuinely close to him for the first time.

Shortly afterward, Marvin blurts out the therapy’s central insight during sex with Phyllis and immediately has a sudden, pleasureless premature ejaculation. Phyllis is irritated; Marvin collapses into depression. The dreamer responds with alarmed images of demons escaping through a jammed door, followed by a rapid series of nightmares about the irrecoverability of the past and the sealed nature of the future. Yalom concludes that Marvin is now confronting death anxiety directly, without the protection of religious faith, children, or a sense of personal fulfillment.

Despite this, Marvin continues working. He also begins sharing the content of each session with Phyllis, who finds the material also applies to her own life. When Phyllis eventually attends a joint session, she reveals deep insecurity about her lack of education, her agoraphobia, and her regret over a self-enclosed life. Yalom observes that sexual control was the one domain where she could exercise power over Marvin and suggests she may have unconsciously preserved her role as his protector because Marvin required it—a role that has constrained her own growth. To address her agoraphobia, Yalom prescribes a paradoxical intervention: He instructs Marvin to call Phyllis every two hours, insisting that she must stay home to care for him and prevent him from being frightened. The instruction initially strikes both as absurd. However, Phyllis soon grows irritated by being ordered to stay home and begins venturing out independently.

At a one-year follow-up, Yalom plays Marvin a recording of their first session. Marvin listens and, hearing his former self, asks who that “jerk” was. Yalom regards the comment as a marker of deep personal change. Marvin reports no further migraines; Phyllis’s phobia has improved markedly, and she has enrolled in college extension courses. Marvin’s mood swings and intermittent impotence persist but are no longer disabling. He has returned to part-time work in real estate, which he finds more meaningful. His final dream in which he peers through his wife’s legs toward his mother’s face on the distant horizon provides the dreamer’s last message: that his perspective remains “bounded by” the women of his life, but that he can still see far into the distance.

At 80, Yalom reflects on rereading Love’s Executioner, a book he had not opened since writing it in his mid-fifties. He finds his younger self energetic but impulsive, at times insightful but occasionally overreaching. He values that version of himself for treating each patient as a unique individual requiring a unique approach, never retreating into a single theoretical school.

Yalom traces the book’s origin to a 1987 sabbatical taken with his wife after their youngest child left home. In Shanghai, sitting alone in an abandoned Catholic church’s confessional booth, he spontaneously conceived the entire plot of “Three Unopened Letters” and scribbled the essentials in his passport margins. In Bali, working from a stack of session notes in a lush garden and free from distraction, stories arrived organically—including the title story and “In Search of the Dreamer.” A protracted editorial battle with his publisher’s editor reduced his 50-page theoretical epilogue to roughly 10 pages. Looking back, he concedes she was right.

He acknowledges one regret: “Fat Lady” has caused genuine hurt to “obese” readers. He defends his intent—the story documents his own struggle with countertransference, not a condemnation of the patient. He also acknowledges greater sensitivity was warranted. He closes by stating that memory loss has made rereading his own work surprisingly pleasurable. He had forgotten how several of the stories ended.