Transforming Experiences in Literature and Psychotherapy

Considerations on Tolstoy’s Novella The Death of Ivan Ilych

Christoph Helferich

Bioenergetic Analysis • The Clinical Journal of the IIBA, 2024 (34), 83–91 CC BY-NC-ND 4.0


The article presents an analysis of Leo Tolstoy’s novella The Death of Ivan Ilyich, with a view to transforming experiences in literature and psychotherapy. It focuses on three central points: the question of personal authenticity, the autobiographic narration of self as source of our identity, and the importance of physical contact as a bridge between individuals. A short clinical note highlights some critical issues that could be important for the reader, personally as well as professionally.

Keywords: authenticity, literature, identity

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By chance, I re-read, after a long time, Tolstoy’s novella The Death of Ivan Ilyich (1886) and was again struck by the intensity and depth of this tale, rightly acknowledged as one of the most famous texts in modern literature. The story is about Ivan Ilyich, a high-ranking judge of the Petersburg Court, who in the prime of life, at the age of 45, is struck down by a mysterious illness that leads quickly to his death. The description of this event inevitably touches the reader on an existential level. Moreover, like perhaps every truly outstanding piece of literature, it evokes a clinical dimension and also raises many questions about our role and intervention as psychotherapists. It would therefore be useful to go into an extensive and in-depth analysis, but let us dwell here on three focal points with which the story confronts us: the question of authenticity, the narration of self as the source of our identity, and finally, the importance of physical contact as a salvific bridge between people.


“In law school he was already what he would be during his entire life: a capable, cheerful, good-natured, and sociable man, but one who strictly did what he considered to be his duty, and he considered his duty to be everything that it was considered to be his duty by his superiors” (p. 17).

From this description of the young university student, there emerges immediately as a distinctive trait the naive conformism of this character and his lifestyle. Indeed, the narrator does not tire of emphasising the conformity of his behaviour with social norms and the expectations of his surroundings. Ivan behaves perfectly comme il faut, i.e. entirely “well-behaved”, leading an “easy, pleasant, decent life” (p. 19). This applies to his professional activity as a judge, a role he manages skilfully and with due separation between work and personal relationships. The same holds for his private life, primarily his marriage, which despite numerous difficulties with his wife he manages to carry on, creating ample space for distance and freedom.

Ultimately, Ivan Ilyich’s life unfolds in that mode that Martin Heidegger in Sein und Zeit (1927) would describe with the concept of Uneigentlichkeit, of inauthenticity. “Inauthenticity” indicates a general behaviour resting on social conventions and thus relieved of the responsibility that every real personal choice entails: “the others” have already thought about it. Gaining awareness of death, on the other hand, is for Heidegger the key event that forces each individual to take responsibility for his or her own life and the choices made and not made. Becoming aware of death is the privileged event for opening up the space of authenticity (Eigentlichkeit).

And this is exactly what happens in the novella. The approach of one’s own death increasingly reveals the unbearable collective lie about illness, “that lie, for some recognized as true by everyone, that he was only ill but not dying, and that he only needed rest and there would be some very good outcome” (p. 36). But at the same time, the protagonist realizes that he, too, has behaved in this way in his professional life. “In them he saw himself”: just like the distinguished doctors who treated him without taking an interest in him as a person, he too as a judge played his role in a satisfied manner, with indifference and without participation.

Faced with this collective lie, in his condition of extreme loneliness, the last two weeks of his life bring the protagonist not only physical suffering, but also increasing “mental suffering” (p. 46). A disquieting question begins to arise in him: “‘Maybe I have not lived as I should have,’ it suddenly occurred to him” (p. 43). This question, brought to him by the ‘voice of the soul’ and at first “inadmissible”, becomes more and more pressing, leading him to the conviction that “‘Yes, everything was wrong’, he told himself, ‘but it doesn't matter. I can, I can do what is right. But what is right?’ he asked himself, and at once fell silent” (p. 48).

Interestingly, the narrative does not provide an explicit answer as to how Ivan Ilyich's life should have been, i. e. what the features might be of what the philosophical tradition calls a good life (Helferich, 2004). But it is precisely in this way that the search for the answer is left to the reader. The reader, empathizing with the protagonist and seeing himself in him, is suddenly confronted with the unsettling question of whether his life is authentic or not. There, in the skill with which Tolstoy manages to bring the reader to exactly this point, lies the reason for the story’s great existential impact that was referred to above.

Narrating Ourselves

Well intertwined in the search for the meaning of life we find the second topic we want to address, the narrative structure of our identity. All theories of narration, from Paul Ricoeur onwards, agree that man is “an animal that tells stories” (A. MacIntire). Indeed, our identity is largely made up of all the collective and personal stories that we are constantly told and that we constantly tell ourselves. Narrating is an active, creative act (poiesis), a process of continuous re-figuration of events and their meaning. This is particularly true if we create a narrative synthesis of episodes of longer duration, “larger-scale actions” (D. Carr), such as certain periods or events in life considered significant, or if we look at life in its entirety. And this is exactly what happens to Ivan Ilyich:

“‘To live? To live how?’ asked the voice of his soul.

‘Yes, to live, as I lived before: well and pleasantly?’

‘As you lived before, well, pleasantly’ asked the voice. And he began to go over in his imagination the best moments of his pleasant life. But – strange to relate – all these best moments of a pleasant life now seemed quite different from what they had seemed then. All of them – except for his first memories of childhood. There in childhood was something so truly pleasant with which he could live, if it returned. But the person who had experienced those pleasant things no longer existed: it was like a memory of something else.

As soon as the process began which had resulted in Ivan Ilyich, the man of today, all the things which had seemed joys melted away before his eyes and were changed into something worthless and often vile” (pp. 42–43).

We are usually accustomed in pondering and revisiting the events of our lives to tinting them with a teleological aura, to see them as an essentially meaningful and directed process culminating in the person we are today. To narrate is usually to “transform contingencies into events endowed with meaning” (Meuter, 1995, p. 255). In this sense, “a significant part of a person’s self-experience and self-understanding is based on self-narratives – an ongoing process of establishing coherent formulations about who I am, who I was, and where I am going” (Rosfort & Stanghellini, 2009, p. 261).

We see in the passage quoted above that Ivan Ilyich is also engaged in this self-narrative process, in an investigation into his own past. But the results of this investigation, surprisingly for the protagonist himself, are entirely negative. Ivan’s entire belief system, his firm convictions about his pleasant and decent life, crumble. In the process of gaining his existential awareness, even the usual narrative of himself is overturned, turning “into something worthless and often vile”.

We see that also in the case of autobiographical narration, Tolstoy’s mastery brings the reader before a rather disturbing question. As we have seen, “we tend to constitute our experience and our identity through self-narratives” (Rosfort & Stanghellini, 2009, p. 262). But, as the philosopher Charles Taylor (1985) rightly observes, these formulations can be right or wrong: there is no guarantee that the image I have of myself or that I am accustomed to showing to the world actually corresponds to the truth! This “complex dialectic between to be and appear to be”, as it has been called, the possibility of a truth hidden from the subject himself, represents the greatest difficulty in our search for truth and authenticity. Indeed, it exposes “the fragile nature of personhood”, the fragility inherent in being a person (Rosfort & Stanghellini, 2009, p. 262).


How is it possible that Tolstoy manages to weave a “happy ending” to his tale, to make up for the dramatic imminence of the end, in such a way that the protagonist can reconcile with his existence and exclaim at the end that “Instead of death there was light” (p. 49)? Synthesizing considerably, it can perhaps be said that it is through empathic contact that the protagonist eventually achieves this reconciliation with himself and the world. The figure of Gerassim, a young servant of the family who is “always cheerful and sunny” (p. 35), combines the two moments of empathy and contact. He is the only person who feels compassion for Ivan Ilyich, who does not hide the truth of his illness and speaks openly with him; he is an authentic person. And Gerassim is the only one to establish physical contact with the dying man, often lifting his master’s legs for hours on end, even at night, to relieve him of his pain:

“Gerassim brought the chair, placed it without making any noise, lowering it in one movement to the floor, and lifted Ivan Ilyich’s legs onto the chair; Ivan Ilyich thought he felt better the moment Gerassim raised his up legs.

‘I feel better when my legs are higher,’ Ivan Ilyich said. […]

Ivan Ilyich told Gerassim to sit down and hold up his legs, and he talked to him. And – strange to say – he thought he felt better while Gerassim held up his legs.

From that day Ivan Ilyich started sometimes to call Gerassim in to him and made him hold up his legs on his shoulders, and he liked to talk to him. Gerassim did this easily, willingly, simply, and with a goodness of heart that touched Ivan Ilyich” (pp. 35–36).

This meets Ivan’s hidden desire – “however much he felt ashamed to admit it” (p. 37) – to be pitied, caressed, “for someone to have pity on him like a sick child” (p. 37). Indeed, as we have seen in the quotation concerning the autobiographical narration, for the protagonist, “the first memories of childhood” (p. 42) remain intact, witnesses of authentic affections, experiences and relationships: And “the further back he went, the more life there was” (p. 44).

Besides Gerassim, it is Vasja, the young son, who feels pity and compassion for his father. In the relationship with Vasja, in the very last scene of the story, we see the meaning of contact still exalted:

“It was at the end of the third day, an hour before his death. At that very moment the gymnasium schoolboy quietly slipped into his father’s room and approached his bed. The dying man was still crying out despairingly and waving his arms about. One of his hands hit the schoolboy’s head. The schoolboy took it to his lips, and wept.

At that very moment Ivan Ilyich fell through and saw a light, and it was revealed to him that his life had been wrong but that it was still possible to mend things” (p. 48).

Clinical Note

Authenticity, narration, contact – it is evident how much each of these aspects or how much Tolstoy’s entire narrative must involve, on a personal level no less than on a professional level, those of us who work as psychotherapists. One element that comes across very well in the story is the patient’s eternal suspicion that the therapist remains overly protected by his professional function, and therefore, like the illustrious doctors during their visits, merely plays a role instead of truly and personally participating in his experience.

We are especially reminded of certain patients who often complain about their loneliness. However sterile and repetitive such patients may appear, they should be received with the utmost openness and willingness, since behind the complaints about loneliness easily lurks these people’s anguish of death, the anguish of having to die and having to die alone. The therapist should in such cases proceed with confidence and courage; he must not, like the others, re-propose the collective lie of removal, of the taboo of death.

Something similar applies to the patient’s narratives. Roy Schafer has described the psychoanalyst as a person “who listens to patients’ narratives, helping them to transform them into different narratives that are more complete, coherent, convincing, and adaptively useful than those they are accustomed to constructing” (quoted in Meuter, 1995, p. 249). Also with regard to the patient’s narratives, we are first and foremost required to be open and willing to participate in their experiences.

In the process of working with these narratives, the therapist easily succumbs to the temptation of prematurely offering “positive” or too easy solutions, solutions that the patient cannot or is not ready to accept. We are thinking here especially of patients with a narcissistic disorder who construct self-satisfied, overly “consistent” self-narratives in Schafer’s words. But just like the protagonist of the novella, these types of patients need to feel authentically taken seriously in their difficulties. And, as is well known, the very feeling of being genuinely listened to with one’s defences and difficulties often paves the way to overcoming them.

Body contact as used in Bioenergetic analysis is certainly a powerful medium in these healing processes, not least because of the regressive qualities it possesses. Our first experiences in the world were experiences of contact, and in the story it is clear how contact can meet the buried needs of the inner child, needs that the adult patient would be ashamed to admit. In this broad sense, it is generally recognized that “touch is an inherent need for survival of the infant” (Guest & Parker, 2022, p. 129). Naturally, there exist various types of touch in social life (see Guest and Parker, 2022, pp. 127–129), and in psychotherapy, too, touch is used in many different ways and meanings.

In Tolstoy’s novella, we see that the servant Gerassim often lifts up his master’s legs for many hours. In some way he employs what in our clinical work is called “nurturing contact”. As I have pointed out in a previous essay, nurturing contact, as applied in Organismic psychotherapy, is “usually a soft, non-directive, long-term contact that provides the possibility for the patient to feel deeply” (Helferich, 2015, p. 34). And this is exactly what happens in the final hours of Ivan Ilyich’s existence. Having perceived this connection between physical human contact as the way out of the anguish of death is one of the great merits of this extraordinary story by Tolstoy.


Guest, D., & Parker, J. (2022). Clinical considerations regarding the use of touch in psychotherapy. Bioenergetic Analysis, 32, 123–134.

Heidegger, M. (1927). Sein und Zeit. Max Niemeyer Verlag. Eng. trans. Being and time, 1962, and re-trans. 1996 and 2010.

Helferich, C. (2004). La “vita buona”. La ricerca esistenziale tra filosofia e psicoterapia corporea. Armando Editore.

Helferich, C. (2015). Body and body psychotherapy in the global village. Bioenergetic Analysis, 25, 19–40.

Meuter, N. (1995). Narrative Identität. J.B. Metzlersche Verlagsbuchhandlung.

Rosfort, R., & Stanghellini, G. (2009). The person in between moods and affects. Philosophy, Psychiatry, & Psychology, 16(3), 251–266.

Taylor C. (1985). The concept of a person. In Human Agency and Language. Philosophical Papers, Vol. 1 (pp. 97–114). Cambridge University Press.

Tolstoy L. (2013). The death of Ivan Ilyich and confession. Trans. by P. Carson. Liveright Publishing Corporation.

The author

Christoph Helferich was born in Germany and has lived and worked in Italy since 1984. He is CBT, supervisor and local trainer of the Italian Bioenergetic Society, la Società Italiana di Analisi Bioenergetica (SIAB).