24th March 2018

The death of a therapist – how to cope.

Death of a therapist - how to cope (c) KarinSieger.com

The death of a therapist can be hard to cope with, especially if you have established a close bond, if the death is sudden and if there was no shared ending to the therapy – no good byes. Why is that and what to do?

Why can the death of a therapist be so difficult to cope with?

When therapy works well, your therapist can become an important person in your life. When therapy works really well, your therapist can become the one person, that knows more about you than anyone else. And their death is bound to hit you hard.

Depending on your own therapy experience you may know what I mean, or not. You may agree, or not. And that is ok, too. Therapy can work for different people in different ways. And sometimes it does not work out.

If your therapist or counsellor has died, then you may feel very alone and not easily understood by others in your grief:

“It’s not like they were family or friends, right? They provided a service and got paid for it. You will find another … If you feel so much grief, then perhaps you got too closer, and then perhaps it was not good therapy ….”

When it happened to me, the shock was immense. I was in the middle of a major health and existential crisis. There was no warning, no good bye, no funeral to go to, very few people to talk to about it, and very few people understood, why this was so painful. I needed to figure out what to do for the best.

Suggestions to help you cope with the death of a therapist

  • Depending on the circumstances of your own experience, you may be offered some help by other therapists, who your therapist may have instructed in the case of their death.
  • On a more personal level, you may want to think about what may help you find closure and say good bye. You may want to do that with another therapist. That does not need to take many sessions.
  • You may want to think of a little ‘ritual’ or practice – an act of remembrance and letting go.
  • You may want to re-visit the place or the neighbourhood where you had therapy, and through the physical closeness find the start of closure. This may be painful, but it can be an invaluable start.
  • Whether you had face-to-face, online or telephone therapy / counselling you may want to think about setting aside some time on the same day and at the same time, when you would have had your session. Have a session by yourself, ideally in the same place where you had therapy (which is not always possible) or in another place you feel comfortable, safe and private. There, try and have an imaginary conversation with your therapist. Talk about how you feel. Say what you want to say. See how you feel. You might need these ‘sessions’ a few times before you can say good-bye.
  • You can write a letter. Putting feelings into words can help process difficult emotions and get some perspective, clarity and direction.

Feel free to use your imagination and think bold in terms of ‘what’ and ‘when’ may work best for you.

Grieving and closure are personal and should not be rushed. But neither is it good to get stuck in the grief process and unable to move on.

Try this simple practice to connect with hope – the Light Chain. Read More

Guide to bereavement. Read More

A letter to my dead therapist

Here I would like to share with you a letter I wrote to my dead therapist, shortly after I received the news. It was subsequently published by the Private Practice division of the British Association for Counselling & Psychotherapy (BACP), of which I am an accredited and registered member. It was my way of explaining and saying good bye.

If you are in a similar situation, it might give you some ideas of what might help you find some closure and peace.

How it happened.

When I received the email it had your name in the subject heading and had been sent by a person I did not know. I instinctively knew…

About four months before then we had (what later turned out to be) our last session. I had just started my chemotherapy for breast cancer and not seen you for three weeks.  Your appearance had changed. You looked much younger, and I told you so. But there was something in your face. And for the first time in all these years I dared to ask about you: ‘Are you OK?’ And for the first time you told me about yourself: ‘No, I am not.’

To me, this felt like a very special moment of trust, but also an indication of a change occurring – somewhere – in you. We both left it at that.

We were due to meet again after your pre-booked break. I said, I felt that that might not be so (not because of me, but because of you). You said, you had no reason to think you would not be there. I left the room saying “Look after yourself.” Another first. I wanted you to know I cared and that I was concerned.

Two weeks later I received an email from you telling me that due to health reasons of your own, you could no longer see clients for the time being. You would provide updates when they became available, and would I like to wait or would I like you to recommend another therapist for the interim or long-term?

The idea of not seeing you, when I was facing the biggest challenge in my own life, not knowing what was happening to you and not knowing what would happen in the future, was shocking and painful.

My inner child was protesting: ‘No, I do not want another therapist – I want you.’ How could I possibly start all over again?

It would take years for someone else to ‘get me’ the way you did. And anyway, no one would understand me and be with me the way you had.

But the adult in me knew I needed a back-up plan.

I doubted and trusted you.

The weeks and months with no news from you eventually re-triggered old wounds of abandonment in me. The child (and sometimes the adult, too) imagined that you had started work again but did not want to see me, that I was too much. I imagined finding my own new therapist. I did not need your recommendation! I was angry. I was afraid, very afraid.

3 three months after our last meeting, I got in touch with the therapist you recommended. Unknown to me, this was a few weeks before your death. The person was exactly who I needed then. So I had some support in place, when I opened the email telling me of your death.

I had finally summoned the courage to send you an email, breaching my self-imposed boundary of no contact outside of sessions. I wanted you to know I was holding you in my thoughts and sending you positive energy. I wanted you to know, you mattered and that I was doing well.

And to be truthful, the angry part in me also wanted you to know that I was doing well without you.

But I know you would have seen through that. You knew me well.

As it turned out, by the time I sent the email you had already been dead for three days.

I am glad that throughout I managed to hold on to the trust in you. That was stronger than the doubt.

What you meant to me – a solid container.

When I first started training as a psychotherapist, a course tutor remarked that our first therapist might become the most influential person in our lives. And you turned out to be that for me. You became parent, teacher, sibling and so much more.

We had just started to make a breakthrough regarding my anger. I even started to be angry with you, and I would tell you so. You encouraged all that, even the swearing.

When I became angry with my therapist Read More

You became a solid container, trusted friend, spiritual guide and mentor. I respected you for the respect you showed me. I admired your integrity and authenticity, your ability to empathise and believe in me. With time I started to believe in myself.

Eventually we (your clients) were told the cause of your death – cancer. I had been wondering, from the day I received your email about needing to take time off.

Your death of cancer felt worse than my own cancer diagnosis. And I am not flippant about it.  And I am the one to outlive you. I – who had been talking about dying and death and much more… The irony of it!  You could not make it up.

Knowing the cause of your death helped me deal a lot better with the enormity of losing you. At least one unknown had been removed and I could focus on the loss. Even though, still now, from time to time, I experience moments of utter disbelief and deep pain that you are gone. I am grateful a process was in place for your clients to be told of your death and to be given an offer of support should we need it.

I dread to think what it could have been like, had we not been told about your death: more doubting you, more fear of abandonment?

But I think I would have found out, somehow, eventually.

Saying good bye.

We, you and I, we did not have an ending together. Your colleagues had an event in your memory, which excluded clients. Part of me thinks this was probably appropriate. The child, however, felt angry and excluded – therapists versus clients.

I do not know what could or should have been offered for clients, indeed, whether it would have been anyone’s responsibility to do so. Or whether other clients would have even wanted such an arrangement.

When you can no longer explain, ask why or say good bye. Read More

But I had an ending of sorts by returning to the room we had worked in last. I just asked, and my wish was granted – 10 minutes. I am grateful for that. I took a photograph of your chair (which came out distorted), of both our chairs, the clock, the tissue box, the view from the window and the view from the waiting room to the steps you would always climb up ahead of me – my eyes focusing on the hem of your trousers and the heels of your shoes.

You would always, without fail, turn around at the bottom of the stairs to check I was there and then smile at me. That’s when our 50 minutes started – not in the room, but at the bottom of the stairs.

When I re-entered the room to take the photographs, it felt empty. I felt empty. You had gone.

To start with, I had the photos on my wall. Over time, I no longer needed to look at them. Then came the day when I was ready to take them down. I still have them, somewhere.

You introduced me to the concept of gratitude for our life experiences. Nothing, you said, is a waste.

Everything is a gift. Everything has meaning – including pain.

It took me a long time to understand what you meant. You have taught me so much.

Why gratitude helps us find inner peace Read More

Making sense of your death.

You had been a gift. Even your death, dare I say, holds in it gifts of guidance. That is the best way I can make sense of your death, for now. Your death has made me re-evaluate my own life and mortality.

I realised just how little prepared I am for my own death, and how that is standing in my way of living, whatever time I have left, to the fullest.

Your death has also made me re-evaluate my own client work, especially boundaries and self- disclosure when faced with ill health and death.

Therapists are mortals, too. Read More

I dealt with your death the best I could, the way I had learnt from being with you. I had internalised your voice:

“Karin, observe, feel, name, accept – trust the process.”

I feel privileged to have met you. You believed in my and my pain. You helped me grow and change.  I trusted you, like no-one else. And the trust continues to contain my grief and makes me feel safe.

The experience of losing you and grieving for you is intense and to start with felt unbearable. Some people who have not had therapy or who have a different experience with their own therapist, found it difficult to understand the intensity of my emotional response to your death.

Indeed, some have questioned whether this is a sign of an unhealthy dependence on you, and whether the therapeutic boundaries should not have prevented this level of involvement. Others know exactly where I am coming from.

Thank you.

In the very early days of our work, you once remarked that you are comfortable with your truth. Then, I had not understood what you meant. You might as well have talked a different language. And you know what, it had sounded a bit arrogant and pompous – like pain is a gift! Yes, right!

But with time I learnt to understand what you had meant, and I started to feel it myself.

I thank you for that – for offering me a unique relationship, which allowed me to explore, make friends with and embrace my own truth.

If your therapist or counsellor has died and you feel you are struggling with grieving for them and finding closure, then I hope this article is of some use to you and will give you hope, that you too, will be able to cope, in your own way.

Do feel free to leave your comments (below) on this important topic. 

Image courtesy of Free-Photos.

First published in 2013 by BACP Private Practice, Winter 2013.  

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