I am a therapist and my client died tragically. Here is what it taught me about grief that can't be found in textbooks.
- I found out through word of mouth that one of my clients had died.
- I couldn't tell anyone I knew this person because of HIPPA laws, so I had to deal with the grief alone.
I found out by word of mouth. While I live in a relatively big city, it can feel so small at times. I heard through the grapevine that someone who ran in a familiar circle had died. I felt this weird churning in my belly as the pieces started to come together, and I figured out that the deceased was my client. I felt dizzy at the realization. I know this person, knew this person, and knew them really well.
So well, in fact, that I potentially knew them better than anyone else in the world. Such is the privilege of being one's therapist. We, therapists, become the keeper of another person's story, of their humanness: their goals, dreams, secrets, shame, desires, longings, and intentions.
But then, what was I to do with the information once I knew it was my client who died? Because of HIPAA — the federal law that requires therapists to protect the information of a client — I couldn't divulge to anyone how I knew this person or even that I knew them at all.
I felt lonely in my grief
It felt surreal. I, the keeper of all the things of this client, was immediately carrying what felt like a burden of knowing. I was holding all of it and had nowhere to put it. Like all of the others who were grieving this person, I, too, felt the magnitude of it all, having come to a screeching halt.
This person would never realize their future vision come to fruition through our planned action steps, would never get the chance to have those assertive conversations we'd role-played, and would never have the option to align their choices with the values we'd clarified. And I would never again see them perched all the way to the side of my teal couch. I'd never see them light up when they talked about certain people or cry at the mention of others. I'd never get to nudge them toward the goals we collaboratively set during our time together.
The loneliness I felt in this solitary grief was immense. It triggered a depressive episode for me as I was constantly slapped in the face with the reminder of the enormity of the work I do as a therapist. I work with people's lives — until I don't.
For the first time, I'd lost a client. Their life, our work, and that relationship ended abruptly.
I don't think of my clients as a job
I was able to share what happened in generalities with some colleagues, my partner, and my own therapist, but I couldn't share in the telling of stories with people who also knew this person. I couldn't show people the last worksheets we had completed together. I could only hope that my describing this person's spirit and laugh would capture some part of this client's energy and the void that I now felt.
The therapist/client relationship is so unique. It may sound like a cliche, but I don't do this as just a job. It's not simply a service I'm providing. It's almost something I truly can't put into words. When the relationship between the therapist and client is the right fit, it is two human beings in deep connection. It's the intention that the client feels truly seen, known, heard, and understood. It's a relationship that doesn't have previous baggage, and it is based on profound trust and rapport. While the relationship is largely "one-sided," inasmuch as the therapeutic benefits are for the client, and the therapist must uphold professional boundaries, it is impossible for me not to grow some level of attachment or connection, as well.
Ethically, we therapists must consistently take stock of our own conscious and unconscious happenings that play out in the therapy room, avoiding or addressing what is called countertransference. Countertransference is defined as "the redirection of a therapist's feelings toward a patient and the emotional entanglement that can occur with a patient."
It is our duty to set and protect boundaries, of course, and due to the intimate nature of individual counseling, we would be remiss not to acknowledge that therapists can end up caring about their clients. It's why we do this type of helping work, right?
I wasn't taught in school what to do when a client dies
I don't remember any classes in graduate school discussing what to do if a client dies. I have a handful of colleagues who have discussed their experiences. But to now be a part of a club that no one wants to be a part of has made me reflect on the therapeutic dynamic like never before. I have to stress what an enormous privilege it is to walk with someone in their story, at their most vulnerable, on their paths to growth, balance, awareness, and healing. I do not take any of it for granted.
I allowed — and still allow — myself to feel the enormity of what happened and what it represented. I validated my own loneliness and grief and then I considered what I encourage my clients to do when they've experienced a loss so that I could do the same.