Confidential Connections
When a client dies, it presents a unique situation for a therapist. Due to confidentiality, many counselors choose to not openly mourn with their client’s family and friends. The reason for this would be because of the common question; how do you know the deceased? This puts the counselor in an uncomfortable situation of lying or breaking confidentiality, which would be unethical.
Confidentiality never dies and it is a counselor’s duty to protect the client’s identity and what was said in session long after the client’s death. Over my seventeen year career, I have experienced client death due to cancer, aging and suicide. There is no formal training on how to deal with client loss. If you are a counselor long enough, you will face your client’s death, at least once.
I was going through some old papers and found a letter I wrote. This letter was never sent because it was written to a deceased client. I am publishing a part of this letter to show how therapy can go beyond the clinical parameters set forth through our profession. As humans, we experience a variety of emotions and connections through our work. Only a small portion of these are discussed behind the closed doors of a supervision session, most remain within the therapist. The names and situations have been changed to protect confidentiality.
Putting Pen to Paper- The Letter
Dear Paulette,
Did you get the card? Before I left for vacation, I sent you a get well card with dogs on it because I know they are your favorite animal. When I returned from vacation, I had a message from Roger telling me to call him. I knew about your scheduled surgery but I had no idea you died.
I have many questions about your physical health and illness, which will go unanswered. I know you would have stayed longer, if you could. You were a fighter and would not give up easily. I wish I knew sooner you were dying and we could say a final goodbye. Perhaps, you did not know you were dying at this point?
I never shared with you how you helped me grow as a person. Through our sessions, I developed patience and insight. There were many times, I found it difficult to sit with the rigidity, defensiveness, and control. We both stayed and worked through these times.
During those difficult exchanges, you reminded me of a family member. This is known as countertransference in our field, when a client reminds the therapist of unfinished business in her own life. I didn’t know how to sit with her anger and blame, without feeling drained. You helped me to see I can do this and not take what was said personally.
We did have some laughs despite the conflicts and came to a place of more calm. Today, I would hug you and say, “You matter to me, not only as a client but as a person.” I saw your soul beneath all of that fear.
The last time we spoke, I called your hospital room. You told me, “Don’t give up my time space in your schedule.” I responded, “I wouldn’t because I didn’t want to lose you as a client,” and I meant it. After your death, I had to fill in your time slot, although, there will always be a space in my heart that is only yours. You will live on as a part of me, due to our work together.
I know you are at peace and this gives me comfort. You are now reunited with your parents, whom you often spoke about. I sent Roger, who knew about your treatment, a sympathy card. I feel you would approve. Your family will miss you and so will I.
Sincerely,
Lisa
Lisa Hutchison LMHC is the Amazon bestselling author of I Fill My Cup: A Journal for Compassionate Helpers and the kindle book Setting Ethical Limits for Caring & Competent Professionals. Lisa is a licensed psychotherapist and writing coach who helps sensitive souls not just survive but shine.
Pick up her FREE gift 8 Simple Things That Release Chaos from Your Life Now! at http://www.lisahutchison.net
Great post 🙂
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Thanks!
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It has always been my experience, especially the years I was doing outreach work, that when we are there for others, we often get so much more from them than we know.
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I agree, Barb. Holding the space and being emotionally supportive, makes a big difference in the lives of others,
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Wow Lisa that was beautiful to read and so insightful. Yes often when someone passes we realise how much more we have gained than we did at the time. Thanks for sharing xxx
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Thank you Suzie and you are welcome. Yes, when we look back on our relationships, we gain wisdom. xx
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When we help others, whether professionally or in a personal capacity, we end up helping ourselves too with new knowledge and insights into ourselves, Lisa. Thank you for sharing the letter, it resonated with me at a deep level.
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I am happy to hear you connected with this letter, Vatsala. In giving, we also receive.
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You bring to light something I had not thought about – how does a counselor grieve the loss of a client? As their counselor, you know them on a deeper, more intimate level than most (or all) individuals in their life. When put into that perspective, the hush-hush grieving process adds a unique dynamic to your own healing. Thanks for sharing this personal, and vulnerable, letter. Thank you for all that you do, Lisa.
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You are welcome, Cindy and thanks. You hit the nail on the head, it is a secret kind of grieving.
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Beautiful post, Lisa. Holding space for others to heal is a sacred responsibility. I had never thought about it. Counselors form a special kind of relationship with the patient, being privy to the inner world of the client and still needing to set the proper boundaries for care, doesn’t stop one from being human. I know this post will help other searching for ways to deal with loss, it’s helped me already. Thank you.
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Thank you Kathleen and you are welcome. I am happy to hear this post has helped you. It is an interesting profession to be connected yet isolated from sharing with others.
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This is such a beautiful blog and tribute Lisa. I so resonate as a fellow counselor and really appreciate you sharing your experience. Thank you so much!
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Thank you Kelley and you are welcome. I am happy to hear you resonated with this post.
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Such a poignant letter, one that shows your compassionate nature and empathy Lisa .. I find putting pen to paper in my journal so very therapeutic and wrote many a letter to my Mother yet never posted them..
We each have emotions to deal with and being a councillor makes you no less sensitive to the loss of a client.
Many thanks for sharing your personal story and letter with us Lisa.. I am sure it will help others who read it..
Much love your way
Sue ❤
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You are welcome Sue. I wrote many letters after the death of my Mom also, although I disposed of them afterwards. As I am sure you understand as a writer, we only have so much space to keep writings. 🙂 Thank you for stopping in to comment, it is always a pleasure. Many blessings of love and light to you.
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Much love returned.. I burnt my letters and asked the Angels to take up their contents 🙂 ❤ 🙂
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A beautiful tribute Sue! 😇🙏
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When I worked as a therapist, it was with an extremely high-risk population. Some of them died and, you’re right — we’re left in a very strange place with our grief. Thanks for a powerful post.
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You are welcome Andrea. Therapy is rewarding but difficult work at times.
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