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
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.
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.
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