Even Therapists Need to Prepare for the Inevitable

So here it is: Therapists die, too. Now that I've got your attention...! But in all seriousness, if you follow this blog, you'll know that I've written about clients' deaths and how they impact their therapists. I've talked about how deeply we feel their loss and alluded to the few support systems that are available to us.

But it works the other way, too. I was reminded of this recently when someone came to me to talk about how bereft she was feeling after the sudden and unexpected death of her therapist. She had received a brief telephone call from an unknown person cancelling her upcoming appointment, and that was all. There was no mention of a funeral or memorial service, and no provision for a referral for her treatment.

I listened to her words and heard the impact of that sudden and unequivocal—and very generic—notice; this was someone she had been working with for years, someone who knew her better even than her own family, someone she had trusted and admired. Even worse, she had no proper way to grieve. The funeral was for family only. She never had a chance to say good-bye.

I found myself frustrated and concerned by what I perceived as the therapist letting her client down, giving her no outlet for her grief. I also realized, in thinking about it, that this therapist's inaction very probably represented the majority of us. Therapists are first and foremost humans, and like all humans, we don't always make the best decisions.

Creating a professional will

What should have happened in this instance was that the therapist should have made clear contingency plans for her possible death—created what is known as a professional will, which is an ethical obligation for people in our field.

Source: Feyza Yildirim/Unsplash

We don't work in a void. People depend on us. And the best way to return that trust is to take care of them even when something totally unexpected happens. (And, after all, death is never "totally unexpected"; only its timing may be.)

So what can therapists do to make sure their clientele doesn't one day endure what my friend had to?

That's where the professional will comes in. Therapists can keep an organized, running list of clients, and designate one person who can access that list should the need arise. The plan should drill down into details: Who will contact their clients? What should that person say to them? And, perhaps most importantly, who are some other therapists to whom the clients can be referred?

Therapists in disarray

Of course, this plan takes a lot of organization and forces us to face our own mortality, which many of us are understandably loath to do. I belong to two consultation groups, and in both of them we've discussed the problem and how to deal with it, all of us affirming that we'd each make another group member the point person for our practice... but we never got around to following through.

Yet there are probably few of us who haven't seen examples of therapists who have died, creating havoc for their clients and for the administrators who needed to contact clients. One psychologist I knew had been diagnosed with brain cancer but thought she had more time to terminate with clients—until she didn't. Her daughter, also a psychologist, had to scramble to figure it all out while she herself was grieving. Another colleague had actually developed a termination curriculum for therapists planning to retire, but didn't put it to work in his own practice, leaving it disorganized when he too died suddenly.

So what should we do? For me, there are two main considerations:

• What needs to be done, and who will do it? Who would you want to contact your clients? How do you want them contacted?
• Just as importantly, consider what kind of grief work your clients will need. Is it private or should it be done in a group setting? Clients develop strong bonds with their therapists, and they need to reflect on that person in a setting that is comfortable and welcoming.

Grief Essential Reads

Long Ago and Far Away

What to Expect From Your Grieving Friend This Holiday Season

If you've read this far and do not have that kind of plan in place, then please take the time now to think about it, to face the reality of your death and organize yourself so the clients you treated so well while you were living get that same level of care and respect when you die.

If your therapist dies

If you're one of the many clients whose therapist has died without leaving a plan, please know that the lack of effective communication is not a reflection of how your therapist felt about you. Be assured that the depth of grief you will experience is completely normal and appropriate and healthy. You've lost one of the most important people in your life, someone who knows you better than anyone else, who helped you and was always rooting for you.

Don't minimize the shock you're feeling. The most important thing for you right now is to see a mental health practitioner who specializes in grief. Don't rush to replace your therapist, but see someone in the short term to help you move through your grief. Later, when things have steadied, you can think about finding the clinician you'll engage with for ongoing or longer-term work. Move forward, but move forward in phases.

Keep in mind that our profession teaches us not to self-disclose, and when it comes to illness, many therapists don't give details—or else give canned responses. The truth is that we're supposed to be good at this, and we're not.

Source: Hrant Khachatryan/Unsplash

I am the designated clinician for a psychologist who is remarkably organized and who elected me some years ago to be the spokesperson in the event of her death. I know where her files are located; I know exactly how to contact her clientele and what to say. This diligence is admirable. And it's a weight off her shoulders: She knows her clients will be taken care of.

Again, if you happen to be one of the unfortunate clients whose therapist has died unexpectedly without provision for your continued care, I want to emphasize to you that your therapist's love and commitment to you hasn't faltered. Find someone to help you grieve, and be angry, and be sad, and feel lost... and know that your continued mental health is exactly what your therapist would have wished for you.

You matter, and you have always mattered.