Grieving the Death of a Client

Grieving the Death of a Client

Well, after being nudged by a social worker colleague of mine who maintains a blog, I decided to do the same—well over a year after creating the space for it on my website, and after a few false starts. Why did it take me so long, I asked myself? Well, for the longest time, I just didn’t have room in my brain for it. Now, well, there’s a bit more room. It was time to edge in and have a seat at the keyboard, I supposed.

I pondered on how to begin the blog, as well, and something happened some months ago that I have felt strongly compelled to share with others. I experienced the sudden, unexpected death of a client, and I imagined writing about the particular way that I grieved the loss. Digging deep, indeed. I hope this entry is of value for therapists and those seeking therapy alike.

Tom (not his real name) and I worked together for about a year, focusing on long-term substance use and emotional attachment difficulties. Tom experienced isolated health scares during the year, some related to lapsing back into substance use, some not. I loved working with Tom, and I saw him make wonderful, if at times very emotionally painful, progress. We met weekly, sharing a cup of tea and exploring his social-emotional terrain. As a new year arrived, so did illness for Tom. We were uncertain what the future held, but Tom was committed to continue our work. Tom expressed concerns about mortality, but we had no reason to believe that his time on this plane of existence was limited.

One week, Tom did not arrive for a scheduled session, and he did not call ahead to notify me of a late arrival or absence. Recently, Tom had missed a couple of sessions out of concern about going out in the cold while still on the mend from illness. Nevertheless, he always called ahead to let me know. The only other instance when Tom hadn’t called ahead was in the midst of an unexpected hospitalization. I feared something was very wrong.

I placed a couple of courtesy calls to Tom over the next two days, and none were returned. This was not characteristic for Tom and, rational or not, I began to wonder if Tom had died. Via an online resource—Tom had a web presence of which I was aware—I discovered a single post from a self-identified friend of Tom stating that Tom had died suddenly and unexpectedly, but in apparent peace.

I had never lost a client to death before. I had lost others close to me, but…this felt different. I experienced a profound numbness that felt very much present but also very distant at the same time. The only word that comes to mind in describing the feeling is, ‘Blecch’. I reached out to a couple of colleagues throughout the day, but most of them were otherwise occupied. I tried to be circumspect in explaining why I seemed so ‘down’ to those close to me, and I spoke with my clinical consultant. Online, I read what I could about coping with client terminations resulting from death, but most of the therapists who posted seemed focused on loss of a client to suicide. I found a couple of articles about maintaining boundaries when participating (or whether to participate at all) in a public celebration or remembrance of the deceased client’s life.

I struggled to decide how I wished to honor this person and the work we had undertaken. I continued to sit with the feelings of loss, but went so far as to re-arrange my office, thinking it would feel a bit better not to look at the sofa from the same perspective. I happened to send photos of the new layout to a close friend who is highly attuned to energy (and to whom I had alluded the recent death of a client). She responded to the photos, saying, ‘There’s someone in your office, and he wants a final session. Could that be the client who died?’ Admittedly, I felt a bit baffled, but then I realized how much sense my discomfort made in this context.

Sitting at the desk in my office then, I immediately turned to the sofa, and said, ‘All right, Tom, I’m scheduling us for our regular time this week. Let’s have our final session’.

That day, at our appointed time, I closed my office door and said, ‘Tom, this is our final session. If you are here, then I hope you’ll acknowledge your presence at some point in the next 45 minutes’. I prepared a cup of Tom’s favorite tea and placed it on the coffee table at his usual spot.

It was as if I were conducting a regular session, with all the periods of talk and silence that one would expect in a comfortable, therapeutic working relationship as I enjoyed with Tom. About ten or fifteen minutes into the session, in a room that is typically about 75 degrees, I felt a distinct chill, to the point that I actually began to shiver. I rolled down the sleeves of my sweater to stay warm.
I continued the session, telling Tom what our collaboration had meant for me and reviewing the progress that I’d seen Tom make in his life since the beginning of therapy—all the while maintaining the same therapeutic tone, the same boundaries, that I’d always maintained when Tom was physically present. I thought I might cry (which would have been fine with me), but the tears never came. I read aloud a couple of remembrances and anecdotes posted online about Tom from others who had responded to the friend’s original post about Tom’s passing.

As the session neared its end, I thanked Tom for allowing me the honor of participating in his life in such a capacity, and I wished him well. I re-iterated that this would, indeed, be our last session, that I needed to make room in the therapeutic space for others’ emotional energy. I opened the door, ushered Tom out with a farewell, and, to my satisfaction, ended a treasured collaboration.

A few moments later, I myself stepped out of my office to clear my head. When I returned, I no longer sensed a chill. I instead felt a sense of both freedom and closure, and I was able to move forward, to return to serving the needs of the living.