Updated: Aug 28
A note before starting: This article is addressed to the friends, family, and presumably therapy clients who have mourned, or will mourn, a loss this year. This group is much larger than normal due to Covid, and this excess spurred this article. I have no reason to believe that my own death is imminent. For any of my own patients who read the following, there is no reason to be worried. I do have arrangements for such a situation (as should all therapists)—but I hope not to need them anytime soon.
No one tells you what to do when your therapist dies. A quick online search provides a few results including articles about preparing a professional will or the suicide of a therapist. These are not helpful when your own therapist has died unexpectedly of natural causes.
There must be reasons why so few write about it. Perhaps one reason is that most therapists will discuss an imminent death and plan for it with their patients. A terminal diagnosis for the therapist can (and usually should) be discussed in session, if for no other reason than to explain why the therapist may soon retire. If they discuss it in session, perhaps it need not be discussed in print. Second, the number of patients who experience the death of a therapist may be quite small. Of course many therapists retire before they die, and therapists usually only carry 20-30 patients at a time—often fewer as they get older—so few patients are actively working with a therapist who dies. Regarding a past therapist, many folks move away or otherwise do not make contact after a course of therapy, so it is likely that many inactive patients do not hear of their therapist’s death at all. Third, patients may stay silent about these experiences. Many people who have never been to therapy have no sense for the magnitude of the loss and do not know how to help a friend or family member cope. Perhaps without a place for the patient to talk about their loss, their hard-earned lessons stay with them. Last, perhaps we just don’t like to think of our caregivers passing away. They help us stay healthy, alive. They help us with our fear of death. We think they cannot struggle with these too. Perhaps those who do experience such a death tend to shut it out, hold it in, or grieve amongst a small number of close friends. Again, the experience remains isolated.
Unfortunately, a couple years ago I lost my therapist in the space between our weekly sessions. Being unexpected, we did not get to discuss it. Having never lost a therapist before, I was uncertain what to do.
It is a strange thing to be a therapist and not know how to be a patient. I knew the rhythm of therapy—I did not ask much about his outside life or exchange pleasantries, because the time was for me. I showed up on time and talked for the same 45 minutes each week. He did not speak much, usually allowing me to discover what I needed on my own, but I knew when he did speak that I should listen. His death destroyed our rhythm.
The following is an explanation of what I did in response. Do not take this as a prescription for what you should do regarding your own therapist’s death. Just take note what you like and what you think might be helpful to you.
The first thing I did was to seek consolation in my closest relationships. I am fortunate that most of my close relationships are comprised of either (1) therapists or (2) people who have gone to therapy. They could understand, or at least imagine, what the loss would be like. They provided validation that this was something very sad and normalization that a normal person would grieve this. If you have nothing else, this is the most important step.
Close, loving, understanding relationships cure a lot of ails.
The second thing I did was to disclose the loss where appropriate and where I thought the loss might affect my functioning. Did I tell the grocer that I was having trouble locating my card because I was having a bad week? No. Did I tell a group of colleagues, with whom I met each week for consultation, that my mind might be elsewhere during our meeting that week? Definitely.
Did I tell my employer? This was tricky. At the time, I worked for a university’s counseling center. My coworkers were all therapists and I knew that the disclosure would be welcome and garner support. At the same time, I wanted somewhere I could focus on other things, and I did not feel that the loss would compromise my work with young, generally physically healthy college students (death was a topic at times, but it was infrequent). At first, I told some trusted coworkers who were not my supervisors (see #1 above—care from caring relationships). A day or two of work and I told my supervisors, not because it had been affecting my work or to get consolation from them, but because they genuinely asked how I was doing and I felt like sharing.
Not making a big deal with my supervisors also gave me another freedom, for my third action—I called out sick the next week and went to my therapist’s funeral.
Going to his funeral was another tricky prospect. Therapists do not generally invite patients to events in their life. However, my therapist had recently served as president of the Boston Psychoanalytic Society and Institute (BPSI) where I was working on a fellowship. Upon news of his passing, an invitation was extended to the fellows. I asked a professor whether I should attend the funeral or skip it. I will share a snippet of his advice here: “Trust your instincts. But if your instincts don’t speak clearly to you, then my next advice would be to attend.” He explained that the funeral would give me a chance to see him as more fully human. In the therapeutic community, sometimes therapists who are patients get to know their therapists professionally, and even personally. His death prevented these future possibilities, but the funeral would provide a glimpse of the man who quietly listened all those Wednesday mornings.
The funeral was long and full of people I did not know. However, I recognized a sprinkling of therapists from the psychoanalytic institute and people packed the church full. Much fuller than I expected. I never knew him with other people—I always had him to myself in his small office. The size of the crowd validated the size of his importance for me as I imagined the impact he made for the many others gathered there. It also revealed some details of his life: who were his family, who were his friends, and what were his interests.
It revealed funny mistakes in my fantasies about his life: as is the stereotype of older psychoanalysts in Boston, I thought that he was an old Jewish man. He was an old man (I got that right), but he was a Congregationalist Christian, and twice a deacon at that! Not knowing this information was actually quite helpful for my own ability to say whatever I wanted during therapy. After our therapy was over, knowing this information was also helpful for transforming him into a real, three-dimensional person who had accepted me regardless of what I had said. His therapeutic impact on me continued even at his funeral.
Finally, and the last “action” I will describe here: I saw another therapist specifically to talk about his death. I procrastinated on this front—like many people, I struggled to find a therapist and invest the effort to make it happen, knowing that I would be talking about painful topics. However, talking with another therapist helped me organize the experience so I could understand it. He helped me see where the therapy might have gone had we had more time before his death. And I used this therapy better than any I ever had before. I did not take this therapy for granted.
Regarding the therapist who died, I saw him weekly for about two and a half years. He was a kind, gentle man who listened and reflected back to me a helpful perspective of who I was and who I might become. There were times I considered ending therapy with him. He was never the perfect therapist. However, Dr James (“Jim”) Walton made a positive impact on who I am, and I regret that we never had a proper goodbye.
If you are someone who has lost a therapist, I encourage you to take that loss seriously. Seek comfort from close, trusted friends and family members. Disclose when necessary or when helpful for you. Consider attending the funeral, if you have been invited* and your instincts suggest it. Last, not everyone needs to seek a therapist afterwards, but it can be helpful. A one-time consultation can clarify this for you. In the worst case, speaking to another therapist is superfluous—in the best case, it can lead to significant growth.
*Respect the privacy of the families and friends of your therapist--if there is an announcement of when and where the funeral will be held and an invitation is extended to the public, or an invitation is extended specifically to patients of the therapist, then you may consider attending the funeral as an option. If the funeral is a private affair held only for family and/or friends, respect those boundaries and commemorate the loss in another way. (Edited to add this note on 8/26/2023)