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How Do I Deal With The Fact That My Therapist Is Dying?

Question:

how do i deal with the fact that my therapist is dying? I saw him for 2 1/2 years and he was diagnosed with brain tumors and cancer in his brain. I finally ended it this August and he referred to someone he is close to but I can’t seem to get over a) the fact that he’s dying b) the fact I can’t see him anymore (my new shrink said I should cut off contact) c) The senselessness of his disease (he used to be a priest) and I just plain miss him and I’m angry he’s dying. I’ve never lost anyone close to me. I can’t shake this pain and misery. I am in therapy twice a week and on a boatload of meds but when it comes to this issue I have no control and cry severely. I don’t know what is grief and what is my depression (I was diagnosed sever major depression recurrent). Any advice?

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Answer:

How does anyone deal with the fact that someone they care about is dying? As gracefully as possible, I think, understanding that there is no really graceful way to grieve except to allow yourself to do so.

Your situation is just difficult. You care about this man after working with him intimately for two and a half years. You want him to live but his illness is so severe (it sounds like) that no interventions will be able to do anything more than forestall the inevitable. This sort of situation is just terrible whenever it happens, but it is also a normal happening and not anything exotic. We who fear death and loneliness find it terrible, but to mother nature, death is just business as usual.

The situation is complicated by the fact that this man was your therapist and not your friend or parent. People sometimes have irrational expectations for therapists (and other parent-like figures), and when these expectations are violated they get angry. For one thing, therapists aren’t supposed to let you down or abandon you, but due to his impending death, he has (seemingly) both let you down and abandoned you. His dying is thus very inconvenient for you (if we can step into a selfish mode for a moment). Therapists are supposed to be selfless and only focus on patients’ needs, but here this guy goes and intrudes his own business into your therapy and the situation is so intrusive that it necessitates the termination of your work with him! How rude! I say this with my tongue firmly in my cheek and with more than a little sarcasm, but I would not be surprised at all if some of the anger you feel could be in this vein. Of course you’d suppress that sort of thought (most of us would) but it might be there anyway.

The formality of the relationship between you is also making it difficult for you to see this dying man. If this was a normal friendship or family relationship, you’d be freer to spend time with him before he died. Hopefully, in that situation, this would be contact he’d want because you’d be his friend and he’d want the comfort of your friendship. However, this man was not your friend but rather your therapist. He may have cared for you, but the essence of your relationship with him was professional. It is enormously likely that he did not share his feelings and thoughts about you in a casual manner, but instead only expressed them after careful consideration of how they might help you along. It is likely that he did not share any negative or irritated thoughts with you, for instance. If he found you to be annoying sometimes (and who among us isn’t annoying sometimes), he was not exactly free to let you know that, but instead needed to maintain a professional manner. It is also likely that you cared more intensely for him than he did for you. This isn’t to say that he didn’t care for you, but rather to say that the nature of his role probably necessitated his keeping his feelings about individual patients under check. Ultimately, he was working when he did sessions with you, and now that he is not doing therapy anymore, he may not want to have to think about his work anymore. As he goes about spending the time he has left, he is more likely to want to spend time with his friends and family than with patients, and this is normal, if hard for patients to cope with. Again, this is not to say that he didn’t care for you, but rather to point out that it is typical of the therapy situation that patients become more bonded to therapists than therapists do to patients. If it were otherwise, he would not have been acting ethically or wisely.

This said, there is no ethical duty that requires your old therapist to not see you at all. If he wishes to see you, he’s free to see you, more or less. The key phrase here being what his wishes are. If you request an audience with him, however, I’d encourage you to be very sensitive to his needs now, moreso than your own. This is a reversal of how things used to be, and you might not be thinking this way by default. If it is the case that seeing him will benefit you more than him, it will be a bad idea for you to ask to see him.

I can only guess at why your new therapist is instructing you to not seek to speak with your old therapist, but my guess would be that (he?) is trying to keep you focused on the work of therapy which should ideally be to help you become less depressed. Seeking out contact with your old therapist might be quite counterproductive (as well as potentially disrespectful if he doesn’t want contact) from the perspective of getting therapy done. And he’d be right, I think, that seeing the old therapist would be a major distraction, but it’s understandable given the traumatic nature of the situation. It may be that you can’t not be distracted for the time being and you just won’t get any new therapy work done for a while. That could be okay. I’ll encourage you to speak with your new therapist about your anger over his prohibition, and what exactly his motivation is in giving you the prohibition. Talking about your different experiences with regard to the situation might be very profitable for your therapy, indeed, taking it in a new direction that will work for both of you. Maybe you can shift the focus of your therapy work temporarily to focus on helping you through this grieving process.

Beyond doing grief work in your therapy and allowing yourself to grieve, I’m not sure what else can be done. It can be a little easier to bear grief if you share it with understanding others, so talk about it when it is appropriate to do so. Also, avoid abusing pills or alcohol or similar bad habits as a means of coping. Ultimately, however, grief is part of the human condition that we need to take on the chin, so to speak, as there isn’t any cure for it except time.

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