Death Of A Client

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

I work with palliative patients. These are the people whose diagnosis does not imply recovery. They are not necessarily sick, living out the last days and weeks, not always "dying" in the literal sense of the word. But the very word "palliative" suggests that the patient's illness progresses and sooner or later will become the cause of his death, and no cure is possible.

Often friends and even colleagues ask me how I deal with this. With the closeness of death in everyday working life, with complex, almost overwhelming topics, with the fact that my clients will not live happily ever after, and most importantly, with the fact that clients are dying. Psychotherapy is not just about providing services for money; it is about relationships that involve a certain level of intimacy. And not everyone is easy to build such closeness with a person who will soon leave, and may not even have time to thank and appreciate the work done. Usually, I answer something trivial to such questions. For example, that someone has to do it. Losing clients is always painful, but it is pain that the psychologist goes to consciously.

The death of clients is faced not only by those who consciously choose the path of oncopsychology and palliative care, like me. Death has no schedule, there are no guarantees from it, so the situation of losing a client can arise in the work of any psychologist. And it is important that the psychologist is ready to deal with it.

Feel

We know a lot about grief, about the stages of accepting loss, about the flurry of feelings and emotions that is inevitable when faced with death, but when it comes to the death of a client, many specialists are not ready for the ambivalence of their own reactions. Professionalism does not play a role here: every psychologist is, first of all, a living person, and hiding behind the mask of an indifferent specialist is a path to emotional burnout and loss of control over one's feelings, which is fraught with the loss of the ability to work for the “healer of souls”. Therefore, my first advice for colleagues - do not be afraid to feel, do not pull back, do not deceive yourself, do not neglect your worries. I would like to remain a cold-blooded professional, but this is not always justified. Often, having survived the death of a client and distanced himself from it, the psychologist then cannot build a truly close, trusting relationship with new patients. But we are not doctors, we cannot work with people as with a set of symptoms, it is important for us to be able to get in touch, so detachment is not an option, not a solution to a problem. Do not be afraid to feel and talk about your feelings, even those that seem absurd and not constructive: get angry, fear, grieve, accept.

Don't blame yourself …

Another, no less obvious, but still important advice: do not take the blame on yourself. This is not always easy, especially if you lose a client with a tendency to self-harm or self-destructive behavior, especially if the death is associated with such behavior or was due to suicide. Feelings of guilt are toxic and will affect not only your well-being, but also the lives of your other clients. Remember that you did what you could, and in any case, the responsibility for their own choices always rests with the client - this is included in the terms of the therapeutic contract. You not only cannot always protect your client, you have no right to do it - thereby you deprive him of responsibility and choice, violate his boundaries. The right to die is one of your client's natural rights. He implemented it, and it was not in your power to prevent it. This does not mean that one must completely relinquish responsibility and refuse to analyze the therapeutic work in order to gain and accept new experience, evaluate the work done, find possible mistakes so as not to repeat them again. But it should be remembered that you most likely did everything you could in the current situation, everything that the client allowed you to do.

Do not discount the work done

Sometimes it seems that if the client died or died, then the psychotherapeutic work did not make sense. This, by the way, is one of the reasons why psychologists do not take to work with dying patients. It seems like - why was it necessary to waste the therapist's time and efforts, the client's money and time, if no one has time to enjoy the result. But it all depends on what we mean by the effectiveness of psychological assistance.

In my opinion, the main goal of our work is to improve the quality of life of the client. And this is the growth of awareness, congruence, harmony within a person. And it is not so important whether a person has lived in this harmony for a hundred years or for several hours, it is important how close he is to it. Yes, the client has died, and he is no longer there, but if before that he received the experience of acceptance, support, care, received answers to some of the important questions for him, found contact with himself - your work is not meaningless. We make the lives of our clients richer, more meaningful, freer - and even if this life has already ended, it was like that for at least some time, or, at least, the client was on this path and managed to get some of the important experience during yours with him meetings.

Don't break boundaries

The therapy contract, like the rules of professional ethics, is not terminated after the death of the client. Sometimes it seems that a violation of the rules of psychotherapeutic work will not be considered a violation if one of the participants leaves. Sometimes, in order to calm yourself down, to cope with your powerlessness or lack of understanding, you really want to figure out what the patient was silent about, or to share your feelings with his loved ones. But remember that even after the death of the client, everything that sounded in your office remains a secret, and you cannot give it to anyone, you cannot betray your patient, even if he never finds out about it. You should not violate the boundaries of a person after his death: tell his relatives about "what he really was", join their life, ask them questions about what he did not want to tell you, come to his house in search of answers to questions and so on. All rights of the client remain with him after his death. Yes, he may no longer care, but your professionalism will still be useful to you, you should not sacrifice your own principles - you will almost certainly regret it after a while.

Embrace a new experience

Death is one of the important, inevitable aspects of life, and the experience of facing death is also very important. Adequately assess the strength of your feelings - if there are too many of them or they are extremely intense, take a break from work so as not to bring your feelings into the context of working with other clients. Live the loss, work it with your therapist (if you don't have regular therapy, find a specialist you can trust for this period). Appreciate the importance of your work with a deceased patient, the value of your contribution in his last days, thank yourself for being with him, and him for trusting you and giving you a new experience.