When a Therapist Loses a Client

Updated: Oct 11



Last month I incurred a professional scar that I'd hoped to never have to wear, let alone so early in my career. I learned of a former client's death by suicide.


For many reasons, this news was difficult to process.


I make it a rule not to have favorite clients, but organically it occurs that with some clients you just tend to co-create more intensely. Clients that are more engaged in their own work can often take the therapy process to deeper levels, and the work I got to witness and support with this client was extraordinary. But I always knew his pain was large, perhaps larger than the enormous effort he put into staying alive.


Two weeks before his death he reached out to me to share a completed creative project that I'd helped him with during our work together. In that exchange we caught up briefly and while he reported some setbacks since we last met, he also reported some new insights about life that gave him hope. He really did sound like he was in a growth process.


But perhaps the burdens that occupied him felt again like they could not be outgrown.


Seeking my own support to navigate my receipt of this news, I shared it with a few people close to me. One friend unfamiliar with my profession asked "is that like when a doctor loses a patient they're operating on?"


At first I thought I suppose so. That inevitable (perhaps) moment in the healing profession when you're confronted with your own failings, your own limitations, your own true lack of control and impact.


This client wasn't in my care at the time of his death, and from what I heard of that day, there likely was a systemic failure that allowed it to happen - not that it might not have happened anyway. When I worked in that setting, I fought against the parts of that system that allow it to fail so easily but, as systems do -- bigger and stronger than any finite grouping of individuals -- it persisted.


But maybe, in part, because I didn't quite feel like I, myself, had failed in action, the more I thought about the comparison to a doctor losing a patient on an operating table, the more distant I felt from it.


Perhaps I imagine a patient on an operating table is more of a stranger to that doctor than my client was to me. In therapy, you get close to the pain of people. You also get close to their joy, their faith, their humor, their existential curiosities. In my particular work with this client, given the setting I worked in, I also got to witness his creative pursuits, his dance with sobriety, his attempts at building relationships. We even collaborated our efforts in trying to amend the system we both saw as broken. This wasn't just a case with a diagnosis and a treatment plan, it was a human that occupies a place in my heart, the same as my other clients, and I saw him as a great light on this Earth that I wanted nothing more than to champion.


And knowing his pain in the way I was invited to know it means I know what took his life. I know his killer. I've looked it in the eye, I've talked to it, I've held it, I've helped calm it, even if just for a moment.


Therapists who love their job often talk about the blessing of being able to witness people overcome that which feels impossible to overcome. There's something quite magnificent about attesting to human resilience and the process of becoming conscious in that way. And I saw him fight to live every day. It was something I always honored in him. He was a warrior for his life, but something else won out in the end and that something else had a determination to die.


...


It was after I heard this news that I realized my body could no longer hold every bit of sorrow it accumulated this year, from all corners of personal and collective life. I decided to honor the anger in my grief and booked some time at a local rage room, a place where you get to smash things with a sledge hammer to your heart's content. I wept and hollered in the process and felt a release in the human way I held this grief.


I also performed a more still ritual where I could grieve more inwardly, feeling into and making meaning of the impossible sadness.


But the therapist within me is still unsure of what to do next. There's a new hopelessness in the way I view the process of therapy. Not that it's all for naught, not that most people can't be freed and empowered, but that if even one person can't be, it must change how it all hangs in my heart.


I'm in the early stages of processing this loss, both as a therapist and, first, as a human. I have no answers.


But one of the first things I learned as I sought out support was that fewer therapists have experienced this than I imagined. In therapy circles it's talked about sometimes as an inevitability, that any one of us can one day encounter a client we can't save in the end, no matter how hard we try. The image at the top of this post feels aligned with that idea, that no matter how tight your grip, sometimes the wind is simply too strong.


And yet, from my recent round of inquiries, so few therapists have experienced this in real life.


So I wanted to share my initiation into this group of therapists scarred by the loss of a client, past or present, especially by suicide, for anyone who may be in a similar position and feels alone. You're not. And as I continue to find resources for myself and process this on all levels, I'll continue to share. Because it is not in systemic places but rather trusted community that we can find our far-off healing.


If you or someone you know struggles with suicidal thoughts, please know that someone cares for you and wants you in this world. Support is available to you, even if you've struggled to find it in the past. Reach out to any of the following support services anytime of day, and don't be afraid to ask your loved ones for help. If they make you feel like a burden, ask someone else. You are not a burden. And you deserve love.


National Suicide Prevention Lifeline: 1-800-273-8255

Crisis Line for Military Service Members and Veterans:1-800-273-8255 (press 1) or text 838255 

The Trevor Project Lifeline (LGBTQIA+): 1-866-488-7386​

National Sexual Assault Hotline: 1-800-656-4673

Para apoyo de crisis en español, llame al 1-888-628-9454.

Alcoholics Anonymous

Narcotics Anonymous

SAMHSA National Helpline: 1-800-662-HELP (4357)

National Eating Disorders Association Support Directory

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