An Ode to Grief: A Therapist Perspective 

In December, I discharged a long-term client due to his prolonged hospitalization for a then-unspecified medical condition. I had been working with him for five and a half years, almost my entire tenure at NYPCC. Discharging him was difficult because it felt sudden and final. While I hoped he would recover and be able to return to the clinic, deep down I knew this would not be the case.

While discharging clients is a common practice in our field, this was one of the most difficult ones I have had to complete. Weeks later, his social worker contacted me to inform me that it had been confirmed he was suffering from Stage 4 cancer and would likely pass away soon.

His medical decline led me to reflect on our therapeutic relationship. He suffered from schizoaffective disorder and had a cognitive delay. Although he was in his 60s, he had the mind of a young child. While this made treatment difficult at times, particularly when working on emotional regulation, it also brought many positives.

Once we were able to build rapport, I became quite fond of him, as did many of my colleagues at the Bronx location. His decreased social awareness made him extremely outgoing, with a lighthearted joy that was contagious. While his lack of patience could sometimes frustrate me, and the clerical staff as well, I came to understand that he did not have many people who gave him their undivided attention. Because of this, he truly looked forward to coming to NYPCC each week.

NYPCC was not merely an agency to him. It was a safe space where he felt comfortable and welcomed.

A few days later, when I received the news that he had passed away, my grief felt heavy and I frankly did not know where to put it. The confidentiality boundaries of our relationship kept me from grieving in the traditional way. However, I still experienced many of the familiar stages of grief.

There was the initial shock that someone you are used to seeing on a weekly basis, you will never see again. There was anger that his cancer was not caught sooner. There was regret that I did not know our last session would truly be the last, and the wish that I had said so many more things to him. I also found myself wondering if I had shown him through my actions how much I cared about him.

Navigating my grief while respecting the ethical boundaries of our therapeutic relationship was a new experience in my tenure as a psychotherapist. While he was not the first client I had lost, he was the first with whom I had built such a long-term relationship.

The first crucial step was honoring all of my feelings so I could properly cope with the loss. I acknowledged that I would miss the light he brought into the clinic every week, while also feeling grateful that he was no longer in pain.

I also reflected on how our work together taught me valuable lessons that I carry with me into my work with current and future clients. I take comfort in knowing that I provided him with much-needed understanding, patience, and stability. I feel peaceful knowing that I treated him to the best of my ability, and that he always openly expressed appreciation for me.

I think most of us hope that before we leave this world, we can touch someone else’s life in a meaningful way. I hope he knows that he impacted my life in a positive way, both professionally and personally.

Writing this has been a part of my grieving process. My initial instinct was to compartmentalize my grief, or perhaps avoid it altogether. But I realized that I cannot help my clients through a process I am unwilling to go through myself.

I have talked about it. I have cried and laughed while remembering happy memories. At times, I have even found myself laughing and then suddenly crying all over again.

Since going through the grieving process, I have also increased my self-care routine. I spend more time with my partner, love on our fur babies, and make space for fresh air and exercise.
In the end, to do this work well, we must all do what is necessary to stay healthy, both for ourselves and for the clients we serve.