We therapists get used to people leaving us and not knowing why they’ve gone or how they are managing their presenting issues. This is a reality of our work as sometime people are just not ready for change; circumstances get better on their own, financial issues impede or they just are afraid of the therapeutic process. This part of our job can make us complacent to transitions, loss, uncertainty and the unknowing part of life. Seems like we have to get used to this unknowing to do our work well. I never know if someone stops coming because they decided to end the abusive relationship, learned how to manage dysfunctional family dynamics, moved out of town, went back to drinking, didn’t like the way we worked together or just didn’t feel comfortable with me as their therapist. I wonder what I could have done, if anything, to make their experience better or help them continue their work. Maybe they finally decided to end their life or left this existence in another way. I reach out but often there is no answer. I wonder if they are still alive. Because of a busy practice and life, the wondering stops and life goes on, leaving me with only fragments of those people who visited my practice. I do what I advise to my clients, which is to trust the process of life and not worry about the unknowing. The truth is I don’t have to know what happens to each person who leaves my office after they stop coming back for therapy. I have confidence I will learn what I’m supposed to about them. So, I go on and focus on those that do return. I get used to the unknowing.

Gifts emerge in the rare and precious moments of resolution, however. The most rewarding times for a therapist are when we get to celebrate a successful graduation from therapy with a client. This is our chance to reflect on their perseverance, the joys and sorrows of their self-reflection, how they negotiated their pain and how they have grown through the therapeutic process. Walking beside them as they navigated the change process is a privileged aspect of my job and one I cherish. These moments happen frequently but not frequently enough.

Another gift of resolution is grieving a client’s death or a loss of what they wanted to achieve and could not make this happen for reasons beyond their control. Through these losses I touch our shared humanity, embrace all life transitions and find connection instead of complacency.

Recently, I had the experience of a long term client dying, prompting me to reflect on the coming and going of lives through my door. My grief as I witnessed a life ending way too soon provided me an honored glimpse into the full cycle of life. My client’s death reminded me of the importance of not taking any moment for granted. This client allowed me the gift of witnessing their exist from this life and all the intricacies, pain and ultimately acceptance that were involved. It was one of those rare moments when I saw the fullness and muchness of life. I am deeply honored to have be able to share this with my client and appreciate her gift to me. It made me want to change any residual complacency I have with all the uncertainty inherent in my work. And while I can’t know what happens to those who don’t come back to therapy, I must grieve them as much as my client who died, for there is loss there too. If I don’t grieve these losses too, then I WILL become complacent about the importance of all life transitions. What a tragedy that would be! So I must honor ALL the losses as much as I celebrate ALL the joys. Then the richness of our humanity is fully alive in me, allowing me to share it with others and providing a deeper meaning to this thing we call life.

Thank you to my client for sharing your dying moments with me. And thank you to all my clients who have walked through my door. I don't have to wonder anymore but simply be present to the muchness of all experiences.


5.23.19 Submitted by Caron Leader, is a one of the partners and psychotherapists at Within Sight.

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