When the Therapist is in Mourning: Exploring the Impact on Clinical Practice

By Mary Dougherty – IFPE conference, Philadelphia – November 2015

Following the news that my husband had 18 months to live, he and I made the decision to try and live our lives as we had been: he as a professor of photography and film, who also made films, I as a Jungian analyst, and we as partners, parents and grandparents.

Our three-story brownstone in Chicago, housed our lives with his studio on the third floor, my office on the second floor, and our family space on the first floor.

We concentrated on making small adjustments to accommodate his treatments and doing “work-arounds” of his growing limitations.   This flexible approach seemed okay for more than a year because I was working at home and could attend to his shifting needs.  During this time, I informed my patients of my husband’s illness as it felt appropriate.

Eventually his illness required me to stop working.  I told my patients at that time, that I would most likely return in three months.  He died one month later.  I emailed each of my patients to inform them of my husband’s death and set the date for my return to work.

During this time, I was blessed with the support of friends and colleagues who emailed me poems and reflections.  A particular poem by Lawrence E. Johnson (2009, p.53) challenged the idea of getting back to normal and actually embodied how I felt.

Here is an excerpt:

He was my giant tower against the stretching sky. 

He was the answer to my every question. 

He was my normal. 

And he is gone…

too quickly gone …

and I am not ready to go on,

So tell me,

someone tell me, please, where,

where is my normal to go back to…?”

  I too, did not know how to go on.  But in returning to my practice, I found that the work itself provided me a foothold for how to begin.  Today, I will reflect on the effect of the mourning process on my analytic work with four patients.

Susan was a patient who had been in analysis most of her adult life having seen three different male psychoanalysts before coming to see me.  When her second analyst died, who by all accounts saved her life, she began analysis with the third.  She saw that analyst for a number of years and after he died, she sought analysis with me.

From the beginning of our work together, Susan lived in fear of getting old and dying in which she avoided being fully alive.  She was haunted by an early memory of seeing an old woman staring out the window into the courtyard of her apartment building where she was outside playing.  This memory seemed to represent a dark anxiety that overshadowed her ability to play.

During the first session after my return to work, Susan expressed her condolences for my loss. She then expressed her worry about how our work together would change as a result of my having lost my husband.  I acknowledged that she had expressed my very concern – that I was in mourning and that I missed my husband.  But I also told her that I planned to continue working because I didn’t want to lose both my love and my work.  She then added that she didn’t want to lose me.

In this same session, her fantasy about our being girl friends surfaced again.  Susan and I are the same age and our transference is infused with the “girl friend” archetype.   Through the years, we have discussed the loss of the analytic holding that would occur if we were friends.   She felt conflicted about having gone to the public memorial for my husband but not having been able to go to the private Shiva at my home even though she knew she would have felt uncomfortable being present among my family and friends, not to mention my personal grief.

We sat together with this conflict as well as with the palpable sense that the loss of my husband had changed me and therefore changed us.  We knew that we would continue to work together but did not know how this change would affect the work.

Don came into treatment because his parents had died within three months of each other.  A mutual friend recommended that he see me, in part, because of my recent loss.  During his first session, Don said that he did not want to wall off his feelings of missing his parents by just continuing to meet the demands of work.  He was an executive in an advertising firm.

Don had grown up in a rural community in a neighboring state.  With the death of his parents, it was his job as the only boy of 5 children, to distribute the family possessions and eventually to sell the family home and the land.  He traveled from Chicago to the family home on weekends to begin the arduous task of sorting through his parents’ belongings.

He reported that when he went home one weekend, he expected to feel sadder than he did but wasn’t able to because his sister was there.  It wasn’t that he didn’t want to feel sad but that he needed to put on a smile for others.  Several weeks later he reported the following dream:  I was walking downstairs away from other people and coming to the bottom of the steps realizing that my father and mother had died in a plane crash.  I broke down crying.”  He saw that the “emotion” in the dream was his emotion, but that he was not actually allowed to express it because his parents died as very old people.  I asked him if he had been younger would he be allowed to cry?  He wasn’t sure.

My sense was that both of these patients suffered a schizoid-like form of self-experience in which they felt compelled to please others alongside of holding themselves apart from real connection.   I came to understand that as I was sitting with these patients, we were in a transitional space in which their long-standing unmediated fears and prohibitions overlapped with the real world of death and impermanence.  Being with these patients in this overlapping space of neurotic and real suffering allowed them to shift, at least temporarily, their normal ways of interacting.

Susan’s normal avoidance of facing “the precarious foundation upon which we are perched” was confronted by the actual death of my husband.  Don, likewise, was unable to engage his normal avoidance of feelings when the feeling of sadness was so alive between us (Epstein, [M.] 2013, p. 14).

I too had to let go of any attempt on my part to find a normal analytic way to interact.  There was no room for pretending to know.  I found myself within a heightened awareness of being in a transitional space with each of my patients that felt more opened and vulnerable.  During this time, I had began meditating, listening to meditation tapes and reading books like “Being with Dying” by Joan Halifax.  These activities supported me to be in this more vulnerable space, and allowed me to tolerate the precarious footing of my own analytic stance.

While those in my practice expressed their sincere condolences to me for my loss, they made use of me in this more vulnerable space in very different ways to serve their own analytic needs.   I will describe two other patients whose analytic needs could be characterized as existing along a spectrum from “how to be alive in the face of death” in contrast to “how to let old patterns die into new ways of being alive.”

Jill started analysis with me after having gone through three months of treatment for breast cancer and during the six months of follow up radiation.   She was on leave from her position in upper management at a prestigious research center.  Much of our early work together dealt with her physical discomfort and her worry about how her illness would impact her college age son.  She then told me that she was also suffering from the second great tragedy of her life – the sudden death of her first love, Joe.   They had separated from each other in their late 20’s, went on to marry other people and then both had gotten divorced.  Their reconnection had reignited a rich and rewarding love relationship, which they lived for 14 months prior to his sudden and unexpected death.

Jill felt alone in her mourning for Joe.   While her friends were very attentive during her cancer treatments, they worried that her reaction to Joe’s death was out of proportion.   While the focus of our sessions was often centered on the psychic strains and the physical demands of her cancer treatments, she insisted that the real tragedy of her life was the loss of Joe.  She described how his love had opened her to the lost parts of herself that had been constricted within her married and her professional life.  She was afraid she would lose these parts again now that he was gone.  Alongside of articulating and affirming these parts of herself that she had found with Joe, we also experienced points of convergence in our work together, that gathered into a sense of renewal.  I believe we had found ourselves somewhere in the territory of “sitting with just our breath, we may find that in losing all that we have associated with life, we discover anew – life within us – raw, elemental and pure” (Halifax, 2008, p. xii).

Julie was aware that she needed to let go of old patterns that were killing her.   As a fine arts photographer, she struggled to feel confident in her creative work in the face of the “real” gender bias of the art world.  Alongside of and perhaps because of her own struggle, Julie mentored many younger women in the arts.  Despite her genuine support of these younger artists, she, nevertheless, compared their success against hers that never seemed to be enough.

Julie also valued her home and family and cherished gatherings at meals.  But she also feared that her role as “wife and homemaker” worked against the serious pursuit of her creative work.  Despite the fact that she worked very hard in all of her endeavors, there was a self-critical voice that drained energy from her actual creative-making, whatever choice she made.

About a year ago, Julie reported that her physical therapist was helping her relax the cramping she had suffered from years of clenching by paying close attention to the constricted muscles that cause the pain.  It reminded me of the idea that “it is not as important to find the cause of our traumatized feelings as it is to learn how to relate to them” (Epstein, M. 2013, p. 17).   Together we speculated that these physical problems were linked to the years of the internal pressure she put on herself to be more fierce in relationship to her work.  Julie decided to hold off any surgical procedure in order to give physical therapy a chance to work.

It was around this same time that Julie had decided to hire younger artists to support her art making practice:  someone to help her organize and execute the larger projects she was ready to take on.  But then she questioned herself about needing too much help and wondered if she was just being spoiled.  I wondered out loud with her if she thought Richard Serra or Theaster Gates worried about hiring too much help when implementing their large projects.

As she took these steps to support her own creative work, Julie felt that her photographic practice was in a more open space and felt more prepared to take the next step in her life.  I suggested that when she prepared to take the next step in her life, she was setting forth her intention.  Setting our intention is all we can do … along with a readiness to live that intention along our way to death.

I don’t think I could have said that prior to my experience these last two years of effort to accept the unfolding of my life as it is.

Once again Joan Halifax sums up my experience:

“Dying became a teacher for me, as I witnessed again and again how spiritual and psychological issues leap into sharp focus for those facing death.  I discovered care-giving as a path, and as a school for unlearning the patterns of resistance so embedded in me and in my culture.  Giving care enjoins us to be still, let go, listen and be open to the unknown” (Halifax, J. 2008, p. 5).

Bibliography:

Lawrence E. Johnson. (2009).  Reclamation: The Collected Poems of Lawrence Ernest Johnson.  Bloomington: iUniverse

Epstein, Mark. (2013).  The Trauma of Everyday Life.  New York: Penguin Books.

Halifax, Joan. (2008). Being with Dying: Cultivating Compassion and Fearlessness in the Presence of Death.  Boston: Shambhala.

Mary Dougherty may be contacted at: marydougherty80@aol.com

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: