If you had asked me a year ago if I could have faced what I am about to describe and come out on the other side I would have said "Hell, no!" It has been a year of pain and struggle, and although certain parts cannot be changed, I still think that if things had been handled a little differently I might not have gone through some of what I did. Here is my story.
The first time it happened was August 2005. I went to my appointment, and my therapist never showed up. I waited about 15 minutes before finally leaving, feeling angry. The same day, there was a big accident on the road that I knew my therapist traveled on her way to work. I left 2 messages at her office, and when I got no reply I became very concerned.
I waited a few days and then contacted her answering service. They asked if it was an emergency and I told them it was not. I explained that my therapist was missing but they could not help me, which only exacerbated my now obsessive concern. I had been meeting with her for years and although she had missed a few sessions, she always called me back. I spent an enormous amount of time surfing the Web to see if she was in the accident, but when I couldn't get the information I needed, I reached near panic.
Finally, I called Dr P, a psychiatrist with whom I had worked for many years before my current therapist. He convinced me to try the answering service again, and when I did, they told me that someone would call back. However, no one did. I tried again a few days later, and the covering therapist finally called me. He said that my therapist was in the hospital but that she was improving, which finally allayed my fears. (I can't speak for all people who go into therapy, but I know that for many, loss and abandonment are huge factors.) I finally received a letter about a month after my therapist disappeared. It turns out someone had left a message on her office door explaining she was out because of medical issues. I have no reason to believe the message was not there, but I did not see it. I was angry, confused, and felt abandoned.
My therapist came back to work about 8 weeks later, but it took a while before I was able to start trusting her again. I don't know if our relationship was ever truly the same. She told me she had had a brain aneurysm, which made me feel guilty for being so angry.
Sick and dying
Nine months later it happened again. (This time I noticed the note on the door.) Since I knew what had happened before, I was angry that I had to go through this again. Why the note on the door and not a phone call? The note had a phone number to call for the covering therapist. I waited about 5 days before I called her and asked if the reason my therapist was out was related to the same issue—she said yes. I wanted to talk to someone because I was again concerned. I set up an appointment with the covering therapist for the following week. She called me a few days later to ask about my insurance. As it turned out, she didn't accept the same insurance and could not see me. Here I was again, feeling abandoned. I didn't have the energy to try finding someone else, so I thought, just forget it; I will cross these roads alone and not depend on anyone.
A few days later, I got a letter from my therapist's husband, who is also a psychologist. As I read it, I had a gut feeling she was dying, even though I was never told this. I tried calling my insurance company to find a covering doctor in her absence but that proved frustrating; I felt I was getting nowhere.
The following week I received a call from the covering therapist who said that my therapist was not doing well. The covering therapist agreed to meet me 3 days later. The next day, I left her a message asking her to call me if my therapist's condition changed. A few hours later, I noticed a missed call; there was no message but I knew that my therapist had died, although I had no way of confirming it.
Two days later, I found her obituary. She died on the same day I left the message for the covering therapist. That was the last way I wanted to find out about the death of my therapist. A person with whom I had worked for more than 4 years, a person I thought of as a parent and friend, was gone.
Would I have never been told about her death had I not been persistent? I am not sure. I felt as if I were alone on my own desert island or lost in a cornfield. I couldn't cry because I was at work, so I just stuffed my feelings back inside myself.
Later that day, I met with the covering therapist. Although she was very nice and it was good to talk with someone who knew my therapist, I was not able to reach out and connect because I would only be seeing her a couple of times and had no idea how long it would take to find a new therapist. I cried, and even though I felt guilty for being angry, I was angry nonetheless. I knew my therapist was a friend of hers and she was the only connection I had, but I still did not feel as though I could trust her. When I had mentioned going to my therapist's wake, she gave me no guidance. I told her of the trouble I was having finding a new therapist, but she only told me to call my insurance company and did not refer me to another therapist.
I walked out of her office feeling completely lost, alone, and abandoned. Usually I can sleep when I am at my "worst," but sleep now eluded me. I couldn't get my therapist off my mind. I spent the night thinking of ways I could hurt myself and reasons why I should not do it.
The next few days were a blur of emotions. I have a hard time get- ting close to people. I felt emotionally abandoned as a child, which makes it difficult for me to have deep emotional relationships with others. With any other death, I could have found some type of support. But how do you explain the death of your therapist to your friends and family when they do not know you are in therapy?
I needed to make a decision: Do I go to her wake? Is that proper, and would it help me or hurt me? After days of thinking about it, I decided to go to somehow create closure.
It was one of the hardest things I have ever done alone. I was shaking because I was so scared. I met her husband, son, and daughter and felt so bad for them. When I saw the open casket, the person inside did not look anything like my therapist. Her body went through so much from her illness. I stayed 10 minutes, left, and cried the whole way home. I felt more alone than I could ever have imagined. Was it a mistake to go? I don't know. I felt as though I was intruding into her personal life. I did not feel that I could call the covering therapist for assistance, so I shut down my emotions the best way I could and dealt with my feelings by writing in a journal.
A slow recovery
The next few months were very difficult. Somehow, I went on with my life, but this cloud of depression hung over me. I was lucky I still had my psychiatrist, and at first we e-mailed every couple of days and then less and less. Even though I was so angry, I continued looking for a new therapist. My insurance company gave me 10 names, but none were accepting new patients. (They also gave me the name of my therapist after I had already told them she died!) It was excruciatingly difficult, but I was able to find someone new about a month after my therapist's death. In the beginning, it was hard because I was angry, skittish, and afraid. I had to start all over again, and with time I did. It was a long struggle, but my life finally started to improve.
I did not allow my therapist's death to push me over the edge, but what about her other patients? Did they get what they needed? Do the professionals in her circle have any idea what her patients went through? Do other therapists have better contingency plans? I know no one likes to think about his or her mortality, but shouldn't there be a plan in place if something happens? If I had not reached out, would I not have learned anything about what happened? Why wasn't the therapeutic community there to help me get through this loss?
What I went through is apparently not an isolated incident; when I told others in the therapeutic community, they reported similar experiences with patients who had gone through the death of a therapist. Therapists need to be made aware of the effect this can have on patients; they should be taught to develop a plan so that they can offer services to those left behind. I know that I would have had a difficult time no matter what. But if people had been available to help me deal with the loss it would have made me feel less vulnerable and alone.
It has been a year since my therapist died. As her anniversary approached, I kept thinking about her and my anger surfaced again. I have gotten over the abandonment I felt from her death, but I still have not gotten over the anger I felt at being left with no support or guidance from her colleagues. I am using this story to help me deal with my anger by putting it to productive use. I am hoping therapists will learn from reading about what I went through. Please take some action so that someone else does not have to go through what I did.