Grief Process Following the Sudden Death of a Patient

One foggy day last summer, I was broadsided by the news that one of my psychotherapy patients suffered an unforeseen cardiac event and did not survive. She was a married, working mother with two young children and a life on the rise. Almost instantly, I was acutely aware that I did not know how to proceed.

I had received training about how to process a patient suicide. Yet the sudden loss of a patient to a tragic event isn’t part of the psychotherapy playbook. I found only one article that discussed mourning the sudden loss of a therapy patient; and while this resource gave words to my experience, the literature seemed desperately thin. I reached out to colleagues, but none had lost a patient in this way.

I felt so alone. Our profession allows us the incredible honor of walking our patients’ lives with them. As we hold a therapeutic environment, we balance authenticity with boundary. We are a part of, and yet distinct from, their lives. I lost a dear person in my life, and yet my professional boundaries prohibited me from the natural process of grieving with a community. As a psychotherapist, I could not share my memories with those who knew her; I could not hear others’ memories of her.

I love my patients. Some I really love, and she was one of those. For weeks after her death, I went to bed crying and thought about her throughout the day. Sitting with other patients, I imagined her across from me with one leg folded underneath her. I remembered her quirks, pulling her mouth to the side in deep thought, rubbing her forefinger and thumb together, or twirling her hair while discussing anxiety-provoking topics.

She had an unresolved issue that I knew one day she would resolve; but now I am left holding it. The termination of a therapeutic process aims to review a patient’s growth and provide structure for moving forward. Yet this sudden, unexpected termination of our work will forever lack that structure.