TRANSCRIPT
An elderly friend of mine who was a psychotherapist recently died. We used to be very good friends. Then we were good friends, and by the end, we were just sort of friends. We talked on the phone a lot. We used to spend time together in person, and then it turned into talking on the phone for a few years fairly often still. I was very curious to watch him get older, but I ended up becoming very, very disappointed in him—how he lived his life at the end and, sadly, especially how he died.
I started realizing that he was ill, very ill, but he never spoke about it. I could hear it in his voice. I could hear it in the way he was not as sharp and tight as he used to be. I could just feel that he was sick. I saw photographs of him sometimes; I could see that he was becoming more and more ill, but he never talked about it. I tried to bring it up with him, but it was something that he couldn’t go there. It was too painful.
And it’s not that he just didn’t want to talk about it with me, because we’d had a relationship for decades, and he had talked about the most intimate things in his life with me. So I knew him very, very well, and I talked about extremely intimate and personal things in my life with him. So we had a really close bond. But dying was something he just couldn’t handle talking about or, from all I saw, dealing with.
And why I say I was disappointed with him? Yes, I was disappointed that he couldn’t face his own dying. Because I really do hope that when the day comes that I find that maybe I’m dying or realize it, or realize I’m getting old enough that I could die, I want this to be front and center in my life. I want to use this for good. I want to use my final days for the most value for myself and others. And I didn’t see this with him. I saw instead that he started shutting down and hiding more from himself and from difficult conversations.
And what makes me criticize him the most, to the point that I want to make a video about it, to use this for good, to share it as a teaching tool perhaps, if only for what not to do and to highlight perhaps what to do instead, is he—I felt—took advantage of his psychotherapy clients. Because I noticed in the last few years, more and more, he talked about his psychotherapy clients with me. Yes, he retained confidentiality. I don’t know any of them specifically, though way back when I had sent some clients to him because I thought he was a really good, insightful, caring therapist. At a certain point, I didn’t send anybody to him, but I realized he was leaning on his clients for social support.
And I’ve seen that with other therapists, some who are not so old even, but many who get really, really old become socially isolated. They can start to lean on their clients. Their clients become, in a way, like their friends and their family. Even this therapist said often he doesn’t talk to very many people at all during the week, and his clients are his basic form of interaction. And to me, that’s kind of troubling. That’s not how I think the role model of a psychotherapist should be.
And sometimes I wondered who was getting more out of this relationship—him or his clients? And he even said this to me a couple of times, rather obliquely. Well, what happened? I heard some of this through the grapevine, and some of this I know just from what I saw, is that he never told any of his clients that he was dying. And at the end, it was clear he was dying, and he never dealt with it. One day, he just closed his psychotherapy practice, and a few short days after that, went into the hospital and died. And his clients were caught by surprise. I can only imagine. I don’t know them, but how could it be otherwise if they didn’t really even get a chance to talk with him about his demise, his end?
And I think that’s negligent on the part of a therapist. I think regardless of how a psychotherapist ends his psychotherapy practice or ends his psychotherapy relationship with a client, it is the job of the therapist, he or she, to close that relationship, to wrap up the loose ends of the relationship, to help the client think about what they gained or didn’t gain from the psychotherapy, what work perhaps they have left to do, perhaps for the therapist to reflect with the client on some of the limitations of the therapist and what kind of therapist this client might want to find if they are going to continue in psychotherapy, or what they’re going to do with their life if they’re not going to continue in psychotherapy.
This is the normal stuff of ending psychotherapy. We learned it back in school when I was studying to become a therapist myself. This is the termination phase of psychotherapy, and in many ways, it may be the most important phase of psychotherapy. I’ve certainly heard many of my psychotherapy clients talk about their past therapists and how so much of the potentially good work that they did in psychotherapy was ruined by a bad termination—a psychotherapist who became rude and nasty toward the end, or who just abruptly got rid of a client, fired them in the words of psychotherapists, or displayed behavior neediness or bad boundaries or inappropriate comments that really made the client question what had happened. Who was I in a relationship with for all those months, or perhaps years, or sometimes perhaps even more than a decade?
Well, part also of why I criticize this former friend of mine who was a psychotherapist was that one time, I remember maybe twice even over the years, we had the conversation about a former friend of his who was a psychotherapist who did exactly what he himself ended up doing. This psychotherapist had serious cancer and knew he was dying. This is going back, I don’t know, 30 years or so, and talked about it with my friend. They talked about the fact that he was dying of cancer. He knew he was dying, but he never talked about it with his clients. And he literally was a psychotherapist right up until he died. And he closed his practice, went into the hospital, and died, and he left his clients hanging. There were all these clients who didn’t even realize he was dying, never had a chance to talk about it, never got a chance to process their grief, their horror, their sadness, the gains they had made in psychotherapy, the work that they had left to do. This is a harmful thing to do.
And also, this other psychotherapist who died, he never had referrals ready for his clients. He never had someone there—”Listen, call this person. This person can help you process what you didn’t get to process with me.” Well, my friend who died did the same thing—no referrals, no “Go to XYZ. Here is someone you can talk to. Here is a place you can go to help process your feelings about losing me.” Very, very troubling. And especially troubling for my friend, knowing that he had an intimate relationship with a colleague who had done the same thing, and he knew it was wrong.
And I think a lot of these dynamics in psychotherapists are pretty common. Back when I was younger, I talked with quite a few different people who had had psychotherapists die while they were their therapist. I think of one woman who I talked to who went to her appointment, her regular weekly appointment with her psychotherapist, and she rang the bell, and her psychotherapist didn’t answer. And she wondered, “Where is she? Where is my therapist?” And she didn’t know, so she thought maybe she just forgot. Yet she’s never forgotten, and her psychotherapist was well older, but not that old, only in her 60s. And so she went home, and she called on the phone—this is before cell phones—and she left a message on the regular answering machine and didn’t hear back. And well, the next week thought, “Well, maybe I’ll try one more time, one more time.” Rang, nobody answered. And then she noticed there was a little sign on the door: “Call this number for the name of her psychotherapist.” And she called that number, and someone picked up and said, “Yeah, I’m sorry…”
To be the one to tell you, but she died. And she also had had cancer. Presumably, she knew she was dying. She never even hinted to her clients, or at least to this client, that she was dying. And she’d worked with this woman a long time, and she was very, very important in this woman’s life, in this younger psychotherapy client’s life. She was almost like a mother figure for her, or perhaps was a better mother figure than she’d ever had.
And yet, it really made my friend question, who was this person I worked with? Why didn’t she tell me? Why couldn’t she tell me? She felt hurt. She felt betrayed. She also felt ashamed. She felt like, oh, maybe I wasn’t good enough to be aware of this knowledge. Maybe she didn’t think I was mature enough to handle it. And I’m like, no, no, no, no. Your psychotherapist wasn’t mature enough to face her own death, and she did not do her professional job. Very, very harmful, I think, in a case like this.
Had the client wanted to, she probably could have sued her psychotherapist, could have sued her estate. This woman, the psychotherapist, had malpractice insurance. I consider it malpractice to know you’re dying for many months, or perhaps years, and to never even let your clients know. To not give them the basic professional courtesy to let them know, if not the personal respect to let them know. It’s very devastating to be abandoned like that for a client.
And I admit, I even felt kind of abandoned by my friend who died, that he never got in touch with me. He never even told me that he was dying. He didn’t have it in himself to do that. I felt he didn’t respect me enough. But I mean, really fundamentally, I know though it still hurts me, I know that he didn’t respect himself or his growth process enough to do it.
And I could give other examples and other examples and other examples of psychotherapists who die or who quit or do different things without wrapping up the loose ends of their psychotherapy.
Motivation for the Video
Well, I think I’d like to just take a step back for a second and think about what motivated me to make this video. On the surface, yes, it was because of my friend, formerly really good friend, who died. But also, I wanted to make a video about wrapping up loose ends in general, to talk about this subject.
So that’s how I want to close this video, by just a quick discussion about the value of wrapping up loose ends. The ultimate loose end being wrapping up the loose ends of one’s life when one’s life is coming to its end, to its natural termination. It’s something that has been very important to me for a long time.
I first noticed it when I was finishing college, and I wanted to wrap up my relationships with all the people I’d become friends with or had once been friends with when I was leaving. Even with professors, old professors I had, and with my schoolwork and my final exams. I wanted to wrap up all the loose ends of this four-year phase of my life.
And I didn’t see anybody else really doing that. Academically, yes, most people did it. The people who didn’t do it didn’t finish college. But pretty much most people did it academically. But interpersonally, not so much. And I realized it was very important for me to say goodbye, to say goodbye to all these people who I knew, some of whom I’d been very, very close with and still was close with, and I didn’t know if I would see them again.
I knew I was profoundly going to change my life, and I remember going around and doing that and how meaningful it was to me and to them. Because many people told me how meaningful it was to have this wrap-up conversation or series of conversations. And for me, that created a template in my life for something that I would do, or at least try to do. Sometimes I failed in various ways, especially when I was younger, but something that was very important for me to do as I grew older.
And certainly, as a psychotherapist, it was profoundly important in each of my relationships with my clients. When we were headed toward the end of the psychotherapy, by their choice or by my choice, mostly by their choice, I wanted to wrap this up and make this a good and meaningful experience to really cement the things that they had learned and they had gained, even the insights I had gained, to make this relationship end in a way so that they could still use it right then and in the future when they reflected back on it for good, for their own good.
And I did eventually quit being a psychotherapist more than 12 years ago now, and I think about how I wrapped that up. It was hell to wrap it up. And so, in that way, I can really relate to why psychotherapists don’t want to wrap up the loose ends. It’s very stressful. It’s very painful. A lot of feelings come out. A lot of grief. I cried a lot. Clients cried a lot. Sometimes they were angry. Sometimes they felt frustrated. Sometimes there were final things that they needed to say. Sometimes it was easier to just want to run away. But to run away felt kind of cowardly to me.
That’s probably part of why I feel frustrated, angry, and disappointed with this friend of mine who didn’t wrap things up.
Wrapping Up Childhood Loose Ends
And then I think about one final area of wrapping up loose ends that for me is the most important thing now that I think about it, and I wasn’t even prepared to think about this when I started making this video. And that’s wrapping up the loose ends of our childhood, resolving our historical traumas. Every single trauma that we suffered in childhood that we didn’t get a chance to heal, it’s a loose end. It’s dangling somewhere inside of us. It’s like a loose wire of electricity that’s still shooting out its sparks. It’s not tamed. It hasn’t been integrated into the self. It’s still suffering with pain and anger and rage and frustration and betrayal.
And for me, that has been the real life work of mine, to resolve those historical childhood traumas, to make sense of what I went through, and to grieve my losses and my violations and my pain, to wrap that up inside of myself so I can become a whole person and love myself more and be more loving to others and to model being more healthy and more healed and having a healing perspective to others.
And when I think, as I close this video, of my friend who recently died, when I reflect on it, I realized one area that our friendship never really touched that much was his childhood. I don’t feel he really dealt with it that much. And I think that’s very common with people in the world, but it’s very common, sadly, also with psychotherapists, that many times, perhaps most times, they don’t really make that much progress in wrapping up the loose ends of their childhood and really resolving that much of the trauma that they went through as a child.
And I think this explains in such a big way why this psychotherapist friend of mine, and so many psychotherapists in general, really can’t be that useful to their clients in the long run. And in a way, often model a life of not wrapping up loose ends.
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