On the talkability of death: lived experience of patients whose therapists died during treatment.

Introduction: Therapists are often regarded as attachment figures not only within psychodynamic approaches, and the stability of the therapeutic setting is broadly acknowledged as a beneficial element in the therapeutic process. The aim of this paper is to explore the experience of losing one's psychotherapist through their death, a rupture that may interrupt the otherwise predictable and reassuring rhythm of the therapeutic process. Methods: Ten adults were interviewed about their lived experience as bereaved patients, how they coped with grief, and their perspectives as witnesses to a relatively unusual circumstance. Qualitative data from semi-structured interviews were transcribed verbatim and analyzed using interpretative phenomenological analysis (IPA). Results: Analysis of the transcripts revealed four themes for discussion: (1) disruption of a sense of continuity; (2) loss of therapeutic bond; (3) grieving process; (4) critical evaluation of events. While some benefits were observed in patients who had been adequately prepared, the findings highlight the potentially traumatic impact of the sudden loss of a therapist and the need for clearer guidance for clinicians. Discussions: Therapists’ self-awareness of this issue may help them provide more effective support to their patients should similar circumstances arise in their own practice. Talking openly about illness and death with patients may be the best strategy to avoid painful, unfruitful resentment. Honesty may help to reduce the risk of jeopardizing further therapeutic progress with other helping figures, notwithstanding the uncomfortable content that is likely to emerge during the task of separation. Theoretical and technical implications of the real relationship for clinical practice are discussed.