When your client is facing a chosen death

I have had contact with a number of people online who have faced a loved one with terminal illness and chose to end their life before their illness ended it for them. Some are aware it is coming, others have already experienced the loss.

How do you help your client in moments such as that? How do help them say goodbye if they do not want the goodbye to be chosen? It’s not suicide, at least not in my thought process. For that matter, it does not matter what any of us think about the decision being made- our role is ot support and to hold that space for your client to process and be ready to finish before death occurs. In some ways, it is a bit simpler- you have a date to work with.

What are you tasked with in that situation?

  • Hold the space. Let your client simply talk it through
  • Being nonjudgmental- the death is coming. The difference is the person dying has chosen to have some control over timing.
  • Help your client finish the relationship before the death if at all possible.
  • Reframe any upset with the manner of death in reference to the dying person having some sense of control, and limiting pain for themselves and their loved ones.
  • Address the guilt
  • Acknowledge the loss
  • Bring the loved one who died into their life in a new way
  • Normalize the grief process
  • Acknowledge that they will be talking to their loved one- probably for the rest of their life. And emphasize that it’s perfectly normal.

Is that enough?

What did I not include? Holding any value judgments about the manner of death. Suggesting that the dying person rethink their decision. Being hesitant about discussing the manner of death. Any hesitation about allowing the client to figure out the best way to say goodbye.

Approaching a death is changing hugely. In so many places now a dying person can choose to finish their life rather than awaiting what is inevitable. It leaves survivors in a place where they may be coping with issues related to a chosen death or simply losing a loved one. We, as therapists, have to keep up and to learn to manage our own responses.

We are the holders of space, the normalizers, the supporters. We can provide the path to recovery. We can be the helpers of goodbyes. We can also be the openers of new relationships with loved ones who have died.

We owe our clients a prepared, supportive environment and approach. They are looking to us to be there.