What Remains: The Aftermath of Patient Suicide

What Remains: The Aftermath of Patient Suicide

by Margaret Clausen

Psychologist Margaret Clausen shares poignantly about the loss of her client to suicide,  the steps she took to heal her grief, and the isolation and shame that many clinicians needlessly suffer in the wake of client suicide.

Note: Clinical material in this article is taken across various venues and years of treatments. Identities are disguised to protect confidentiality. References used in writing this article, as well as resources for clinicians, can be found at the bottom of this page.

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Silent Mourners

The memory is quite clear: several years ago, early one morning checking my voicemail, two messages in I came upon a message from my patient, Jill. The message was date-stamped the evening before. She said she would miss today’s session due to a need to find new housing; she thanked me for our work thus far (as she frequently did, sometimes out of social politeness or her fears of abandonment, other times out of sincere heartfelt gratitude, something we frequently explored). This time her gratitude sounded heartfelt in tone. Her message also left me perplexed, as we had not talked of housing, and I saved it. Another message, left moments before I checked my voicemail, was from Jill’s psychiatrist, Brian, asking me to give him a call when I got in the office. Brian and I spoke frequently of Jill, her ongoing medical decline at a relatively young age, and her persistent depression and posttraumatic stress. We followed her carefully, exchanged perspectives, and possessed mutual respect for one another’s clinical skills.
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Margaret ClausenMargaret M. Clausen, PsyD, is a clinical psychologist in private practice in Berkeley, California where she specializes in the treatment of trauma, addiction, and living with cancer. She is affiliated with the Chronic Pain Program at Kaiser Permanente – San Francisco, and with the Commonweal Cancer Help Program in Bolinas. In addition to providing psychotherapy and consultation, Dr. Clausen enjoys writing, teaching, and supervision. She is working on a book of essays regarding psychotherapy practice. She can be reached through her website at www.drmargaretmclausen.com.
Margaret-What a beautiful and heartfelt article. This will offer validation and hope to so many clinician-survivors. Thank you.
NIna G.
I cannot thank you enough for this article. It speaks to my experience in such a beautiful way, both intelligent and compassionate. I will read and re-read it again.
Dan M.
Hi, thank you for this beautiful, humane, compassion piece. In all honesty, the adjectives for the praises you deserve go on and on. And I really want to thank you for being so open, so willing to share, for a purpose of connecting/establishing/re-establishing a relational home between us who cross each other's paths. What you have written is really touching and moving. I hope you will see all of our responses.
I think this is a bit of a romanticized approach about life, therapy, and death. Death is not the worst thing that can happen to a person and a therapist is just a hired hand who may or may not be useful to a client. I don't find the therapist is that big of a deal in my real life - I would hope the one I sees has more perspective on the limited role she plays for me.
ST. Topper
Dear Margaret, Thanks so much for this beautifully written and poignant article. In your transparency & self-disclosure you so lovingly normalize this human struggle. After reading this, I feel your deep empathy and knowing through direct experience.
Belle Hazlehurst, RN, MFT
Thank you. Having lost a client to suicide I relate to all that you wrote. It is very difficult to find information and literature on clinician survivors so, again, much thanks. I am sorry for your multitude of losses.
Clinician survivor
this is thoughtful and compassion article speaking truth. What a wonderful healer Dr. Clausen is. BRAVO!
katie stephenson
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CE credits: 1
Learning objectives:

  • Learn what is commonly experienced by clinicians when their patients commit suicide.
  • Describe tactics, rituals and resources used by Clausen to heal her own grief following her client's suicide.
  • Understand the reactions among psychotherapists, from a psychodynamic perspective, to their colleagues who experience the suicide of a client.
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