ABSTRACT
The sudden loss of a therapist can be confusing and damaging for a patient who has been in ongoing psychotherapy. We posit that there is a similarity of affect between patients whose analysts die and children who have experienced a variety of parenting failures, including the actual death of a parent. Children react to the death of a parent with a sense of shame, as though they feel themselves to be defective being unable to keep the parent attached to them. A further link is made with the development in infants of a sense of shame in the face of their parents’ unavailability because of depression or withdrawal. Children who need to deal with misattuned or rejecting responses from parents who have been unable to sustain interest in them also feel shame. Such infants learn to look without seeing, listen without hearing. We suggest that these early experiences shape a patient’s response in the face of their therapist’s untimely death, where the child-patient has been unable to keep their therapists attached to them—especially when there has been prior illness.
