ABSTRACT
Early in my (JT) training as a psychologist, I worked for a year in a cancer center, and my dissertation involved working with women with Stage III and IV cancers. One patient I treated during that time developed a recurrence of her cancer, and after a period of valiant but unsuccessful oncological treatment efforts and subsequent decline, Ms. A. died. I had the privilege and deep pain of being her psychotherapist during the last stages of her illness. Ms. A. had struggled in her life with substance abuse, was estranged from her children, and had many regrets about the life she had lived—a life that was now coming to an end. It was in this context that she was referred to me for psychotherapy. In Erikson’s life stage model, she wavered between ego-integrity and despair, and at the time of her death this crisis was not resolved. I felt very sad and was deeply engaged and moved by Ms. A. during the final months of our work together. Her death left me with much to think about; somehow I wished our work together could have led her to feel less despair about the course of her life. Yet, I know that it was Ms. A.’s commitment to an honest, if not ruthless, self-appraisal that would not let her rest with too much of a sense of satisfaction. Hers was not an easy death, but I felt that our work together had been deeply meaningful to both of us, and she was grateful to me for the work we did together while she was ill. When she died, I was sad—I felt an empty spot in my week—and I grieved for Ms. A., quietly and alone as therapists often do.
