The Ghost in the Therapy Room

The sudden loss of a trusted therapist can leave patients not only grieving, but feeling shocked, abandoned, and without closure. That was the case for Dr. Jeff Axelbank, a psychologist in New Jersey, whose psychoanalyst canceled a June session, saying she wasn’t feeling well. He thought little of it at first, since cancellations happened occasionally, but weeks passed without a word. Then came the message from a colleague: she had died of advanced pancreatic cancer, an illness she had never mentioned. She was the person who knew him better than anyone, the one he had told everything to. And now she was gone, without a goodbye.

Ethics guidelines urge therapists to prepare for situations like this by creating a “professional will,” naming someone to notify patients, transfer records, and help them find new care. But most therapists put off the task, and there is no system to enforce it. When no plan is in place, patients often learn of a death in jarring ways: a locked office door, an obituary, a secondhand remark. Some, like political consultant Eric Hensal or client Meghan Arthur, describe the experience as abrupt and disorienting. Others have been met with more care, such as personal calls, warm letters, or even invitations to a funeral, gestures that made the difference between loss and traumatic loss.

In the months after his analyst’s death, Dr. Axelbank began urging colleagues to face their own mortality and speak honestly with patients about it. He found others with similar stories and even visited his analyst’s office, where her family let him take the dream-catcher that once hung by the window. He treasures it, but the ache remains. “She deprived me of saying goodbye,” he said. And he hopes that in the future, more therapists will make plans so their patients are not left to piece together the truth after it is too late.

For more information see Ellen Barry “The Ghost in the Therapy Room,” The New York Times, July 24, 2025.