Grief and Loss Outside of End-of-Life Care

Note: This is a guest post by Gabby Ritter-Cantesanu. For more information about Gabby, please refer to the “Contributors” tab at the top. Please feel free to leave a comment here, but if you wish to contact Gabby privately, she can be reached at Thank you!

“Life has no meaning. Each of us has meaning and we bring it to life. It is a waste to be asking the question, when you are the answer.” –Joseph Campbell

This quote comes from the memory cards given out at Hannah’s memorial service. Hannah was a special kind of child, the kind that brought fullness and light to any room. Her smile was contagious and when she laughed, she filled your soul. When she sang, she sang with a full spirit and heart. And when she danced, her clumsy steps showed everyone around what pure joy looked like. Hannah most certainly brought meaning to life.

I had the privilege of working with Hannah in a community music school setting for a year, but I hadn’t seen her for over a year when she passed away suddenly at the age of ten. Hannah had a very rare disorder that was so rare it wasn’t named. Some of the features of this disorder were almost complete hairlessness, a heart defect, learning disabilities, facial abnormalities such as large ears and a small face, small stature and a rare bleeding disorder so severe a tiny paper cut could land her in the hospital for a blood transfusion.

What Hannah didn’t have was a single complaint. Although she was a very fashion conscious ten-year-old girl, she never once complained of having no hair on her head or no eyebrows and contented herself with stylish caps. She never complained about things she wasn’t allowed to eat because it could nick her gums and cause her to bleed (although she did trick me into giving her Skittles one time, then laughed hysterically when she told me she wasn’t supposed to eat Skittles. I was terrified.). Hannah was happy to be alive, happy to give you joy, and happy to make music.

When Hannah passed away, I felt shocked and confused, and was immediately thrown into feelings of intense grief. She was a vibrant child with so much life in her eyes and joy in her heart. And while I knew she was having some heart complications, she wasn’t particularly ill. I questioned my work with her:  Had it been good enough? Did she get enough out of our time together? Did I try hard enough to make a difference for her, even on those days when I felt like I wasn’t at my best? It was difficult to not second-guess my clinical work.

It’s never easy to lose a client, but losing a client who is so young and vibrant was particularly difficult for me. I cried on the way to her memorial service, during the service, and after the service. Her family spoke with grace about her passing and the joy that Hannah brought to their lives. Hannah was a bright light and her light remains, shining over everyone she knew. I’m forever grateful to have played a small role in bringing Hannah the joy that she so often shared with others.

A therapist’s grief is often overlooked in the literature and not often discussed in our coursework, particularly for therapists who do not work in end-of-life care. Our relationships with our clients are unique and special. We build up a rapport with them, and often with their families, which brings a sense of closeness and trust. We feel proud of the changes we see in their lives and while patients leave therapy services for a number of reasons, clinicians who do not work in end-of-life care may not be prepared for the possibility that termination will be due to a client’s death.While the therapist’s loss is different from the loss the family experiences, because we typically know our clients outside of the social structure of their life, our loss is nonetheless significant. When I hear specific songs on the radio that remind me of Hannah, I am emotionally back with her in our shared musicking. The reminders of grief that accompany those songs and memoriesare real and can be intense.

When Hannah passed away, I had immense grief. Hannah had participated in a community music concert where she performed Taylor Swift’s “Love Story”. I had pictures of that concert on my laptop and changed my Facebook profile picture to a picture of Hannah and I at the piano during that concert. Hannah had a difficult time playing the piano but with some musical adaptations she was able to successfully perform with her peers. Hannah did a great job and the audience stood and clapped for her. She did a perfect little bow for the audience and her family presented her with flowers on stage. She was glowing. That look of pride and joy is what I remember when I look at that photo. The night I heard she had passed I listened to, and played along with, Love Story several times and held that image of Hannah in my mind.

Since Hannah’s death, I have lost several more former clients. I feel fortunate not to have lost a client I’m currently seeing for services because I suspect that would be a more difficult loss for me. Each loss has been difficult, but different. Just like personal relationships, relationships with clients vary and I find myself more or less drawn to memorial services for clients that pass away. For me this is dependent upon what type of relationship I had with the client and the clients’ family. When I have attended services, parents typically greet me with warm welcomes, thank me for coming, and are happy to hear of memories I can share of their child during therapy sessions.

I know it will never be easy to lose clients, but I feel a sense of peace knowing that I am making a difference in my clients’ lives and am proud of the changes that I can help actualize while they are with me.

1 thought on “Grief and Loss Outside of End-of-Life Care”

  1. Thanks for sharing this. I lost two former clients this year; both “too soon” and one at the end of an intense tragedy. Music therapy is based on relationships and even though we have a therapeutic relationship (not a friend, family, etc. relationship), losing folks still hurts.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s