Welcome to the Winter edition of the dilemmas page, in which we ask for answers to fictional ‘what if’ nightmare scenarios that we might find ourselves in as psychotherapy trainees. The range of responses from our readers from within the psychotherapy world provides us with tools should anything similar ever happen to us in our personal practice.
You have been working for a couple of months with a client who suffered a suicidally depressive episode as a result of not being able to say goodbye to their father, who died last year. One day the client comes in with their large pet dog, Chunk. The client tells you that Chunk has been recently diagnosed with terminal cancer and only has a few days to live. They want to keep him with them at all times to ensure that they are there when he goes. Chunk looks ill yet fixes you with an aggressive stare with his beady eyes – How do you cope with this situation?
Diana, CCPE student says: i think I would ask the client if the poorly Chunk is comfortable in the room (to make sure I don’t get snarled at, bitten etc). Then, I think I would just let the client talk about his sadness around Chunk dying, and ask how the client is preparing him/herself for this. The conversation I imagine would then naturally drift to what the client wished he/she had said to their father last year. If Chunk got restless I’d probably suggest taking him home.
I add that I am now thinking of Chunk’s archetypal role of Receptive Saint – counsellor/healer and what it feels like to have one’s ‘comforter’ snatched away, both as adult and child. Also Chunk is holding some fire, maybe around the anger of dying.
Kelly, CCPE student says: Assuming I was in a space where I could make the call whether to keep the dog in the room or not, I would definitely allow for it, as I think it could be quite healing for the client (and potentially the dog) to maintain that closeness for the last few days and explore all the feelings ‘the end’ brings up for the client. It would seem important to make ongoing distinctions between the here and now (dog dying) and ‘back then’ (dad dying) as this, too, as it could be part of the client’s healing process, processing grief of father and what client felt and wanted to say then vs grief of losing the dog and what they are feeling now. Undoubtedly there are some similarities but perhaps a risk of the client being totally overwhelmed by flood of emotions around losing their dog if distinctions are not made?
Suzie CCPE student says: The sudden appearance of a dog in the therapy room does represent a challenge to boundaries. I would tell the client that given the circumstances, Chunk can stay with the client for the session. I would also make it clear to the client that bringing Chunk into the room without notice is not desirable and that if anything similar was to come about in future it should be discussed between us beforehand to ensure the therapeutic space is held.
Another factor to consider is how to go about the work in session while Chunk looks on with his aggressive stare. As someone who has had a difficult relationship with dogs in the past, I am not sure if I could maintain my therapist role while Chunk is in the room and would have to assess the situation before agreeing to Chunk staying.
I do feel that the sudden appearance of Chunk, and his nearing death, could be a fruitful avenue to explore with the client in the here and now and possibly link back to the death of the client’s father. The client now has an opportunity to make his farewells to Chunk, something he couldn’t do with his father. This reworking could help resolve the client’s grief and allow him to connect emotionally, something, which may have been previously blocked.
Next issues Dilemma: Facebook
One of your friends puts an embarrassing picture of you on their facebook page from the last time that you had a big night out together. you notice that a few people have ‘liked’ the picture. One of them turns out to be a client of yours who unbeknownst to you happens to be a mutual contact. How do you deal with this situation?