I recently experienced something that I had not experienced since I opened my practice several years ago; several open session slots. This was not due to the economy or because my clients just stopped coming to treatment, it was due to the fact that several clients were heading off to faraway places to attend college. Some of these clients had been with me for a few years and in a sense became fixtures in the office. I mean, sure they improved and as a result came to sessions less and less based on need, but for the most part not a month had gone by since they entered treatment that they did not have at least one session. Some of them left an impact either by being extra nice to staff or by going out of their way to pet our mascot Ophie (short for Ophelia of Shakespeare fame) or a number of other things. A few left an impact because of just how far they had progressed from when they first entered the waiting room. Rule one for counseling: do not get attached to your clients; do not blur boundaries. We all know that and I suspect that everyone reading this follows that rule as we are all ethical practitioners. Is it really realistic though to think that people, who work with one another for months or more, even when it is kept professional, will be able to maintain a total lack of emotional connection? I would say that it is not. Sure, many clients you can maintain such a balance but I think many of us have at least once in our career had a client that it almost felt weird when they discharged. I do not mean weird as in getting divorced or breaking up with a significant other but weird as in, “hmm, it’s Friday and I haven’t seen so and so.” Then again, I felt weird when our mailman was transferred so maybe it is just me. Then I started thinking about my life and “my” treatment over the years. I thought about the MD that I saw on and off for years for follow-up treatment after tumors and cyst clustered were removed from my neck. How he knew me as the poor kid that was the first in his family to go to college and then just kept going. Although always professional, he eventually wrote a few recommendation letters for graduate and post graduate programs and became a professional reference for me when I was looking for clinical work. In fact, he has referred many people to my practice over the years and has been known to make a donation or two (we are a 501 © (3) not for profit). Though I was never at his home or met his family, we have become colleagues. Though I have not been a patient of his in many years, we still have a good communication that is professional but I get the sense that he has a “personal” stake in my success meaning, he is proud of what I have become and wants to help if needed. I have spoken with a few clinicians who have stated that it is bittersweet when certain clients discharge. It is sweet knowing that you did a fine job and are no longer needed but feels a bit weird knowing that you will no longer have any connection to that person. Over the years I have seen many clients come and go, and some that come and go again and again. Some I have seen from afar after their discharge: I have read about them in the paper, watched them on TV or heard them on the radio. Some simply fade away never to be heard from again. It’s the way of the world I suppose. I don’t know if we truly get empty nest syndrome; I think that is a bit of a stretch but I will not deny that there are those who leave my office that I think of from time to time and wonder if they are still doing well. Sometimes it is as if my former clients may be thinking of me as well as evidenced by a note or card that I get in the mail or an email that is waiting for me in my inbox when I log in at work. Some start with “I was thinking of you the other day Doc and wanted to tell you how much you did for me…” or “Thanks again Doc for saving my life…” Sometimes I get a short update like “Remember me? I was there for …. (I remember every client I have treated) well, I wanted you to know that I am still doing well and I just got (engaged, married, had a child or whatever). I tell them all that I appreciate their message and remind them that I did not save anything, that we as a team worked hard and they got better… Who knows, maybe our clients feel an effect like empty nest syndrome from time to time, but from the perspective of the bird who learned how to fly on their own but who occasionally remembers the nest that provided the safety and nurturing before giving them the subtle push out of the nest.
Warren Corson III (Doc Warren) is a counselor and the clinical & executive director of a community counseling agency in central CT (www.docwarren.org).