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Commentary
An unexpected ally in therapy: my patient’s dog
I’ve been a psychotherapist for 30 years and even now I occasionally encounter a totally unexpected moment in a session, a moment for which no graduate school class or textbook could prepare me. Last spring, I found myself saying a tearful goodbye on Zoom to my patient’s dying dog.
Trixie (not her real name) was an important companion for my patient and we talked about her in nearly every session. Adopted 13 years ago from the streets of Puerto Rico, Trixie was a mix of Dalmatian and Chihuahua. She had a pointy face, pointy ears and long legs, like a very large Chihuahua.
Although my patient had made immense progress in our years of work together, she needed a kind of healing that psychotherapy alone couldn’t provide. Trixie loved my patient well, took her for walks every morning and evening, gave her a sense of meaning and purpose, and stood by her when others couldn’t or wouldn’t. Unaware of her role as co-therapist, Trixie became my ally.
Before the pandemic started, I held all of my therapy sessions in person. Trixie didn’t attend but I heard a lot about her. Trixie injured her paw, Trixie was adjusting to a new cat in the house, Trixie modeled for another drawing, Trixie liked or disliked the latest boyfriend. I treated her like I would any of my patients’ important family members, inquiring about her in each of our sessions. I could see that she was thriving in my patient’s care, and over time I saw the therapeutic benefits of Trixie’s love for my patient as well. They had created a mutually beneficial healing loop.
Though I hate to admit it, I don’t consider myself a “dog person" ...
When the pandemic began, we transitioned our meetings to Zoom. For the first time, I could see Trixie, napping in the background or nudging my patient for a head pat. As the pandemic dragged on, most of my practice returned to in-person therapy but this patient lived far enough away that we decided to continue meeting online. As a bonus, Trixie could be there, too.
Trixie had faced a series of medical issues in the time I knew her, but each one had been treatable. So I was surprised one week when my patient told me that Trixie was actively dying. I listened intently as my patient described the thoughtful care she had provided, the visits to the vet, the carefully administered medicine, the extra snuggles. Through heaving sobs, she told me she had decided to pursue ending Trixie’s life peacefully and humanely in order to relieve her suffering. It had been a gut-wrenching yet selflessly loving decision. The arrangements had been made for that evening.
I was so sad for them both and worried about the impending river of grief that could sweep my patient away. Though I hate to admit it, I don’t consider myself a “dog person." I don’t like all dogs universally, but Trixie had earned a special place in my heart. I was grateful for her steady presence and worried about my patient’s well-being once she was gone. Frankly, Trixie had been important to me, too.
[She] had loved my patient well, taken her for walks every morning and evening ...
At the end of our session, I asked if I could take a few minutes to say goodbye. I knew that my words would be important, not only to Trixie but also to my patient. She turned her laptop so that I was face to face with Trixie, our noses just inches apart. Trixie lifted her head when she heard my voice, now familiar to her, and stared straight into the camera. I wanted to gather just the right words.
“You have been such a good dog,” I told her, my eyes filling with tears. “We will never forget you, and I promise you that a lot of people, including me, will be taking care of your human.” I thought this was a message we all needed to hear. She looked into my eyes, sighed her dog sigh, and lay her head back down on the couch. I hoped she understood.
My patient has a new dog now. Trixie's successor is a ridiculously cute Shih Tzu who wears two pink barrettes to keep her hair out of her eyes. Her cheerful demeanor helps soften the sharp edges of grief that have been carved so deeply into my patient. When I catch a glimpse of her in our sessions, I can see that this new dog loves my patient, too. I think we will work well together.
