Pulling Up a Chair

As therapists, we are trained to notice what isn't working.

We look for distorted beliefs, unhealthy patterns, unresolved grief, damaged relationships, and behaviors that no longer serve the person sitting across from us. Our profession is built around movement. Helping people move from suffering toward healing. From confusion toward clarity. From surviving toward living.

We become so accustomed to asking, What can we do? that we rarely stop to ask a different question.

What happens when our role changes, but our purpose does not?

It is an uncomfortable question because it challenges one of our deepest professional instincts. We entered this field to help. To relieve suffering. To believe that with enough time, insight, and effort, life can become a little better.

Then one day, a client quietly tells you they are dying.

In that moment, you discover something graduate school never really taught you.

The work didn't end, it changed.

At first, you may question yourself. You may leave sessions wondering if you should have said more, done more, or somehow found the perfect words. You may feel strangely inadequate because many of the interventions that have served you throughout your career no longer seem to fit the moment.

This is where many therapists become unnecessarily burdened.

We mistake the absence of solutions for the absence of purpose.

They are not the same.

There are moments in therapy when insight changes a life. There are moments when challenging a belief opens a new future. There are moments when teaching a skill reduces years of suffering.

End-of-life care reminds us that there is another kind of healing.

One that has nothing to do with changing the outcome.

I think of the ladderback chair my grandmother kept by the back door, the one that got carried into a bedroom whenever somebody in the family was dying. Nobody had to explain what it was for. You pulled it up close to the bed, you sat down, and you stayed. That was the whole job description. Country people used to call it sitting up with the dying, and later, sitting up with the dead, and nobody thought either one required a certification. They understood something we spend years in graduate school circling back around to.

As therapists, we often think our greatest value comes from what we know. The interventions we choose. The questions we ask. The theories we understand.

Yet clients approaching the end of life rarely remember brilliant interpretations.

They remember who stayed.

They remember who allowed them to speak openly about fears that others were too uncomfortable to hear. They remember who did not rush to reassure them, change the subject, or search for silver linings. They remember the person who made enough room for their reality that they no longer had to carry it alone.

Presence is easy to underestimate because it looks so simple. A chair pulled up to a bed doesn't look like intervention. It doesn't chart well. But it is the thing people remember fifty years later, long after they've forgotten what anyone said.

Remaining emotionally present with someone who knows they are dying requires us to face something we spend much of our lives avoiding.

Our own mortality.

Without realizing it, we may begin thinking about our parents. Our spouse. Our children. Our unfinished dreams. The conversations we keep postponing. The people we assume will always be there.

Death has a way of making life impossible to ignore.

This is why these sessions can linger long after they end. Not because we failed our clients, but because they quietly held up a mirror to our own humanity.

Many therapists worry that they will become too emotional.

The goal, however, is not emotional distance.

It is emotional steadiness. Steadiness lets you sit beside another person's suffering without needing to escape it or absorb it. It lets you offer compassion without believing you have to carry someone else's pain home with you to prove you cared.

Their story deserves your presence.

It does not require your burden.

Perhaps one of the greatest lessons these clients offer is that hope does not disappear simply because a cure does.

Hope changes.

It becomes hope for one more meaningful conversation.

Hope to mend a fractured relationship.

Hope to laugh with family one last time.

Hope to leave behind words that matter.

Hope to be remembered honestly.

Hope to die without feeling alone.

The therapist does not create that hope.

The therapist simply helps protect it. Sometimes that looks like nothing more than a chair, pulled close, and a willingness not to leave the room.

There is another unexpected gift in this work.

Clients nearing the end of life often teach us far more about living than we teach them about dying.

When time becomes visibly limited, life's priorities become remarkably clear. Love matters more than achievement. Connection matters more than productivity. Presence matters more than perfection. We begin to recognize how much of our own lives have been consumed by worries that would never survive the perspective of a finite timeline.

These clients remind us that meaning was never found in doing everything.

It was found in loving well.

There is also something profoundly sacred about being invited into another person's final chapter. Few professions are entrusted with such intimate moments. A client who allows you to witness their fears, regrets, gratitude, reconciliation, and final hopes is offering something that cannot be measured by treatment goals or progress notes. It is a privilege earned through trust, the same privilege my grandmother's neighbors extended to whoever agreed to take the chair for the night. Not simply to solve problems, but to walk alongside another human being when the road becomes most difficult.

When therapists learn to see these moments differently, the pressure begins to soften.

Your responsibility was never to prevent death.

It was never to rescue someone from the reality of being human.

Your responsibility has always been to reduce unnecessary suffering where you can and to bear witness where you cannot.

There is profound peace in accepting that distinction.

Because when we finally let go of the belief that we must fix every pain, we discover something unexpected.

Sometimes the greatest healing occurs when nothing changes except the knowledge that another human being no longer has to face the journey alone.

We spend our careers believing our value lies in helping people change.

Then, every so often, someone enters our office and teaches us something we could not have learned any other way.

That our greatest contribution was never found in having the right answers.

It was found in being willing to pull up a chair.

A Closing Thought Shared..

If you remain in this profession long enough, you will eventually sit with someone who is approaching the end of their life.

You will likely wonder whether you said enough.

Whether you did enough.

Whether your presence truly mattered.

It did.

Not because you found the perfect words.

Not because you somehow eased every fear.

But because, in one of life's most vulnerable moments, another human being did not have to face it alone.

There are few greater privileges than that.

When your own career comes to an end, it probably won't be the treatment plans, diagnoses, or interventions you remember most.

It will be the people.

The ones who trusted you with their stories.

The ones who changed you while you were trying to help them.

And perhaps you'll discover that some of the most meaningful therapy you ever provided happened when there was nothing left to fix but the chair, pulled up close, and you, staying in it.

McHenry Counseling