Psychotherapists preparing for death: denial and action.

There is a striking silence in the psychotherapeutic, psychiatric, and psychoanalytic literature with regard to psychotherapists preparing for their deaths. The anxiety-provoking nature of contemplating, let alone actively planning for, death as well as the experience of separateness and timelessness that can be an integral aspect of the practice of psychotherapy, are factors that contribute to the denial of death. It is suggested that psychotherapists have an ethical responsibility to their patients to plan for their deaths by deciding who should contact which patients (current and perhaps past) and leaving instructions as to how this should be managed and what clinical measures should be considered with current patients. In addition, therapists (particularly those with serious illnesses) need to consider what (if anything) to tell patients before their deaths.