Sole keepers of their secrets: "Hidden continuing bonds" and disenfranchised grief among therapists.

Résumé

This qualitative study provides an in-depth exploration of disenfranchized grief and continuing bonds of Israeli therapists who discovered a sudden client death during treatment. The findings indicate the therapists developed continuing bonds with their deceased clients but their expression remained concealed, stemming from the paradox between emotional intimacy and professional boundaries. Lack of social recognition of the therapists' mourning produced disenfranchized grief that ironically amplified continuing bond intensity, due to possibly being the sole "keeper of knowledge" of the client's inner world. Continuing bonds manifested in private rituals, symbolic practices, and professional identity transformations, yet were constrained by confidentiality and absent social legitimacy for their grief. Therapists felt compelled to uphold professional obligations and social expectations, but felt silenced and excluded. Practical implications include needed recognition of therapists' grief, development of specialized support frameworks, and encouragement of professional discourse that acknowledges the existence of continuing bonds within therapeutic spaces.