Jennifer Aniston’s therapist had the audacity and bad manners to pass away just as the Friends star was dealing with her ex-husband issues. Jennifer explains, “When your shrink dies, you just go, ‘Really? Is this some kind of cosmic joke?’ I will never forget that moment. It was devastating.”

It would be horribly devastating to me if anything happened to my therapist. Thank God she is alive and healthy. Although a bit older now, fourteen years more than when I first met her; with a few more wrinkles and laughter lines, slightly greyer hair and with a vaguely stiffer slightly arthritic countenance - although gravity (and genes) have been very kind to her. Over the years I feel she has gained a much younger, albeit more philosophical, existential outlook on life, an increased tendency to eat well, exercise regularly and look after her health in a big way which she is role-modeling, somewhat successfully, for me. In other words there is nothing ancient or doddery about her yet. She is aging well with much grace and dignity. She once told me she plans on retiring when she is taken away in a coffin.

So the chances of her falling off the perch (or should I say couch) is very minimal. I have arrangements with my long-term, highly-valued therapist in case that happens. I know who to contact in case the unthinkable happens. I know where my records will end up. But how do you do effective therapy with someone else when you are grieving your mother figure/supportive mentor/internalized role model? Are you allowed – is it ethical - to attend their funeral?

What are your rights if your therapist ends up with ill-health, in hospital, a paraplegic, a quadriplegic, has a life-threatening disease, or more likely, if she/he retires or moves to another state or country or simply gives up the therapy profession altogether? This happened to me once. My therapist of eight sessions decided I was cured, dismissed me and reinvented herself as an artist. Luckily I had still viewed her with ingrained suspicion and there were no transference issues. A therapist I know of gave two years notice to her clients that she was retiring. This allows time to work through important concerns - transference problems or anything else. Will the retiring therapist allow post-retirement email/phone/fax/text message contact and for how long? Does the umbilical cord get slashed, cleaved, and lacerated immediately with a pounding iron fist leaving a bloody mess the client has to clean up. Or is it gently and slowly whittled away, reduced, reshaped and reformed with healing, caring hands till it is possible for the client to build up a nourishing life support system of their own?

Therapists are not like lawyers, accountants, dentists, lawn-mower men, posties or video-outlet consultants, where you would be sad if they passed away, but who are highly replaceable. If anything happened to my therapist I would feel as though my world had been rudely shoved off its axis and was heading at light-speed towards a rapidly looming sun and instant disintegration. In some instances clients feel more for their therapists than they do their own mothers.

According to Nancy McWilliams, author of “Psychoanalytic Psychotherapy”, therapists owe it to their clients to stay as healthy as possible. She says that patients need models of adults who take proper care of themselves; that therapists must take care of their health in the long as well as the short term.

This also means not being so exhausted you have to be propped up during the day to function. Too much exercise can be just as detrimental as not enough exercise. There’s no point doing therapy with a traumatized client if your body is aching and craving to lie down and sleep. A good therapist is also an Oscar-winning actor, breaking through that physical barrier to look alive and alert even when catatonic with exhaustion. I have to admit I have never seen my therapist in this state but I do know she has given me a few heart-stopping moments of existential grief.

A few years ago she told me she had gone for a mammogram and then never actually got around to telling me the results. Meanwhile I took her lack of response as meaning she had received a negative outcome. Because I am hypersensitive to emotionally-loaded information from her I panicked and got very upset. A few sessions later, she randomly told me what would happen to my records should she one day shuffle off this mortal coil. I put two and two together and came up with terminal breast cancer. Lack of resultant information about the mammogram made Chinese whispers look like a fully-documented, highly-evolved mission statement. Not that I blame her. She had no idea the association patterns I was forming in my head. She felt the two pieces of information were unrelated.

It’s hard, very difficult for client and therapist to talk about these things. It’s not a topic I bring up in therapy because something always jams in my throat at the crucial moment. It’s an unthinkable thought, but it’s always there lurking under the surface. There’s an inherent vulnerability that simply being alive brings out in all of us. The inevitability and the fear of death is what Irvin D. Yalom, psychotherapist and author of “Staring at the Sun: Overcoming the Dread of Death”, believes is the cause of most anxiety. On the other hand, Adolph Meyer, Swiss psychiatrist and President of the American Psychiatric Association wrote over a hundred years ago, “Don’t scratch where it doesn’t itch.”

The trouble is, I’m starting to get that prickling, irritating, crawling skin sensation more and more of late. But it’s not that itchy – just yet.

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