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The American Psychiatric Association, at its meeting in Chicago in May 1961, examined the question of whether the dying patient should be told that he is dying. Divergent points of view were expressed, but all psychiatrists agreed that “loneliness can be as bad as the pain of dying, and yet society too often condemns a dying man or woman to precisely that fate.”10
No one apparently voiced the opinion that on the unconscious level at least, the dying patient knows that he is dying. I agree with Eissler that “it is immaterial whether the patient knows this consciously or not. Somewhere within him there is such knowledge, and the psychiatrist, even when he is merely present, is always in contact with the patient's unconscious.”2 I believe that what is essential is that the patient not be left to his loneliness and despair while he awaits death; that in the case especially of the patient who has undergone analysis, he be in close contact with his analyst; that the path they had trodden together in analysis for so many months and years in intimate communication, often on the deep unconscious level, should now enable the analyst to bring comfort to his patient in his final extremity.
Some years ago Alice, one of my patients, died of an incurable and inoperable carcinoma. Her death left me confused and disturbed, unsure of myself as an analyst and bewildered at the depth of my countertransference during her fatal illness. I was far too subjective and emotional to be a good analyst I thought, and I lacked judgment in having considered terminating Alice's treatment at the point that I did. I had apparently worked through neither her transference to me nor own countertransference to her.