As a therapist working with chronically ill clients or those facing a life-limiting illness, one of the most important and powerful roles you are assigned is as a facilitator in the journey to “give your client voice”.

Too often clients and their family members, as well as the clinicians around them, do not provide a safe environment from which the client can express their thoughts, feelings, questions and concerns. They don’t feel they can talk about their pain, their fears, ask those most intimate questions, and share their concerns about dying.

As some theorists have posited, the defense mechanism of “denial” is often a very productive one and should be maintained. In the case of a serious illness, it can serve as a very effective survival mechanism, one that may be needed to move forward during treatment or in some cases, enable patients to move on to another day.

Many people mistakenly believe that by talking about things, acknowledging feelings, etc. “it/they become too real to ignore” – can no longer deny what is happening and therefore “if I don’t talk about it, then it does not exist”. Clinicians can inadvertently support this belief with their actions.

As a child, a major factor in the development of self-esteem and a sense of self-worth is the recognition of “being heard”, both literally and metaphorically.
With an unbelievable sense of loss of power manifested by serious illness, by “giving your client voice”, you are empowering them, ressuring them that in fact, they are being heard and re-establishing their sense of self. Through this process, you are symbolically taking the journey with them and together you can confront their fears.

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