Debra was a 60-year-old, Catholic woman who, eight months prior, lost her 28-year-old daughter, Lindy, to a terrible autoimmune disease. Though the illness was long, fi lled with extreme pain and physical degeneration, the actual death was sudden and unexpected. Debra had, a year before, quit her job to become the full-time caregiver for her daughter and was proud of the excellent 24-hour care she provided. Throughout Lindy’s illness, Debra often recounted to me her gratifi cation over fi nding a good balance between being her daughter’s primary care giver and also her mother and friend. The sudden death of her daughter caught her completely off guard and she was totally devastated by the loss of her child and her role as caregiver. She was deeply hurt by friends’ attempts to console her by stating that “Lindy was in a better place” and that she needed to “Let Lindy go and be happy again.” She repeatedly reported that her heart was totally broken and that she was forever changed by the experience. The loss of Lindy took a huge emotional toll on Debra and also seriously compromised her physical health. Due to ongoing health problems, Debra was only able to attend therapy sporadically.