10/07/2011 12:53 pm ET Updated Dec 07, 2011

A Love Letter at Death

My office phone, also in my home, rang at 6 a.m. My client's voice a whisper due to shock. Her mother, enduring a long illness yet completely coherent the evening before, had died peacefully in her sleep an hour before. This day was my client's 30th birthday.

One of my close friends was caring for her mother following a difficult surgery. Her mother had been depressed since the death of her husband, her childhood sweetheart, the year before. Though she told her daughter, only child, again and again how much she loved her, she also said repeatedly that with her husband no longer with her, she wished to die. My friend's mother died a few moments after her daughter stepped out of the hospital room for a cup of coffee. It was my friend's 50th birthday.

Another client, adopted at the age of two, had an excellent relationship with her adoptive parents. With their understanding and support, she spent several years searching for her birth mother. When she finally found her, she also learned that this woman had died three months earlier. Her death was on my client's birthday.

Do these deaths coinciding with the birth of a child hold any meaning? Or are they mere coincidence? All of my experience, in studying cases of clients who have experienced this depth of loss on such a significant day in their lives, shows that this kind of dramatic event holds great meaning.

A child's first home is within the body of the mother who births them. This connection to the one who gives birth is primitive as well as, consciously and unconsciously, enduring -- even when a child is raised by others who love him or her deeply and dearly.

A graduate school friend gave up her son when she was 15 years old. She knows who his parents are now, how cherished he is and how he has flourished. She does not wish to be part of his life. "I think this would be selfish and disruptive to him, giving unnecessary conflict and anxiety," she has confided. My friend has gone on to have a very fulfilling marriage. She is a mom of three and an attorney concentrating in family law. However, in her words: "Since I gave up my child, even without realizing the day, each year on his birthday I wake up, heart pounding, eyes tearing."

I have also learned that the decision to have a child is an act of hope, even when one is not ready or able to care for a child. This is true even for those who chose to keep a child and may make dreadful parenting mistakes. It is important to remember that the behavior shown to a child that can be the most harmful is almost always a repeat of, or reaction to, the way that parent was treated during their formative years.

A mother I know well, who abused her daughter emotionally and physically, who was never able to find the strength within to see or understand the harm she inflicted, died on her daughter's 25th birthday. In therapy, this young woman remembered that there were many times when her mother did her best to love her in a better way than she had been loved. She saw that her mother loved her as fully as she was able, and was able to forgive her. And she began to see that her mother's death on her birthday -- as painful as this was -- was her way to express her connection, as well as her sorrow that she had inflicted such pain.

Another example of this complex life event involved a client with a mother who was exceedingly overprotective and had enormous difficulty with the "letting go" process that all parents must eventually face. What my client described as his mother's "strangle hold, which feels like some kind of noose around my neck," kept him in a constant state of guilt when a love or work situation took time away from his mom. When his mother developed a virulent form of pancreatic cancer, she took her son's hand and apologized for her selfishness, asking for his forgiveness. She died two weeks later, her son at her side. It was his 32nd birthday.

Again and again, in situations like these (which are more common than most realize), a parent, sibling or other relative -- usually one full of rage, as well as envy and jealousy and whose animosity has made it necessary for my client to seek treatment in the first place -- often says something like: "Now you can never again have a happy birthday." Or, "How she must have hated you." Or, "What a curse you now will always have."

But I can tell clients and friends something very different. There is often a message in death that one has been unable to express in life.

When the moment of death comes on the birthday of a daughter or son, all of my clinical experience points to this life event as a mother's expression of love, often tinged with sorrow. Death at this time is her wish to share one more milestone -- her way of expressing that, even when her mistakes have been grave ones, her love is eternal.