When I became very suicidal during a bad depressive episode last year, my Psychiatrist told me about losing one of his other patients to suicide and how the news just hit him like a tonne of bricks - it was clearly something that effected him deeply. I asked how long he'd been seeing this patient, and he just replied "not as long as you", so I kind of got the impression that losing me that way would probably have been pretty devastating for him. Apart from that, although he never gives out any sort of detail that might lead to the patients being identified, I am aware there are a couple of patients he's treating who aren't doing so well. One of them is a patient with a severe eating disorder, and because I've managed to achieve a fair degree of recovery myself after having anorexia for over 20 years at one stage he was trying to see if there was anyway he could bring me in as a support person, or just to have someone his patient could talk to, who'd been where she was, without breaking any sort of confidentiality rules (unfortunately he couldn't - and before anyone says anything about my Pdoc trying to put responsibilities on me that aren't my own, this would have been part of my therapy as well). Anyway I do know when patients are struggling like this, or if therapy doesn't go well for a particular patient, he constantly asks himself things like 'Where did I go wrong? What could I have done differently? How could I have helped his person better?' He's said sometimes he does need to step back and allow himself some perspective, or else the failures can end up seeming like a personal failing of his own (he's 'not good enough', he's a 'bad doctor') and if he allows ideas like that to take hold too much and knock his confidence then he can't effectively treat his other patients.

Edited to add: My point amidst that rambling was that I think it depends on the individual practitioner, some are fully prepared to exam their own failings (potential or otherwise) with a view to improving future client care, whilst others will most likely point the finger at everyone but themselves, including blaming the client. Classic example of the latter was a well known Eating Disorders treatment hospital and clinic that once admitted a 100% treatment failure rate, but went on to blame the patients for "usually needing 5 or 6 go's before they 'got it'".