I have posted before about my continuing evolving relationship with my therapist, who is both a psychiatrist and an analyst. It is intensive therapy long term. It is not necessarily about symptom management at this point but more about growth and transformation though of course there still are issues that need attention.

My latest concern is that I am now developing a new professional identity as a clinician working with people with psychotic disorders, which I intend to continue to do. I am developing some apparently new ideas about how to see and understand some of the way people work, at least according to my supervisor and my therapist, both of whom have experience with this particular population.

My therapist has flattered me, which I posted about before. He has been a sort of mentor figure earlier but now I guess because I am coming up with different ideas and strategies, he is treating me more like a colleague, which is weird since he has 35 years of experience, has an MD from Stanford, where he also was a professor, plus went back into training to become an analyst, doing 5 years of his own analysis, course work, and a dissertation to earn a doctorate and is now a supervising analyst for that institute.

He has now told me that in his experience in charge of a locked ward, supervising residents at Stanford med in psychiatry, and then a supervising analyst, he still has not encountered the way I am thinking and handling this particular group, who might be characterized as chronic, low functioning psychotic patients.

That is kind of intense to hear. I asked about "dual relationships" since it is part of my ethical code, but not his, and he said he didn't think it was outside of his way of interacting with me in doctor-patient terms.

Still I wonder. And during this period he has been more personal and even suggestive. His masculinity and sexuality has come up. Compliments toward me of a personal or physical nature have come up. Then one morning when things were very personal, I texted him about something and I got a video of him, clearly not dressed. I wasn't sure why he sent it, but he did say that he sent it on purpose to let me see what he looked like early in the morning and made a joke about hoping it wasn't grotesque. I didn't respond.

I love the closeness between us. I don't believe that is harmful to me. We are not friends. We are not even colleagues, regardless of the collegiality. The boundaries are clear to me and I have no interest in overstepping them. I don't think he does either. I guess his shifts recently have raised questions though.