[Syra]

I was at a Memorial SErvice for a person who was a psychotherapist and everyone present had an opportunity to speak. A few of the people spoke about how their relationship with the deceased started as client-T, but they realized they (both the client AND the T) wanted it to be client-T AND friends. And I heard of another client who remained a client while moving in to the T's home help with an aging parent (the client had nursing skills and limited funds for therapy).
And then I have heard of lesser stories of the client staying for dinner with the therapist, or picking up take-out for the therapist and staying to eat.
And part of me thinks it would feel so wonderful and validating to think have a richer, fuller relationship in which the T's regard for me was demonstrated as not "just because I'm a client and he has to" but because he really enjoys me, and part of me thinks this might be risky. I've heard of a therapist who loaned money to a client. (for a very worthwhile endeavor, and not so much as to put the therapist in any difficulty, and more than the client could afford.)
I'm wondering what experiences people have had. I have struggled with making sense of what boundaries are necessary for me, and what boundaries limit me (I realize the therapist must also answer these questions for themselves. I'm focused on how does the client respond to different boundaries, which is different from the therapist's comfort level.) Would lowering of boundaries enrich the relationship and therapy, or risk it and be confusing and more vulnerable to the kinds of things that happen to people in regular relationships. or both?

[feralkittymom]

To be in a friend role while a client feels untenable to me. It would have been impossible for me because of the nature of our work together.

But having said that, I do think it's possible sometimes for relationships to grow and change as a result of therapy, if both parties have developed beyond the mutual dependencies that therapy can entail. In other words, that all transferences have been resolved successfully, and if the people involved genuinely like and respect each other.

It doesn't mean that the basic roles in the relationship have to change, but that any dependencies which arose from those roles must be resolved.

So in my experience, I don't really feel like my former T and I are friends, though we share a friendly warmth and fondness for each other; the parental relationship is still there, but it isn't a parent taking care of a young child dynamic, as it was. It is a parent to adult child dynamic, each respecting the other as an adult with autonomy. It feels like what I've witnessed between a few friends and their adult functional relationships to their parents.

[mazing]

Having been on both sides of the table I would be hesitant to have a friendship while in therapy (or providing therapy). While I can completely understand how it could help make the relationship stronger in some ways it also blurs the boundaries between what is and isn't appropriate. I would also be concerned about issues that may arise. For example, if as a friend there was a falling out it could jeapodise the therapeutic relationship, or an issue sharing in therapy and being able to have the difficult conversations for fear of risking the friendship. The issues around transference in therapy are also escalated.

I don't know about where you live but I know here in Australia there are some very strict guidelines about forming relationships with clients outside of a therapy setting. They do relax a little if the person is no longer a client but it still needs to be considered due to the position of power that the therapist can have. There is always the risk of 'taking advantage' of a client who may feel pressured to continue the relationship.

Now don't get me wrong, a cup of coffee or meet up every now and then, especially after therapy has ceased, is not a problem to me but I would be hesitant to take it further than that without a lot of discussion and consideration of the risks.

As a client, I feel the same way - therapy is great for what it is but I would be worried about how it could negatively impact on my therapy by knowing my therapist outside of that setting.

[stopdog]

i became friends with the first therapist I ever saw at her suggestion. It was fine but not a big deal. She was just a normal (or what passes as such for a therapist) person and we shared a couple of interests and pursued them together. I have not had the urge to befriend the ones I see now.

[BlessedRhiannon]

I've always thought my T is a very interesting person, and that if we'd met outside of the therapist-client relationship, that she'd make a great friend. That said...I need her as my T, not as my friend. I would feel very uncomfortable with a dual relationship with T. I think it would be difficult for both the T and client to separate friendship and therapy. I mean, if you scheduled an appointment for a therapy session, then you'd want to do actual therapy at that time, not chit-chat. But, if you were going out to dinner or shopping or a movie with the T as a friend...how do you stop that from becoming an impromptu session as well? Part of friendship is sharing things that are going on in your life...you'd have to be careful not to take advantage of spending time with your T to get in extra therapy sessions. The therapist would have to be careful not to offer therapeutic advice during the "friend" times.

I suppose it's possible, but I think it would be very hard on both the T and client, and is a risky situation.

As I'm typing this, I find myself trying to imagine how it would work to be both friends and a client with my T...and I just can't see it. It would feel so awkward to me to go to a session and talk about my deepest thoughts, secrets, fears, etc. Then...say a few days later, go out to lunch or something, and have a light, casual conversation. It just wouldn't work for me. I'd either become hesitant about sharing things in session, for fear it would spill over in to the friendship, or I'd become hesitant about spending time as friends, for fear it would become a mini session.

[refika]

I have thought many times about having my T as a friend aside from therapy. But the more I think about it, the more I really wouldn't want it (as much as I would "like" it). The reason being is my T knows too much about me, and I don't think the transition could be made to friendship.

If I just wanted to "vent" to them as a friend, and not for introspective examination, I would be worried if something I said would be met with "well, how does that make you feel", rather than "yeah, that stinks, I agree with you" (as a friend would say). I would also worry whether the T could make that leap and leave the therapy hat home.

I have a really really close friend who had years and years of therapy but was not a therapist. I confided in her about one of my issues and she started "playing therapist" with me, asking me questions a therapist would based on her own experiences with therapy. She was helpful, and did it from a friendship point of view, and with care and love, but I found I was starting to resent her because she was making me mad with forcing me to look at myself the way a therapist would. Fortunately, our friendship was(is) strong enough and I was able to tell her to stop acting like a therapist and just be a friend.

I keep remembering that incident whenever I think I want to be friends with my current T.

[CantExplain]

I desperately wanted to be friends with T but she was quite clear that could never happen.

[ScrewedUpMe]

Personally I would find it extremely anxiety provoking to see my therapist outside of her setting. I know that I am someone that needs the security of boundaries and I don't think my head could cope with separating the friendship from the therapy. It is, however, something I have fantasised about, because I never want her not to be in my life, but I think all I could cope with would be meeting for coffee or something a long time after ceasing therapy. But then my therapist is a mother figure to me so friendship wouldn't really work, it would be more like mother and daughter and that would be weird and I'm sure not what she would want since she has her own daughter. (who of course I am insanely jealous of )

My first T and I have remained friends now for almost 30 years (God, I'm getting old). We don't live near each other so our contact is a few emails and perhaps a phone call a few times a year. It is NOT a therapist-client relationship anymore in any way and hasn't been since I left college. But we have a genuine affection and respect for each other just as people that caused us to have the desire to remain in touch.

I think it is VERY important that the relationship is no longer and never will be ever again a therapy relationship in these cases. I never had any illusions that it would be and didn't really have any transference issues to deal with, so it worked for us. In a way, I think it worked BECAUSE it wasn't something I longed for or dreamed about or had some deep desire for; it was just the natural evolution of our relationship as our roles changed over time.

[southpole]

Yeah I don't think I'd want to be friends with mine. I mean I do feel sometimes that I want to be her friend, and I do have this strange transference attraction going on, but to be honest I would never, ever want anything to move beyond the therapist/client relationship. It just wouldn't work. It's better to have the strange "fantasies" and realise that that's both exactly what they are, and what they're meant to be - just fantasies that reveal something about me, rather than anything else. Wow, that's good to realise actually. Makes the whole thing feel less screwed up.

[Crescent Moon]

I just cannot imagine it in any way, shape, or form. I don't know how either of us would separate one from the other. A possibly interesting tidbit... I was supposed to see my therapist early yesterday morning. She got ahold of me by phone and said she needed to cancel because she was sick. She sounded god-awful. She told me she hoped to feel better in the afternoon, and asked if I'd like to see her in the afternoon. She said she 'just' had a dry cough that wouldn't go away, and was having trouble breathing. Said it started Monday, then got better Tuesday so she went to work, then over night Tuesday night it came back.. cough worse and a fever. As a healthcare provider, I knew right away that she probably has Influenza. In the last month, I've taken care of two previously very healthy boys, patients aged 9 and 11, who ultimately died of influenza as a result of the aveoli (little air sacs, sort of) in their lungs hemorrhaging from working too hard to compensate for difficulty breathing. So as you can imagine, after hearing her talk about it being hard to breathe, my concern shot through the roof. So I told her "T, I think it sounds like the flu - and you've got a bunch of the symptoms that make it emergent. The flu can be deadly - please promise me you'll get in today to see someone," She sobered somewhat, and promised me she'd call her GP. A couple hours later, I sent her the "symptoms requiring emergent care" from the CDC, and told her to keep me posted. I told her that I realized it might be a little inappropriate of me to be kind of bossy about it with her, but said I'd worry about that later, because "I am just colossally selfish enough to need to make sure you know how important to me it is that you take really good care of my therapist." After I sent it, I realized that I had sort of put on a professional hat myself, and it was like I was (without my concern being solicited), taking on a role uninvited in order to urge the "person" within whom my therapist resides, to get my therapist the medical attention I thought she needed! It felt a little weird to me in a way, but I just did not care about boundary violations - - so intense was my need to make sure this woman did not neglect my therapist! But I cannot imagine trying to navigate a dual relationship with her on an ongoing basis. I want her to be my therapist only.

[sconnie892]

I think my t is a wonderful person and would make a wonderful friend outside therapy - but what I value most about our relationship is the objective perspective she can bring to the sessions. That boundary is what makes me feel safe in sharing with her. I don't think that boundary would be so clear if we were friends. So as much as she would make a good friend, while she is my t, it's important for me that she is just my t.

[anilam]

I could see how for some ppl therapy RS could grow into some other kind of RS- though it wouldn't work for me.

However, I think being in therapy and consecutively being friends can't be healthy.
Like come on, could any of us imagine our real friend to be in our Ts role? For one hour (more or less) a week you would meet your friend in some special setting and do therapy then stop and go have a drink with some other friends?
That just cannot work- these types of RS are too different. You'd end up either not being friends or not doing a real therapy. Yes, some friendship can work therapeutically but I think it's important that they are reciprocal which client/T RS isn't (shouldn't be).
Plus paying my friend for his/her time would feel awful (not to mention him/her giving me a sliding scale )

It would be difficult IMO to be friends with an XT, as they know all about you and you really don't know them. I could see my feelings regarding them change as I started to notice that they were messy too.

[anilam]

Originally Posted by anilam

I could see how for some ppl therapy RS could grow into some other kind of RS- though it wouldn't work for me.

However, I think being in therapy and consecutively being friends can't be healthy.
Like come on, could any of us imagine our real friend to be in our Ts role? For one hour (more or less) a week you would meet your friend in some special setting and do therapy then stop and go have a drink with some other friends?
That just cannot work- these types of RS are too different. You'd end up either not being friends or not doing a real therapy. Yes, some friendship can work therapeutically but I think it's important that they are reciprocal which client/T RS isn't (shouldn't be).
Plus paying my friend for his/her time would feel awful (not to mention him/her giving me a sliding scale )

Semantic false friend- hate those.
Anyway, what I meant was: at the same time- I know you guys have probably guessed that from the context and IDK why I feel the need to correct myself but here I go .

[sunrise]

I would only consider being friends with my T if we were done with our therapy relationship. It wouldn't work well for either of us to be friends at the same time we have this professional relationship. The therapy relationship is very special--I would not want to jeopardize that by simulataneously trying to be friends. I am sure my T would not permit that anyway.

Syra, the examples you gave of the client staying to share dinner with the T or of helping take care of the T's aging parent (for a fee, I assume) are unconventional and certainly push the edge of traditional client-T relationships, but they don't sound like friendships to me. I think loaning the client money was probably inappropriate, but it does not mean they were friends.

Originally Posted by Syra

Would lowering of boundaries enrich the relationship and therapy, or risk it and be confusing and more vulnerable to the kinds of things that happen to people in regular relationships. or both?

I think this is a different question than about being friends. I think it really depends on the T and the client. My T often eats when we are together and sometimes offers me some of his food. When my T goes out right before my session to get a coffee, he sometimes brings me back the kind of hot drink he knows I like. When something awful had happened in my life and I hadn't slept all night or eaten anything and showed up at T looking pretty dog-eared, my T brewed me a cup of tea, and put a big piece of carrot cake in my hands and took care of me. Some would consider this pushing boundaries, but it was helpful, enriching, and memorable to me (but it did not mean we were friends). My T also shares plentifully about his life with me. We have gone on walks a few times during the session. He has served an additional professional role for me, so I saw him outside of the office a number of times in this capacity. All of these things have enriched our relationship. This has worked for me. But I have seen some people post here about how they would not want their T to eat in session, self-disclose, etc. So for these people, relaxing that type of "rule" may not be helpful. I think the T needs to be savvy about individual client needs and not use a "one size fits all" approach. The T must also know himself well and not relax boundaries he needs to protect himself. I think especially new Ts need to err on the side of caution.

Originally Posted by Syra

I have struggled with making sense of what boundaries are necessary for me

This is a very interesting question to learn about oneself. I have found a boundary I don't want T to cross, and it involves his attending celebratory events in my personal life. I am in school now and he has hinted that he would like to attend the graduation. I don't want him there. I am sure he will not push it, he just threw the idea out there a couple of times. Another time, he was encouraging me to sign up for a training program he thought I could benefit from, and he said they have a graduation for that and that he would go to that. I think he had several clients who were going to do the program so he was kind of warning me that he would there at the graduation (the other clients evidently had no problem with his presence). Because of this, I withdrew from the class. I don't want him at "my stuff" outside of therapy.

[skysblue]

I need a therapist more than I need another friend. I like my T a lot. But I don't know much about her outside of therapy. I do know she has a dog or two. I do not know if she's married. I do know what university she attended. I do not know a thing about her family life except she has a stepmother in another state.

Although I would love to spend more time with her cuz I really do enjoy our interaction (it's not always strictly therapy related), but $80.00 a pop prevents more contact. AND it would feel weird to see her outside of session.

I've learned (was difficult) to talk only about myself in therapy. A friendship is a 2 way street. How would I feel if I learned about my T's own psychological issues? A friend is there to support.

Nah, would rather let my T stay my T.

[amandalouise]

Syra... in the united states of america we have many small towns. some so small for example the school nurse is also the therapist, psychiatrist, trusted member of the community and yes friends of everyone in the town...hard not to be a friend of everyone when they are the one that delivered every baby in the town...

here in america we also have the freedoms of choice... that freedom can come in many ways in which other locations and countries may think is strange and hard to comprehend.. for example I just read an article this morning about a girl in iceland who's mother and she both had to fight the childs whole life just so that the girl can have her own identity...in iceland when someone has a baby the baby can only be named from a government approved list of baby names. this parent named her child a name that could fit for both girls and boys that was not on the approved list of baby names... now to me that is such a mind boggling idea that a government says what a parent could name their child when here in america a parent can name theeir child anything and I mean anything..

well here in america even each state government, agency and profession with in america has the right to make their own choices / rules. in the profession of psychotherapy theres three different set of choices/rules of ethics... theres the national ones, then theres the state ones and then theres what each agency has decided is best for therapist-client relationships.

the nationwide government who over sees mental health rules is the american psychiatric association. they say its best that a client and therapist not be friends during the time that the client is in therapy but they also understand that america is a nation of freedom so they also allow each state to set their own rules and government that over sees mental health issues.

on the individual state level the overseeing governement is called the state board.. each state has their own panel of people that choose what the mental health standards are going to be in that state. the board is called by many names. Here in New York the mental health ethics are that a therapist and client can be friends after 2 years in which the therapist and client have ended therapy sessions with each other.

I have a client who came from another USA state whos mental health ethics are they the client and therapist cant be friends until after one year in which they haven't met for therapy purposes.

I also have a friend who came from another USA state in which that states mental health ethics stated they can be friends even while the therapist and client are in therapy together ...as long as the friendship does not hinder the therapy process, and their sessions are observed by the therapists supervisor to ensure the friendship isnt interfering with the therapeutic process.

I know there are some USA state ethics boards that say absolutely no friendship can happen between therapist and client. not before, during or after they are client therapist.

now about the going to dinner, moving in with the therapist and all that stuff...again sometimes the towns are so small that a ...barter system.... works. a barter system is where instead of money changing hands services changes hands this person will fix your car if you fix their roof, that person will sit and take care of your elderly relative if you will provide what ever service you can. one time I provided therapy for a client of mine who had no money and they used their craft abilities to make me a hand crafted quilt.

here at the crisis center our agency allows us to meet our clients in other places besides here in the office.. we get calls from the hospital on rape victims that need our help so we go to the hospital. sometimes a client will be working and something will come up and they call and ask if we can meet them someplace close to their job, sometimes people dont have transportation so we meet where ever they are able to get to, sometimes I have held sessions in diners, fast food places and even resteraunts. my own therapist has a private practice which is in her home and in a small office building. sometimes we do meet in her home and have a meal together while we are talking. I have also gone out to dinner with my therapist. one time when my finaincial aid hadnt come in yet my therapist hired me as a house keeper...clean her house once a week and I got therapy free.

my point is each location has their own rules of what is ok to do in therapy and what isnt. and each therapist and client goes according to how things are in their own locations. just like you go according to whats allowed in your location....you can find out what the choices/rules / boundaries are in yours and your treatment providers relationship by asking them whats allowed and what isnt.

Originally Posted by Syra

I was at a Memorial SErvice for a person who was a psychotherapist and everyone present had an opportunity to speak. A few of the people spoke about how their relationship with the deceased started as client-T, but they realized they (both the client AND the T) wanted it to be client-T AND friends. And I heard of another client who remained a client while moving in to the T's home help with an aging parent (the client had nursing skills and limited funds for therapy).
And then I have heard of lesser stories of the client staying for dinner with the therapist, or picking up take-out for the therapist and staying to eat.
And part of me thinks it would feel so wonderful and validating to think have a richer, fuller relationship in which the T's regard for me was demonstrated as not "just because I'm a client and he has to" but because he really enjoys me, and part of me thinks this might be risky. I've heard of a therapist who loaned money to a client. (for a very worthwhile endeavor, and not so much as to put the therapist in any difficulty, and more than the client could afford.)
I'm wondering what experiences people have had. I have struggled with making sense of what boundaries are necessary for me, and what boundaries limit me (I realize the therapist must also answer these questions for themselves. I'm focused on how does the client respond to different boundaries, which is different from the therapist's comfort level.) Would lowering of boundaries enrich the relationship and therapy, or risk it and be confusing and more vulnerable to the kinds of things that happen to people in regular relationships. or both?

[autotelica]

I am grateful for the informal relationship that I have with my therapist. But I am very glad that I don't have to keep up with her in the way that friends do. I just wouldn't be a good friend, and the failure would crush me. But being a good patient is easy.

Friendship-lite is kinda what I enjoy with her.

[Syra]

Originally Posted by anilam

I could see how for some ppl therapy RS could grow into some other kind of RS- though it wouldn't work for me.

What does RS mean?

[Syra]

Originally Posted by feralkittymom

But having said that, I do think it's possible sometimes for relationships to grow and change as a result of therapy, if both parties have developed beyond the mutual dependencies that therapy can entail. In other words, that all transferences have been resolved successfully, and if the people involved genuinely like and respect each other.

I agree with you. I am friends with my thesis advisor and a couple other professors from over 30 years ago. They aren't friends in the same sense of the people I hang with most of the time. But there is a mutual fondness with no obligation to connect.

[Syra]

Originally Posted by mazing

Having been on both sides of the table I would be hesitant to have a friendship while in therapy (or providing therapy). While I can completely understand how it could help make the relationship stronger in some ways it also blurs the boundaries between what is and isn't appropriate. I would also be concerned about issues that may arise. For example, if as a friend there was a falling out it could jeapodise the therapeutic relationship, or an issue sharing in therapy and being able to have the difficult conversations for fear of risking the friendship. The issues around transference in therapy are also escalated.

I don't know about where you live but I know here in Australia there are some very strict guidelines about forming relationships with clients outside of a therapy setting. They do relax a little if the person is no longer a client but it still needs to be considered due to the position of power that the therapist can have. There is always the risk of 'taking advantage' of a client who may feel pressured to continue the relationship.

Now don't get me wrong, a cup of coffee or meet up every now and then, especially after therapy has ceased, is not a problem to me but I would be hesitant to take it further than that without a lot of discussion and consideration of the risks.

As a client, I feel the same way - therapy is great for what it is but I would be worried about how it could negatively impact on my therapy by knowing my therapist outside of that setting.

I believed as you did in your first paragraph. And then I watched several people develop some sense of a friendship outside of therapy and it seemed to work. Having watched this, and experienced some of this, I think it's absolutely true that it's risky. I wonder if it actually makes the relatinship stronger, or just feels more nurturing to the client, or are those one in the same?

I agree with you about cups of coffee and maintainng some kind of contact is very different that becoming "friends"

I resonate with your concerns about the risks. I have heard others say that the fear of the risks prevents the benefit that could be had now. then I get confused

[Syra]

Originally Posted by stopdog

i became friends with the first therapist I ever saw at her suggestion. It was fine but not a big deal. She was just a normal (or what passes as such for a therapist) person and we shared a couple of interests and pursued them together. I have not had the urge to befriend the ones I see now.

or what passes as such for a therapist LOL

Were you friends during the therapy? or after?

I'm curious about a couple of things that aren't any of my business so I totally understand if you don't want to answer. How do you balance out the relationships that starts off with you revealing A LOT about yourself and the T not revealing all that much? or was it like that?

[Syra]

Originally Posted by BlessedRhiannon

I've always thought my T is a very interesting person, and that if we'd met outside of the therapist-client relationship, that she'd make a great friend. That said...I need her as my T, not as my friend. I would feel very uncomfortable with a dual relationship with T. I think it would be difficult for both the T and client to separate friendship and therapy. I mean, if you scheduled an appointment for a therapy session, then you'd want to do actual therapy at that time, not chit-chat. But, if you were going out to dinner or shopping or a movie with the T as a friend...how do you stop that from becoming an impromptu session as well? Part of friendship is sharing things that are going on in your life...you'd have to be careful not to take advantage of spending time with your T to get in extra therapy sessions. The therapist would have to be careful not to offer therapeutic advice during the "friend" times.

I suppose it's possible, but I think it would be very hard on both the T and client, and is a risky situation.

As I'm typing this, I find myself trying to imagine how it would work to be both friends and a client with my T...and I just can't see it. It would feel so awkward to me to go to a session and talk about my deepest thoughts, secrets, fears, etc. Then...say a few days later, go out to lunch or something, and have a light, casual conversation. It just wouldn't work for me. I'd either become hesitant about sharing things in session, for fear it would spill over in to the friendship, or I'd become hesitant about spending time as friends, for fear it would become a mini session.

I've found a few professionals in my life, a couple of them T, that I thought I would very much like as a neighbor (But I doubt I would have gone to them if they were my neighbor. Ick.), or friend, or community member.
I'm not sure how the people who I've heard talk about being friends with clients/therapists pull it off. I wish I understood the experience better (without actually wanting to actually try it for all the reasons you and others have mentioned.)

[Syra]

Originally Posted by refika

I have thought many times about having my T as a friend aside from therapy. But the more I think about it, the more I really wouldn't want it (as much as I would "like" it). The reason being is my T knows too much about me, and I don't think the transition could be made to friendship.

If I just wanted to "vent" to them as a friend, and not for introspective examination, I would be worried if something I said would be met with "well, how does that make you feel", rather than "yeah, that stinks, I agree with you" (as a friend would say). I would also worry whether the T could make that leap and leave the therapy hat home.

I have a really really close friend who had years and years of therapy but was not a therapist. I confided in her about one of my issues and she started "playing therapist" with me, asking me questions a therapist would based on her own experiences with therapy. She was helpful, and did it from a friendship point of view, and with care and love, but I found I was starting to resent her because she was making me mad with forcing me to look at myself the way a therapist would. Fortunately, our friendship was(is) strong enough and I was able to tell her to stop acting like a therapist and just be a friend.

I keep remembering that incident whenever I think I want to be friends with my current T.

[/QUOTE]If I just wanted to "vent" to them as a friend, and not for introspective examination, I would be worried if something I said would be met with "well, how does that make you feel", rather than "yeah, that stinks, I agree with you" (as a friend would say). PERFECT!!![/QUOTE]

and your anecdote is very helpful. Thank you.