Boundaries

Emotionally, yes, it's about the client's safety.

But in regards to boundaries? I'm sorry, but the therapist is more at risk than their clients are. The therapist knows how to respect boundaries and won't be invading their client's lives beyond the therapy sessions. The T's safety is of concern precisely because they are the one who is stable and solid.

The T sets boundaries, like anyone else.

Boundaries are simply going "this is what is ok with me for you to do/be involved with. this is what it is not ok for you to do/be involved with."

Boundaries are someone else's ways to SHOW someone how to be respectful to them - it isn't in lieu of respect. It's a clear way to help someone else who may struggle with it to see clearly what they need to do to be respectful.

If a T did not have clear boundaries set, then the client will cross them whenever they want. The T's safety is of concern then, because not everyone can handle things respectfully - and the T is working with those people to try to help them.

Boundaries can be fluid. What I may not be comfortable with my students doing, I might be totally fine with a friend. My boundaries may change with one person over time as I get to know them differently.

But the fact remains: they are my boundaries. If my boundaries are more strict than another persons, they still have to respect my boundaries. Their looser boundary does not negate my tighter one.

That would still be the case in a therapy setting. A T will, by default, have their own personal boundaries along with any ones put in place by their employer. Which is why some Ts will hug and others won't. That's their boundary, and it needs to be respect and upheld even if the client feels like it will slow down their own healing. The T should not have to give up their entire personhood to a client.

So I am cutting this short because I see it's rather long.

It's all semantics really, to me healthy boundaries is just a short-hand word for what you've described mutual respect, honour and positive regard. For example, my cat right now has no respect of my boundaries and is currently crawling over me and digging her nails in to my skin, i've had to move the laptop and everything!

Perhaps that's more about the person's therapeutic orientation than personal boundaries per se. I think old fashioned psychoanalytic therapies rely more on people projecting their stuff onto the cold distant authority-figure type therapist. So maybe he would have preferred different kinds of boundaries too in other situations, but due to his orientation, felt these more strict ones were more likely to suit the purpose of the therapy. But I'm just guessing, he may have had personal issues about more relaxed boundaries, who knows.

The term "boundaries" did seem a little cold when I first began hearing it in the context of therapy. But since I've been back in therapy with my pdoc and T as well as in the training program, I really get what the whole "boundary" thing is about. Therapy is an unusual profession - one that has both the power to help and harm people. Because of the sensitive nature of the profession there are rules that have to be applied across the board in order to protect both the patient and the therapist. Maybe we don't all need to adhere to such strict rules, but then you don't always know that boundaries are necessary until they've been crossed. In some cases it can be quite dangerous (for a T or a patient, depending). Therapy is both incredibly intimate yet impersonal at the same time. You are telling your innermost secrets to a complete stranger, someone you know nothing about who has no preconceived notions of you. They are treating your issues without any personal context and that is the point. It is how a T can best do their job. There will always be the presence of personal feelings since they are human after all. And the feelings can be positive OR negative. They are not there to judge us. So even if a T likes you personally, it HAS to stop at a certain point - that is where the boundary comes into play. We are paying for training and expertise coupled with an objective point of view. No matter how educated your T is, once a personal relationship is formed some (or even all) of that objectivity is lost. I have a dear friend who is a LICSW and therapist. Because she is emotionally involved with me, it is hard for her to not be biased when I am talking about something that is bothering me. And honestly, when she slips and falls into therapist mode, I find it oddly annoying! When I go to my friends, I want someone to bounce things off of, to vent to, to just listen. To be a friend. If what I want and need goes beyond that, I know I need to go to my pdoc or T.

I think the issue of boundaries becomes a problem when the patient is missing love, contact and support they need in their personal lives. So, their T becomes this person to them. But the T's role in this case is to address the issues preventing clients from having relationships in their real life. Its also about setting limits and understanding that a T cannot be there all the time, much like a parent/ child.

The other issue is that the T cannot let their professional life become their personal life. Just like a teacher or a lawyer, it does not mean they do not genuine care for you. But there is only one of them and many of us. Not separating the two is only going to cause burnout eventually for the T. These guidelines were created for a reason, mostly because without clear limits for behavior more harm than good has been done. It can and often does lead to mixed signals, hurt feelings, over dependence...exactly NOT what the point of T is. Sometimes for the good of all, the profession has to set limits that may seem unfair. But in the end these rules are in the best interest of everyone.

great post amee!

Archipelago, can I ask you what you mean when you say your shrink "blocked" you?

I think the problem is and the thing I see over and over on this forum is that you do NOT get to set the boundaries for the other person. If a T says that her boundary is that she does not do email (or hug or whatever), that just IS the T's boundary and the T has the absolute right to set that boundary. It doesn't matter is anyone else thinks emailing (or hugging or whatever) is a bad thing or a good thing or normal or whatever. Regardless, that IS the T's boundary and she has an absolute right to set that boundary and expect it to be honored. If a client disagrees with that boundary, that client can find another therapist, but does not have the right (in my opinion) to try to force the T to allow email or hugs or whatever.

If stopdog has a boundary that the T should stay back, the T should absolutely honor that, and if the T fails to do so, she acts improperly. If a T has a boundary that the client should not drive by her home, and the client does so anyway, then the client acts improperly. We each should have the right to set our own boundaries and expect those boundaries to be honored. Complaining about the boundaries someone else has set and attempting to stomp on those boundaries or break them down shows a fundamental disrespect for the other person, in my opinion.

I think people can discuss boundaries with their therapists, these things can be negotiated. So I would say discuss it first, try to see if you can get the therapist to change their way and their boundaries in a way to suit you and if they refuse then you can find other therapist. Most therapist have some flexibility with their boundaries. The ones who are completely inflexible either have personal issues or stick dogmatically to some particular old fashioned way of doing therapy. But most therapies have flexibility, though in regards to some boundaries they have absolutely no flexibility. I assume this is the same with their clients.

For instance I have some flexibility with how close a therapist can sit to me. But I have no flexibility with the therapist physically hitting me. I think that makes sense, does it not?

I think another issue about boundaries is that some clients might feel like the therapist is permitted to challenge their boundaries but not vice versa. But I think that's the nature of therapy. You get to share, tell very private and personal stuff, have your beliefs or values or boundaries challenged. But the view is that all this is done for therapeutic reasons, not because the therapists gets to do whatever he wants and you don't.

I've been in training programs as well and know a variety of ways this topic is handled. Some stress professionalism to the extent that it seems unreasonable and even not very humane. Along with that the emphasis on expertise and objectivity, which simply can't be upheld because this is not a science (and even in science it is not upheld strictly). This work is about subjectivity, the experiences of people, their take on things, their emotions. And that includes the therapist.

In the therapy I do, the therapist/analyst reads his own subjectivity, monitoring during and after sessions, to see how he is reacting. This is not only to make sure that he doesn't have issues; it is formative because his attunement leaves a mark inside him that he can use to understand the insides of the patient. The basic principle is not to correct behavior or even change things, but to get at the truth of subjective experience. That's where understanding comes in.

To put up barriers to this mostly empathic and affective process is to hinder the process. Being to rigid about rules and boundaries in the name of supposed professional can actually get in the way of being open enough to take in a client's reality and try to understand it.

Again I know what people are saying about disrespecting a therapist, and have already said so. But what I'm pointing out doesn't seem to be getting across so I'll try it again.

There just can't be absolute rules about this, no "across the board" except for sexual contact or exploitation. And therapists change with different clients. What they allow with one may change with another. It boils down to mutual respect, not rules. Rules are authoritarian and tempt people to break them. I guess you can say boundaries are equal to mutual respect but the word has connotations of walls, barriers, territory and is implicitly warding off not welcoming. Boundaries keep people out, not let people in.

Yes, that is what boundaries do. They keep people from crossing the line. It's usually a fairly strict line that is set up between person A and person B. Person A might have a different boundary with Person C.

But they are rules.

And there's nothing wrong with that. No one has to be fluid with what makes them comfortable or uncomfortable. They can indeed have a very absolute rule.

The difference between a T and most other people - is that the T will make those boundaries explicit (at least most of them) so that the client is aware of it. And the T is likely going to be a bit more forgiving when those boundaries get crossed - to an extent. And when the very clear boundary has been crossed, the T can point that out, and can point out that the client was aware of that boundary already, and then they can discuss it and how it affects the client. If the client continues to ignore that boundary, then the T will possibly decide to terminate because it is not healthy for the T anymore.

When the boundaries are blurry and unfocused, then the client is unable to see what's acceptable to the T or not, and thus is either going to be excessively worried about crossing those unknown boundaries..... or they'll go the other way and decide that they can have total control over what they do to the T and feign innocence when the T expresses displeasure at the boundary being crossed.

Boundaries set up the boundary for what's ok and what's not. It's like having a big indoor ballpit - the glass barrier is the boundary. Real-life on the outside, therapy on the inside. What the T puts into that ball pit is up to them, but the client knows very clearly what's there and what is alright and acceptable. It's not refusing to let people in. It's not keeping someone out. It's showing what is and is not acceptable to Person A. It's not making Person B guess. It's being as transparent as possible to help avoid confused and undue upset.

" Complaining about the boundaries someone else has set and attempting to stomp on those boundaries or break them down shows a fundamental disrespect for the other person, in my opinion."

.....
I think we can complain - we might not bump up against a boundary until some time has passed in our therapy. We start wanting or needing out of session contact, for example. We complain, we change ts or we learn to live with it. I don't see anyone here "attempting to stomp on boundaries or break them down" - and if I did, I would invite them to be curious about it - not command them to stop. Stringcheese hit a boundary problem with her t and everybody here tried to talk her thru it and support her. I guess that's what is puzzling to me about this whole debate - are we talking about what actually happened, or worst possible theoretical case scenario? People seem to be extrapolating from "one time" to "you always" - which we all know isnt allowed in fighting anymore!

He was not responsive, was withholding, didn't let me know where he was at any given time when it seemed important to have that "safe harbor." This was his approach but it also had to do with strict boundaries. And they were not only negative; they made it feel like there was no safety. In the end it did me more harm than good.

I realize this depends on what you are going in for. In my case I needed much more flexibility and openness. And a willingness to bend a little to my specifics and not just adhere to principles.

I think good therapists all recognize that regardless of what they've been taught or believe, that they modify according to the patient if they want to really be dedicated to helping that particular person. And much literature supports this.

I read an article about therapists working with a Latino population. They were taught to have strict boundaries so no touch, no accepting gifts, no self-disclosure. By the book rules.

But what they found is that this didn't work for the clients. They found themselves modifying their "rules" and "boundaries" to accommodate the cultural differences. And to much success.

They later found out that there is a whole body of literature that supports this view and adaptation so they changed their minds.

Remaining flexible and open has to be part of a therapist's mind set. Otherwise they can do harm and serve themselves, even if seems "on principle" or based on "rules."

I guess I'm not entirely understanding just what our differences are here when we refer to boundaries. I certainly want to feel a connection with anyone I'm in therapy with, that is essential to the experience. I myself am overly concerned with boundaries, especially with men and shy away from asking personal questions- but that's my own issue with insecurity. I think it's fine to ask some personal questions within reason so you feel like you are speaking to a human. But I also think the objectivity is important in T, but again that is my perspective. There will be personal feelings and biases in the client-T relationship, it can't be helped. My husband came in with me once when I first started seeing my pdoc and after the session said he'd never go back. HE found him biased toward me the minute he started speaking. When I mentioned this to my pdoc later, he said he always tries to be objective, but that in my case it was different. So it happens and its natural. My approach to therapy is very solution oriented. I've been in treatment for years and started up again to deal with my separation. So I had a goal going in- to gain confidence enough to run a family, get a job and continue my education. And now that I'm back with H, my goal of continuing is managing my moods when I'm living in a less than ideal scenario (on a personal level). But the reason I continue with my male pdoc and not my female T? Becuase he's divorced with young kids like me and he helps me navigate through my life and keep on focus. So you could say I see him because I know he can relate to me.

When I say across the board rules I think they are more rigid with opposite sex T's (or same sex depending on orientation). There just have to be firm boundaries here, especially in the context of text and cellphone communications. I also don't like the idea of saying you "love" a client, at least not one of the opposite sex. I don't think that is in any way appropriate. You can like them, be concerned for them and many other things. But love is a loaded word and can be interpreted or misinterpreted in far too many ways.

Again, my pdoc is a guy and we do just fine. I've never had a bad experience but was too needy at one point when I was going through my separation and father's death at the same time. I would call his office crying to his assistant when I couldn;t get an appointment when I wanted one. He would always fit me in, but did remind me that he's the psychiatrist and my T was the one I should see for more frequent, longer appointments. I felt hurt but respected his request. Now, a year later I no longer see my T, and he told me I can see him for longer appointments any time. So it's a balance and a matter of respect, just as you say. And it absolutely changes with different clients. Kind of like an open window: with each client you open the window more or less depending on how much information you feel is appropriate to let in.

But what I'm curious about is your perspective of the rigid rules and boundaries. Which do you think are the ones that hinder the therapeutic process?

This is true. When working with multicultural clients, the T must be flexible in these areas or therapy will not work. But this is kind of a different issue, as it deals with cultural values. For some cultures, disclosure can be crucial or trust can't be established, but again there will still be boundaries applied. But in mainstream therapy, this generally isn't the rule.

I appreciate your sharing your perspective and experience. I don't think I am really saying anything that is that controversial but it sorta feels that way here.

About rigid rules and boundaries, let's take the example of the Latino population that was in the study. Gift giving is often taught as something that you just don't accept, like touch and other things. But to refuse a gift, especially like homemade food, is a great insult.

So that "rule" and "boundary" had to be modified and really discarded in order to accept the people as they were, how they felt, what their values were. Other modifications such as sitting closer, using a combination of Spanish and English in an appropriate way, touch, self-disclosure, transparency--all those things evolved from work with this particular group.

What would have happened if the therapist just maintained the rules and boundaries? Wouldn't that be ignoring the client? Wouldn't that be kinda of selfish and unaware? Not culturally or subjectively sensitive?

Absolutely correct. Cultural factors are important and T;s that are not in tune with this fact can do a lot of harm. I actually think if any client offers a gift it should not be rejected by the T. To turn away a sincere gesture is kinda mean. So we probably agree here more than it appears.

I'm glad. The cultural difference is meant as an example that I think just highlights what happens at different levels for different people. It just makes it really explicit that holding onto rigid rules and setting boundaries can be a potential problem and even as I suggested rather selfish and unaware for the therapist to insist upon. The therapists I know and have followed in their publications all show an amazing ability to be flexible and change according to what they experience in their sessions. It is a demanding and honorable profession so I think for the most part people are doing the best that they can. So are clients, but clients need help and how can they get help if there are barriers in the way.

This is off-topic since I read only about gifts but I noticed my T loves to wear scarves so I went out and bought her this beautiful, albeit cheap, scarf (I am broke! I bought it with 700 pennies!) and I went to give it to her and she wouldn't take it because of her boundaries. Sigh.

See. It can be kinda ugly and even a bit stupid and clunky to cling to rules like this. It certainly doesn't show any feeling for the client's situation and generally good intentions. That can be harmful and shows a lack of respect in some cases. Again I say that boundaries and respect are different.

No matter how flexible boundaries may be, there likely will come times that Ts feel that they must say no. How do you see that: When must a T say no?

Anything that disrupts the therapeutic relationship is grounds for confrontation. Not necessarily a "no" just decided in advance, but perhaps after discussion.

Other obvious things of course deserve a "no" right away. I don't have a problem with that. I'm talking about subtler things than obvious violations.

So the T's initial sense of boundaries and disruption of the therapeutic relationship initiate a discussion.

After the discussion, what if the T still sees the need for a boundary, but the patient/client disagrees?

Yes, the therapist is responsible for maintaining the therapeutic relationship so that it remains healthy and productive. But the client might also have a sense that something is "out of bounds" so it could be a mutual discussion than adversarial. A client who understands the therapist's needs around certain things has a more realistic picture.

A client might object. Then there might be need for further discussion. Or the therapist might just draw a line, but this has to be done carefully and gently with sensitivity to the circumstances and the feelings of the client.

In other words, it still has to be flexible, tailored to each individual. I'm afraid that if it stated as an absolute rule then there will be harm done.

Oh..I have been in this situation in T and it really does hurt. I am not sure it´s a boundary thing as much as her trying to help you realise you can cope and it will " pass" even if it doesn´t seem that way in the moment. See the highlighted part