Boundaries

I am too embarrassed to push boundaries, and I also don't want to annoy my T. Personally, I don't like showing neediness even though I often feel needy. I feel like an inconvenience and a burden enough with the hour sessions. Unless Googeling counts, I haven't broken any boundaries on account of that probably.

It doesn't always happen on purpose. In fact I think more often than not it's by accident. Because therapy is so different from other relationships, so clients don't know how to navigate it. Like when I had a T, I once asked him about his kids but he said he can't mention his personal life. It was so weird for me and I felt both angry and embarrassed. It felt like such a natural question. Nowhere else would anybody not answer that question. Heck, many people volunteer that kind of info. But I quickly realized this was not a social occasion. He was not my friend. He was getting paid to help me get better and feel less anxious and depressed. That's all. But that's something I had to learn. I still did not like it, but eventually I stopped taking these things personally.

Sorry you had that experience. I can understand a T not wanting to discuss kids in detail. But asking your T if they have any and how old they are is not going to far. How do you not answer and then not feel like a jerk? Some T's who have not so great social skills need to consider how some of the things they say would sound/feel to the person on the receiving end.

I agree that a T should set and explain their boundaries with sensitivity to the circumstances and the client's feelings, but I think Ts learn, over the years and through experience, where their boundaries NEED to be with respect to their clients. They come to understand that clients with similar histories and issues will constantly want to "push" the boundaries (whatever they are) in a desire to become enmeshed with their T. Indulging that will not help the client. So, when a T notices that, it's in the client's best interests for the T to hold firm to their boundaries. Or, a T might learn that they NEED certain boundaries in order to stay healthy and available to their clients and avoid burn-out. I think Ts are the ones who come to the relationship with a lot of experience and knowledge, and they don't necessarily have to "reinvent the wheel" anew with each client. Of course, there are exceptions. If a T is unfamiliar with a particular demographic (cultural differences) or with a client with a particularly unique background or presenting issue, then that does require a more individualized approach and some boundary negotiation may very well be warranted. However, I don't think it is often in the client's best interests to continually "push" the Ts boundaries and try to change them in order to get the T to fulfill more and more of their needs. Often, when Ts begin to do that, they end up creating a really harmful situation where they realize that they've given too much, and suddenly need to pull back and tighten their boundaries. This often causes clients to feel rejected. Having good boundaries at the outset is often a better solution. For me personally, knowing what my T's boundaries are, up front, is really helpful. I want to know exactly what is okay and what isn't. That helps me feel safe and helps me trust my T. There have been times where I've asked T about a boundary and she has said "I haven't had that question before; let me think about that." or "Hmm, I don't know, let's talk about that." I think that's great. When a T is asked about a boundary and she doesn't have one set in that particular area, talking about it with the client is great. However, that is very different from the client rejecting T's boundary and trying to get her to loosen or change her boundaries. I also think there are instances when having "universal boundaries" are also less hurtful to clients. For instance, if "no hugging" is T's personal boundary-- because SHE does feel safe or comfortable hugging clients-- then I think it's less hurtful for the client to hear that T does not hug, rather than "T hugs, but T does not feel safe hugging YOU." It makes it less personal, and more about T's boundaries and T's need to stay safe (and keep her clients safe). It prevents it from being a personal rejection.

I find this a really interesting topic, so I'll probably have to go and read through some of the posts more carefully when I have a bit more time. I find it really hard to put boundary stuff into words.

I found my own therapist to be relatively relaxed in terms of boundaries when we first met. At least, I was very careful not to go near any potential boundary and so my therapist never brought the subject up...and that's what worked best for me. I didn't like to think of the relationship in terms of boundaries and restrictions. I respected her space and time and that was enough for me.

Earlier on in therapy, there were some things I did with my therapist that involved what could be considered more relaxed boundaries. Over a period of years we have had two or three sessions in a coffee shop, once I attended a social event that she was at (at her suggestion), and once she attended something because I was there. For me, right now she definitely is my therapist and not a friend. I feel quite clear about respecting any potential boundaries of hers without explicit rules and restrictions.

My therapist has now tightened up her boundaries a lot and suddenly it's like it really doesn't work for me. It would be okay if we discussed the situation and I could understand what was okay to ask for and what wasn't, but the rules and explicit boundaries just don't sit quite right with me.

I feel like my therapist is in this world where she's learned to see things in a certain way. It is almost like the boundaries are treated as if they were solid concrete objects. And I am a client, which is also a solid concrete object. There are some rules that come along with being a client that do feel difficult to understand. At least, it's hard to understand why some of the rules apply to me. There was a boundary that my therapist changed, as she described her own behaviour as too friend like (after speaking with her supervisor). It was funny how much this "friend like” behaviour was helping me to make progress and move forwards, and didn't confuse me into thinking she was a friend and not a therapist. It was just something that worked for us, something that sat right with me.

Losing the relationship completely after the end is quite hard for me to comprehend and my biggest difficulty with boundaries that are largely universally applied. With other therapists it doesn't matter so much, but with my current therapist, she always used herself and a very genuine relationship to help me to move forwards. She has always been someone I like very much and she's become an important part of my life. Once she even thought that something after the end might be possible. I didn't take that something as meaning a friendship, just something little, something that would work for both of us.

Respecting the nature of the relationship is easy, but the new, clear, explicit boundaries haven't helped me to do much other than shut down the part of myself that needs help, just like I did when I was a child. And it's brought up such a fear of the end that wasn't previously there. I might even appear better on the outside at times, but it’s only because I “grow up” when I realise no one will ever come for help, because there is no one to hear me and no one to go to. That wasn’t a problem before the new boundaries, it was more like a fear that I could challenge and not a reality.

I guess I'm very lucky(?) in that my T would answer simple questions like that. It's nice to know the basic framework of T's life, it helped me build trust I think, I'm not sure what I would feel in your shoes. Personally I think there is some info a T can share, and some they shouldn't, and I don't know much about my T nor ask many questions.

When I started therapy I googeled what I "should" do and what people did, so I read all about boundaries. Some of them surprised me, as well as the fact it was such a big deal, so I can see breaking one by accident had I not known. For example giving T's gifts is a no-no. I wouldn't have guessed that, but it makes sense. I also really want to give mine gifts, and pie, media, and whatnot.

Nightlight - wow. Very sensitive. But I think that feeling of "no one is coming" is a phase we pass thru on the way to standing on our own. I am in a phase of partnership right now - I even dreamed that my t helped me vacuum - and I rarely dream of t (or vacuum) - and I am starting to get a subtle feeling of looking forward to starting school, getting away from the nest. But it takes time. And it sounds like your t had unresolved issuesalso. But nobody's perfect. Stuff happens. We can still move on.

What people are talking about are the subtleties of interpersonal interactions. Rules for that don't usually work too well, especially if those rules are rigid or inflexible. Humans and the way they relate to each other are too complex for a nifty tool kit. Respecting and honoring people does work. Some people bring more of that in with them; and others need to learn about it with some guidance. That learning can also be therapeutic.

Therapists also learn. In fact, they are required to to keep their licenses. Therapists evolve and change over time from these experiences. Things that they learned in training may drop away, replaced by things they learn after either through the reading and workshops they do or mainly through working with clients. It seems to be a very fluid profession that way, with people being pretty adaptive and flexible. After all the field itself shifts a lot with new methods and research all the time.

And the relationships change and grow too. My shrink has relaxed into a more informal mode with me over time. He knows I respect and honor him as he does me so he doesn't worry about things. He knows I'm not going to take anything the wrong way or let something damage the working relationship. So he is more casual with me than he might be with others with whom he has to maintain a more professional seeming stance. This all feels very natural and what just evolves in human relationships. It's about trust.

This is an example of how I think not having those universally applied boundaries can lead to problems. Though it may seem small, meeting a client at a coffee shop or asking them to attend an event they will also be at immediately creates a dual relationship. And once the therapist is called out on it by a supervisor and has to tighten the boundaries bit, it is very hard on the client. Meeting outside of the office (unless in certain situations) and attending the same social events create the illusion of friendship even if it's not conscious. It is not wise and something that is very easily avoided. If a patient feels that this is cold or unfair, then that is a good topic for discussion. Sometimes t's say things we don't want to hear but sometimes we need to hear them even if it hurts.

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Yes, I agree that there are rules that I have called "obvious" such as no sexual contact, no exploitation, no dual relationships, no reciprocation that is misleading, no flagrant exceptions (like not charging), and all those things that make the relationship a therapeutic one and not a regular one. I just take that for granted that these things are in place and clear. It is more the subtle things that I was trying to address. And also to find out why people feel so strongly when the issue comes up. I have learned some reasons why now so I have taken in opinions that differ from mine and will consider them further.

I don't believe it's possible to have one answer or one right view in regards to a situation like boundaries. What you say may apply to many people, but it does not mean that it is universally correct. Dual relationships are also not inherently bad. The construct of a dual relationship is also not a solid concrete object, they are still just words that may mean a lot to some and have relatively little relevance to others. Also, many therapists conduct sessions outside of an office for many different reasons and I don’t believe that interactions outside the office are inherently bad either.

What sort of subtle things are you actually talking about?

Hand-holding/hugs? Some people are not comfortable with physical contact, and others want it. If a client wants to have contact with a T, that is entirely up to the T whether or not they oblige. The T might not be comfortable with physical contact, and even though it might help the client... they T doesn't have to bend themselves that far. Of course, it would be nice if they would explain that to the client, and it's a-ok for the client to want it. But the T is a person, and they shouldn't have to be super uncomfortable at work.

Presents? Well, personally, I hate being given gifts. But I accept them from my students and say thank you. A lot of the presents they give me? Well.... they're usually things I don't use and so I give them away. But if they've drawn me a picture? I stick it on the wall and it stays there until the end of June. So unless a T has been told or views being given a present as something that's like a bribe or inappropriate... it's pretty easy to bend on this one. Again - hopefully they'll explain if it's a policy or not to the client.

Out of session contact? Some Ts may be ok with texts or emails, others aren't. The client unfortunately needs to accept that, as it's the Ts personal time and they really might not be comfortable having someone text them when they're out with their friends. It puts them in an uncomfortable situation - should they reply to this client even if they aren't quite sober at the time? what will happen if they ignore it?... and then they end up as hostages basically. They need to make this boundary clear to the client.

Saying "I care about you" to a client? I can see how a T would be flexible with this depending on the client. I don't think it would mean that the T cares more or less about different patients (although really, they're human, so they probably do!) but this is the T's judgement on what would or wouldn't be helpful to a client. Like.. if my T said that to me? I'd probably withdraw from him because it would scare me. But other people might be at the point where they would accept that from him and find it comforting. Others might crave it because they're trying to get the T to fill a void that the T can't fill.

Were you talking about things like those? I do still think that the T needs to make those boundaries clear to a client, so that the client doesn't end up feeling rejected or hurt when they find out tha the T isn't going to do things their way.

Yes, some of those things, but more in the sense of the "how" not the "what." In other words, it is the way the therapist communicates and interacts, not the actual content or result. That's what I've meant sometimes when I use words like rigid or inflexible. I don't necessarily mean that the therapist has to bend to the client in the sense of doing something she doesn't want to do, but rather the therapist has to bend to the client to meet the client where the client is rather than just slamming down a rule or not being open to discussion. That is not therapeutic. It is about the therapist's needs, which are supposed to be put on hold for the most part because they are getting paid to attend to the needs of the client. They don't have to satisfy those needs necessarily, but they have to be therapeutic in their responses to those needs and not just think of abstract principles or their own preferences.

I guess then I'm confused by your whole thread, because I don't really see anyone at all saying that a T shouldn't have to be respectful in how they explain their boundaries?



I do, however, understand what you're saying better now. It explains why I kept getting confused with your responses! I'd thought it was a given that a T would respond respectfully to boundary-crossing.

I'm glad things are a little clearer. I was feeling a little bit misunderstood in general so I realized I was not coming across in the way that I thought.

Anyway, there have been posts that have either explicitly or implicitly suggested something kinda absolute about rules and boundaries. Also the needs of the therapist without a lot of regard for the client. And there have been examples of how someone set a boundary or rule in a way that was hurtful because it was just done with a kind of flat footed automatic manner.

The problem is that the client is vulnerable in all kinds of ways and also has less experience with how the therapeutic relationship works so extra consideration needs to be taken. Someone said something about not having "reinvent the wheel" with every client, but in practice that actually has to take place because the client doesn't know. And also I believe that there are lots of variations between clients so therapists have to adapt to each individual and their differences from others, including but not exclusively to cultural difference, as I pointed out. Time also makes a difference. Things shift over time. What was true at one time in therapy may not be the case later. Flexibility and humbleness are necessary for the job. When things sound kinda authoritarian I worry that that is not in place.

I'm honestly surprised by some of the responses to this issue. Perhaps it's my age. I grew up in an era when there were distinct personal boundaries, especially with professionals in the medical field.

I'm stunned that therapists are touching their patients in any way. To me this is inappropriate behavior and no patient should expect it.

I'm equally surprised that contact occurs outside of the office, the appropriate setting for therapy, and that people are exchanging emails, texts, and phone calls with their therapists.

Also surprising is that therapists are discussing their personal lives with their patients. To me this, like touching patients, is crossing a strict professional boundary.

IMHO, none of these things should be happening. I think they encourage the crossing of boundaries that, in a professional medical relationship, should never be crossed. While I understand that some familiarity is necessary to make the patient comfortable, so much familiarity seems to me to be more along the lines of a personal relationship than a professional one.

As I stated, perhaps it's my age. I maintain a strictly professional relationship with my doctor and therapist.

I was also thinking how clients have all these extra communications with thier therapists, which I mean to each his own,(not being judgmental of them) I can call my t if really important (leave a vm from 9 to 5 m tru f and she will get back to me, for a very brief moment, and refer me if the situation is dire, other than that there is not text email or any other contact.

My shrink is an MD, but neither of us believes that therapy should be based on the medical model. There is plenty of literature out there about how these approaches that involve more contact, be it touch, personal, or outside session, are productive and useful. And critiques of how not having that to at least some extent can be counterproductive. I don't think it is just opinions or personal styles. There are principles and methods behind a lot of this.

There are other examples in the birthday thread where people say that their therapists don't say "happy birthday" to them even when they know. You could say that is a boundary, but jeepers how much effort does it take to wish someone a happy birthday? And why in the world would someone do that to another? It's just not human.

I don't expect therapists to remember birthdays or do anything about it if they do know, but a verbal gesture is hardly asking for much.

I feel very close to my T and until recently after 3 years of therapy, I have known very little about her personal life. Although somewhat curious, that curiosity was not compelling and I knew my job in therapy was to access my T's guidance to help me - not to dig into her personal life. I still feel the same way and I've experienced just this month how damaging a T's self-disclosure can be to the therapeutic relationship.

I perfectly admit that for some people more disclosure by T may be very therapeutic and I would never argue that they should feel the way I do about it. Each situation is different and each situation is personal. If the 'boundaries' are crossed but it helps the healing of an individual, who am I to protest?

My issue with boundaries is that I was unclear where the boundaries were in my relationship with my T. I am VERY respectful of her privacy and her free time and do not want to intrude in any way.

But, I've gotten mixed messages. I got into 'trouble' the first month of therapy because I called and left a message asking a question about our session. After I left the voicemail, I got hit with the realization that I shouldn't have done that and I called again and left another message telling her that there was no need to reply.

She didn't get the 2nd message and I was 'scolded' for calling her about wanting clarification of something that had happened in session.

BUT, in later months she encouraged me to call and leave messages. I always felt terrible but could not resist when I was going through something tough. She kept reassuring me it was o.k.

So, I've never felt really comfortable although I still contact her by text if I'm going through something (well,not so much this last month cuz of her self-disclosure) and she would always reply with some supportive words.

I never want to intrude but I am very happy that my T encourages me to contact her. I would never spy on her or push the limits of our relationship. Her personal life is hers to maintain and I have no rights to it.

I am thankful she is my T and I am thankful she is the professional I need in my life.

But, understanding where the boundaries are (besides the obvious ones) has been a challenge.

I'm curious but don't want to pry or raise a difficult issue. You say some things about how self-disclosure can be harmful, and yet it's unclear how that worked for you. You don't have to answer. I was just wondering. Like I have said before, perhaps on another thread, self-disclosure is quite complex and needs to be very thoughtful most of the time. My shrink uses it well and often, but he learned that I can handle things. Whereas I'm almost certain that he doesn't do it with everyone or even with many. He is an MD so he has to maintain a certain style for his patients who expect that in a doctor.

I discussed it a bit in this thread http://forums.psychcentral.com/psych...ing-out-t.html

I'm disappointed in myself. The clues about T's personal life - where she grew up, where she attended grad school, what hobbies she likes, etc. were happily consumed by me - I loved knowing those pieces of her life.

That she's facing challenges now that seem much worse than my own challenges might make it more difficult for me to feel free to take myself seriously. It was my last session that she self-disclosed almost 2 weeks ago. She took a week off to deal with her own issue and so I won't see her until next week where I will be faced with how to conduct my own therapy.

That does sound difficult. It makes things complicated and could be taken on as a burden. It is honest though. And she probably needed to say something, but maybe not in detail. Just something like she needed time off for personal matters without specifying them.

I had a slightly similar issue with my shrink. He told me about his mother's health and I ended up spending time encouraging him to visit her. Then when he decided to, she died. I became more concerned about him than focussing on my treatment. But it was human. He didn't mean to burden me. And it was my own issue of wanting to take care of him like I do with my brother so I learned something. It didn't disrupt anything though.

It seems many refer to boundaries in a tangible or behavioral sense, such as actions or lack of actions, whereas I tend to conceptualize boundaries in the psychological sense, much like object relations.

Boundaries represent a person’s sense of self. With my childhood abuse history, experiencing or hearing about boundary issues can evoke strong feelings, since continual violation of my boundaries has had a profound impact on my development and my life.

When someone abusive violates another’s boundaries, or continuously relates to you in an intrusive and controlling manner, they don’t ‘see’ your boundaries, so they don’t see you as a person, but instead, as an object to gratify their own needs (although they are probably not even conscious of it). When someone continually relates to you as if you are not even worthy of being treated with the minimal human dignity of being seen as a human being, because they cannot see how the manner in which they relate to you might impact your feelings, it can profoundly affect your identity, the core of who you are. When significant others continually relate to you like that, it often leads to deeply-rooted issues that can take years to heal from. There is almost nothing more that says ‘you do not matter’ than having your boundaries violated. It can lead to severe sense of worthlessness.

Actually, I don’t feel uncomfortable around anyone who has insight into these things and who is trying to get better. What I have a real hard time with is those who violate your boundaries, maybe it is not outright physical or sexual abuse, but by intrusive and controlling behavior, then when you call them on it, they make themselves a victim. That is a pattern I have come across from time to time in my adult life that is extremely triggering. Taking responsibility makes all the difference in the world, in my opinion.

Boundary crossings are ways to get to know one another and limits in a relationship, but boundary violations, while might be determined to be a mistake or isolated incident, often signify abuse and reveal how a person views and relates to others.