[clinpsycstudent]

Would be most appropriate to establish clearly at the beginning of therapy?
I think that was when things got incredibly complicated for me and former T - as it was about 9 months into therapy that the e-mailing/messaging suddenly were not appropriate and she said she didn't do text therapy. It was so difficult to respect the new "therapeutic boundaries" that were not there initially - and I was confused to why she implemented them so quicky. It would have been more helpful for boundaries to be somewhat more consistent... though perhaps she thought I needed the extra support at the beginning... who knows?
Anyone else really struggle with boundaries that were implemented too late?

[tinyrabbit]

I personally think a T needs to have clear, realistic boundaries at the start.

This question has come up many times on this forum.
It seems theres a lit of people masquerading as professional s who get totally out of their depth.

[JustShakey]

I think there should be some fluidity with boundaries, because the whole idea is to help you create your own, not adapt to someone else's. However, it's the T's job to ensure that the boundaries are being maintained appropriately. You can't just suddenly change the rules all at once like your T did. It seems like she panicked and you paid the price for it. It's much like deciding you're being too lenient with a child and going from permissive to authoritarian literally overnight. I don't think I need to explain what kind of hell you're in for if you ever try that one btw...
I think it can be hard to be completely clear with the boundaries though. Realistically, they are going to change depending in what 'developmental level' you're at in therapy at any given time. As with kids, the younger ones need more solid rules than the older ones.

[clinpsycstudent]

Originally Posted by JustShakey

I think there should be some fluidity with boundaries, because the whole idea is to help you create your own, not adapt to someone else's. However, it's the T's job to ensure that the boundaries are being maintained appropriately. You can't just suddenly change the rules all at once like your T did. It seems like she panicked and you paid the price for it. It's much like deciding you're being too lenient with a child and going from permissive to authoritarian literally overnight. I don't think I need to explain what kind of hell you're in for if you ever try that one btw...
I think it can be hard to be completely clear with the boundaries though. Realistically, they are going to change depending in what 'developmental level' you're at in therapy at any given time. As with kids, the younger ones need more solid rules than the older ones.

Hey JustShakey! (I still need to PM you! )
That is an interesting POV - I do like how you used the analogy with children! Me and new T have discussed boundaries on our first appt - which has been most effective, and have no need to e-mail or message her (unless it is about an appt!) It is a complete change from former T - and it is incredibly healing to know that I actually know I AM respectful of boundaries, I am not a bad person.... etc.... everything that ran through my head at the time!

[ThisWayOut]

I think a general set of boundries needs to be discussed at the beginning, but like JustShakey said, they can be fluid and adapt to where the client is at. I know I asked my T for her boundaries at the beginning because I always get anxious about crossing them, especially when I hit a crisis point. I have asked her more than once to reiterate the boundries for me so I know where I stand. I think though I am generally more worried about boundaries than my T is because I alwasy worry about beign a bother.

[brillskep]

I agree with you. I believe boundaries can change as the relationship changes, however I think the most important stuff needs to be put in place from the beginning. I share a similar experience with my therapist too. On the first session, he asked me to inform him at least 24 hours before the session if I was canceling. That was that and it was all I agreed to. I was always on time or early for my sessions and the few times I canceled, I did so as early as I could and never later than 24 hours before the session. Then, almost a year later, while we were discussing something about my almost being late one day (but I had eventually managed to make it on time), my therapist suddenly told me that he has this policy with all his other clients and asked me to agree to pay for sessions I cancel less than 24 hours in advance. My first reaction was to agree, but after I went home it didn't feel right and I became annoyed, because I had NEVER cancelled a session without enough notice. The only time I would ever do that would be if I had some serious accident or something, which would be a time i would be needing him the most So the next time I came in I told him that i couldn't agree with his policy, that I needed him to realize he didn't make that contract from the beginning, that it was me he was talking to and I never canceled in such a way. So we agreed to drop this policy (and maybe resume it if it ever became necessary with me). On the other hand, I have no doubt that I would have agree to this without a second thought had he mentioned this on our first session, when we were establishing rules and he didn't really know that i wasn't one to cancel lightly. So yes, in my experience, it's definitely better to be upfront about it from the first session.

Though on the other hand, I think it's important how boundaries are stated and negotiated. A therapist sure wouldn't want the first session to feel like a set of rules to be followed. I find that, with some tact, boundaries can be incorporated naturally into the conversation and negotiation as to what therapy will be like.

[HazelGirl]

Yes, I basically agree with what has been written: boundaries need to be clearly established, but allow room for the individuality of each client and their individual needs.

[stopdog]

The first one I see started off with the whole "there are no rules" until I pressed her, at the few appointments, to tell me what they were. I knew there were rules, and I have no idea why she was trying to keep them from me. I was quite anxious over the lie.

[growlycat]

The basic boundaries need to be set day 1. T needs to be clear which ones have any flexibility at all. I hate being surprised by hidden rules!

[stopdog]

I did let the woman know my boundaries at the beginning too.

[Perna]

I think a lot of boundaries cannot be established until they are threatened with breaking or break. How much is "too much" emailing? 1 email a week? 5? 6? 7? 10? One has to try out some situations to see if they will work with "this" person or not. My T did not mention until 6-8 years in that I would have to pay for sessions where I did not give 24 hours cancellation notice. This was after I notified only a couple hours before, because I was in the hospital ER and desperately wanting to be out and able to go to T so put off cancelling as long as I could. I was not charged for that cancellation, it was only for after. I had not needed that boundary before because I had never cancelled before. . . shown up hours and hours early, but never cancelled

I saw my T for two periods and the intro session of the second period she told me she was not an "ambulance chaser" and I wanted to be offended as that particular boundary was about as needed for me as the paying for cancellations of less than 24 hours notice but felt more personal since my T and I had seen one another for 9 years the first period and knew one another a bit I thought (why I called her instead of starting over with someone nearer to my job/home). But I took it as just a piece of business to get out of the way like price, day/time to attend, etc. It was a solid boundary that would/could never change is what I knew. The other stuff gets negotiated as one goes along and she would/would not allow some behavior, maybe for the entire time I saw her or maybe just until she felt it got to be in the way of my therapy. Any correction of a boundary sort during therapy I took on faith was something she felt would be beneficial to me. At one point, for example, we decided I would not say "I don't know" in answer to questions anymore That was a joint decision but there were others where she would say "tell me" instead of let me read to her or show her a book's passage, for example, where I just assumed, as hard as it was, that the boundary was to help me move in a particular direction, like you herd cattle through chutes to slaughter (or to get on the trailer to go to. . .). As hard as many of the boundaries were, both that she put in or I agreed to or I put in, monitoring myself (not to write her between sessions anymore), I cannot remember any that did not make sense and/or ultimately help me in some way.

[Lauliza]

I've never had a formal discussion about boundaries with my T or PDoc, but I seem to have my own boundaries so it's never been really necessary to go over them. Plus they are part of a group practice that has a set of guidelines, so they don't really need to go over things like email, texting and phone calls - the group has its own policy.

As a practicing T, I think it is crucial to have boundaries firmly in place from the start. Even if it's only in your own head and you don't go over them formally with clients. If a client asks, you should be able to give a clear answer (with room for flexibility according to situations of course). But in general, I think T's can run into the most trouble when they have trouble setting boundaries in all parts of their lives. If they lack confidence and have trouble saying no to people in general seem to me like they wouldn't be very effective counselors.

I've never had a discussion about therapist/client boundaries with any of my T's. They've been a non-issue. Not every client has issues with boundaries so I can see how this topic may not necessarily come up right away in most cases. It isn't that my T and I don't have them; it's just that we easily understand and respect each others' boundaries I guess rather intuitively.

[stopdog]

Actually, it has not started from the therapist side when it has come up for me - it has been me telling the therapist to stay back/don't call/ etc.

[Depletion]

I think that it can be very helpful to verbally establish boundaries up front. And I don't think boundaries should just be about a T's limit they should also be about the clients needs. When I started with my current T I told her that I didn't want any hugs because touch can easily trigger obsession for me. I also don't want her accepting gifts from me for the same reason.

For you Clinpsy you might consider telling your T that you need consistency and that discussion of things like what your appearance has to do with your sexuality is off limits, or at least shouldn't be taken as a sign of anything in particular.

You might also consider thinking of boundaries in terms of hard and soft limits. For example, Emailing might be a soft limit for some T's where they are willing to accept the occasional email, but going to a T's house would be a hard limit.

I think what is most important over all about boundaries, however, is that there is an open conversation about them, and that the conversation is not a one time thing. Everyone in the relationship needs to be open to discussing their needs, and should do their best to be honest with the other person about what those needs are.

[ScarletPimpernel]

I agree with the rest. Basic boundaries should be established at the beginning. And they should maintain a level of stability.

But things change: relationships, people, life... If a T decides to change the boundaries, T should bring it up before the client unknowingly pushes it. T should explain the change, and help the client process it.

Least that's what I would consider the appropriate thing to do.

[nummy]

Well, I personally let things go, but I'm not sure my therapist didn't think I wanted things that way. She didn't know me and I didn't know her, so we were just taking things as they went. It's been 6 sessions. It has damaged my therapy sessions, my not setting down boundaries, as it were.

As for your situation. Personally, I would never text my therapist or agree to it. To me that crosses the lines for me. I don't want a friend, I want a therapist. One who sees me face to face. 80% of communication is reading physical cues, I have heard, and to me it makes sense (as an aspie).

I might give it one more session (I'm scheduled anyway), but frankly my therapist is far too informal for me. I need structure, and there's no structure in the sessions, which leaves me uneasy, since in my experience structure and boundary go hand in hand.

[Wysteria]

I also think most of what has been written is very correct...basic boundaries set up front and some that need some flexibility discussed properly and fully in session.

In Brillskep's case, although she has always been quite conscientious about keeping appointment times and such...we have to remember that others might not be. Eventually, when abused too much, the T may feel that (s)he had to set a firmer boundary with all his patients. If s(he) had said, "I've had a problem with clients not showing up and it hurt my other clients that need to be fitted in and causes loss of income or whatever the issue, AND thus I am reiterating what my policy is and how it will change in the future..." then Brillskep would not have taken it personally as it was not directed at anything she had done...I feel bad that she was caught up in changes perhaps put in place for others that did not have her consideration...

And as technology has developed and the laws change over electronic communications use and abuse, some T's are becoming either more or less accepting. Thus another reason that things have to become somewhat fluid..

Ultimately, if the boundaries created do not allow for what you need in therapy then we as patients always have the choice and right to change providers...but there are boundaries that protect the sanctity, privacy, and safety of both parties and have to be firm.

WB

[tinyrabbit]

My T issues his cancellation policy in writing. He allows email and texts because his information is on his website and it's up to clients to decide whether to use it.

I never had any rules or boundaries in therapy. I managed okay. I suffered from the boundaries being what was arbitrarily changed as a kid. It lead to making a crazy adult. Thank goodness my therapist and I learned to have a mutual respect for each other. Boundaries - whatever they maybe fell into place naturally.

[clinpsycstudent]

Thanks everyone for their responses and point of view! I think I struggled with it as I felt that I was the "major fault" in not respecting the boundaries (and I completely understand that this was my issue now) but I do feel that she made it very difficult with her still complimenting me, and then the very awkward termination. She was so closed off and seemed to be strugging to try and connect with me... I could feel it. I first determined what I felt were her boundaries were when she gave me her opinion on a relationship (romantic) between a professor and student - and she didn't understand why it was an issue. So I thought that was interesting... and as soon as my feelings developed, initially she guessed I was attracted to her and she said it wasn't an issue... but it soon became an underlying issue when she kept it a secret that she was 'suspecting' that I was reinforced by seeing her... arrrrgh!

[Depletion]

Originally Posted by clinpsycstudent

Thanks everyone for their responses and point of view! I think I struggled with it as I felt that I was the "major fault" in not respecting the boundaries (and I completely understand that this was my issue now) but I do feel that she made it very difficult with her still complimenting me, and then the very awkward termination. She was so closed off and seemed to be strugging to try and connect with me... I could feel it. I first determined what I felt were her boundaries were when she gave me her opinion on a relationship (romantic) between a professor and student - and she didn't understand why it was an issue. So I thought that was interesting... and as soon as my feelings developed, initially she guessed I was attracted to her and she said it wasn't an issue... but it soon became an underlying issue when she kept it a secret that she was 'suspecting' that I was reinforced by seeing her... arrrrgh!

I tend to push boundaries just like you do so I understand. I know now that doing that can get me in a lot of trouble but I'm not always good at stopping myself, so I now try to make a point of telling Ts that is is tendency I have. I want them to know so that they can stay safe people. One of the most special things about a therapy relationship is the fact that you have the opportunity to be upfront about this kind of self destructive behavior. Wishing you well!