Comments on boundaries

I totally get what the article was trying to convey. But, at the same time, the intimacy of a therapeutic relationship is very different from the relationship I have with my dentist and general practitioner.

I think this is interesting, and I can see the point the person is trying to make. However, the therapeutic relationship is a little different than seeing your doctor or dentist. A lot of people see their therapist once a week on a regular basis. You don't have as much contact with a doctor dentist. Plus, some dentists and doctors hug their clients. I have seen my doctor hug clients. She hugs my mom. I think boundaries are important in any relationship, but to compare it to a relationship one has with their doctor or dentist seems very cold.

I don't see it as being particularly cold to see them as dentist-like. I don't find therapists warm or intimate either.

[QUOTE=sub-dural;4858572]. . . . . I'm not sure why this blog/article writer chooses to out the medical field as being cold, dead-eyed and full of boundaries. If you have a cavity, you get it filled, no need to go back again for 6months (whatever the recommendation). If you have schizophrenia or a personality disorder or an intractable depression, a 50 minute appointment one time isn't going to "fix" it. Those patients become under your care long term. That involves communication and.. well "caring." Don't choose therapy or mental illness as your chosen care specialty if you are not committed to that, in my opinion. I totally agree with what you've written here. It's how I see things when it comes to boundaries and therapy. I understand why the person might want to equate the boundaries of a dental office or a physicians office with psychotherapy, but I don't view them as the same.

The amount of infantilizing that goes on with therapists claiming to require all of these boundaries against their "weak, vulnerable, needy" patients is so absurd to me. Treat someone as a human with respect. If you are afraid of patients so much that you need to place yourself above them (not all therapists, again), then don't go into a field of care. <<---Love this.

If the therapist doesn't want email (etc, or hugs), then say it. <<--This in my opinion is the most important thing that a therapist (new or experienced) needs to get straight. Know your boundaries going into the relationship and be able to state them clearly. Don't play coy. If you don't want to be answering tons of emails, don't allow them. Don't agree to let someone email and then whine, complain or rant about the dang client abusing you. If you only want one email a week, say so. Two or three? Say so. Just know what you can handle and then stick with it. If you don't want to hug or touch in therapy, say so, but don't dance around the subject, allow it for a while and then decide it's making you uncomfortable. Jeesh, I thought therapists were the one's that had their *^%$ together . . . just kidding, I know they're just human

Also, I don't believe that boundaries are for "the good of the client". I think that's a cop out that therapist insist on. They need to get real. Boundaries can be for the safety of the client (especially, the one about no sexual contact with clients--which is crazy that anyone in a work environment needs that spelled out for them, but I guess they truly are human), but many times boundaries are really for the safety and comfort of the therapist. I wish that therapists had the honesty and guts to freakin' admit this! We all know we live in a litigious society and therapists are frightened of being sued, but it's really ridiculous to continue to insist that you're "only doing this for the client's benefit." I hate when I hear a client talk about a therapist hurting them by suddenly withdrawing a particular thing (ie. hugs, email, phone check ins, extra sessions etc.). In most cases, the withdrawal is because the therapist offered the "item" and then got overwhelmed and decided their effort to foster trust/dependence wasn't working or resulted in "regression" in the client. In other words, "bad client", you have to stop this behavior and so I'm taking this item away from you. In reality, the therapist should be owning up to his/her failure to conduct therapy appropriately and with a good solid therapeutic frame and he/she was the one who got emotionally overwhelmed.

Whatever, I hug my dentist and my therapist.

i consider my Dentist a friend, even though we're not close. I met him via a social group we have in common.

In terms of social circles, I'm closer to my doctor than I am my T. We are in a small town and my T is like an hour away (I started seeing him when I lived closer to the clinic he works at). I email my doctor when I have a quick medical question. She's a warm, compassionate person.

So. I don't know. I guess I too don't like the idea that the medical profession is a bunch of cold, dead-eyed zombie robots.

Well. Okay maybe that wasn't implied but it's more fun to type out.

My T is really clear that the boundaries in therapy relationships are to protect him and he needs them in order to do the job.

I have one friend who teaches medicat students and another who supervises internships. Both complain of wanna-be doctors' incuriosity and inabilty to take the initiative.

I'd prefer robots to human passivity.

My dentist calls me after appointment to see how I am feeling. My t doesn't call check up on me unless I don't come see her for awhile. But I do like my t. I like my dentist too

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It's standard practice or policy for medical doctors and nurses to call patients after hospitalizationd to check on them. Therapy is a caring relationship for me, so of expect him to check on me during tough timed.

The blogger sounds very naïve and inexperienced. The easy thing to do is to be conservative. But the 'easy' way isn't always the best way. No big deal-just my 2 cents.

I wish my dentist would take a lesson from my T and not call me, ever: he calls once to remind me of an upcoming appt, and then a request to call back in order to confirm I am going to show up! I mean, if he has that many no-shows, bother those people, not me!

I am always a bit skeptical of Ts who don't seem to understand the relationship between the therapy frame and boundaries, and who persist in seeing boundaries as "should nots." As FJ said, it's much more nuanced than that, and boundaries don't all serve the same purposes. There's a difference between a T not accepting e-mails from anyone as a self-care issue, and a T deciding that e-mails serve no therapeutic purpose for one client, while being a valuable motivator for another client. Rules can't substitute for clinical judgment, they can only be starting points.

I wrote a longer piece somewhere on the bipolar forum, but can't find it. So here's a shorter version, though still too long. A summary of my boundaries is, I grew up in a dysfunctional, emotionally and physically abusive family, particularly my dad. So I learned not to set boundaries. My school and actual local community were also very, very rigid. Late in life, I have been learning, and HAVE learned how to set boundaries I never cross. Three of them are, NOBODY is allowed to yell at me. Ever! The second one is, I won't be blamed for something that I did not do, or that is untrue. The third one is I don't like people to be rude or emotionally/verbally aggressive towards me. As for the second one, four of the people who accused me or someone or a group, of something that was untrue/unreal had dx's of paranoia. I've had several experiences with women in the past 3-4 years, where they did just that. Either directly to me, or about another person or persons/groups. I got tired of this, and dropped these people. The third category has become a problem for me with two political activist groups I've been in. One during the last 3 years; another similar situation in another political group about 15 years ago. I spent too much time listening to others' problems, for several months each one. I was kind, gentle, very supportive, nice to them. Finally, I ended the relationships, or dropped out of the activist groups. The political groups were the worst. In each one, one of the group's women screamed at me and blamed me for "abandoning" the "cause" they were working on, and "abandoning" her, PERSONALLY. They screamed at me on the phone, non-stop so I could not speak rationally to them. Has anyone here had such extreme responses to you when you state your personal limits/boundaries?

I think they are in the same ballpark, and neither of them have to be "cold" - as some are making out dentists to be. My dentist is actually very warm and is a Facebook friend and I am way more 'comfortable' with her than with T. A different kind of comfortable because I'm not open and vulnerable and worried that she knows my deepest secrets. They are in the same ballpark because they offer a professional service and are being paid to do so. Both need to have clear boundaries. I am one who believes Ts should not be making calls and such because it goes beyond their job description and duties. If they do, then that is their personal choice, but I wouldn't expect it. As a professional myself, I have to be very clear with my boundaries and work-time or I know what it is like to get burned-out and taken advantage of. Usually after surgeries and such, it is a nurse or assistant who calls to check how the patient is doing.

I said that they were not in the same ballpark in terms of the kind of pain - physical vs. emotional - that they deal with. Nothing to do with what your post focusses on.

Quote" Hugs at discharge are a stick subject."\

Yes, that's the truth. My present therapist and I give each other a hug when I finish my therapy, but it's because I asked him one time if it was okay. Besides, he's gay and I'm a straight woman. Anyway, I had a therapist at another clinic one time. After he wasn't my therapist anymore (form some reason -- maybe he switched to another clinic, something innocent) I saw him in the parking lot of a supermarket. He had his son, about 6 years old, with him, and he gave me a big smile and hugged me!! I was shocked! Talk about breaking ethics! Therapists aren't even supposed to show recognition of their clients, in public, unless the client speaks first! It's a breach of clients' privacy! Same with pharmacists, by the way.

I'm hoping my T is not like a dentist or doc (T's been in practice 30+ years), but I wonder if my demeanor when talking about the hard things are misconstrued by my T. I tend to 'report' things that happen(ed) like a book review. My clinical way of dealing with feelings might keep my T at arm's length when, in fact, I so want a hug when tears well up in my eyes and I can't find my voice to continue.

Good for your T (and you) that s/he was honest and forthcoming.