[BudFox]

Therapists are said to have good boundaries if they avoid things like excessive self-disclosure, dual relationships, inappropriate touch, and too much contact outside sessions.

But therapists trample other boundaries and nobody blinks. Examples: expecting trust without earning it, failing to explain risks before rummaging thru your psyche, pushing you to expose yourself while they observe voyeuristically, collecting your intimate disclosures and secrets while keeping theirs largely hidden, interpreting your thoughts and behaviors sometimes aggressively, giving life advice, behaving ambiguously, withholding important information.

Not saying all therapists do all of these things, but most of this is codified in the literature.

These things are commonplace in therapy and thus people are told it's perfectly "normal". But in any other context they would likely be considered violations of personal dignity and autonomy.

Therapy is claimed to help strengthen one's interpersonal boundaries. But as someone pointed out, in fact it can be an exercise in having your boundaries systemically broken down. For me it was.

[*Laurie*]

Hi BudFox, I'm sorry that you've had such a painful therapy experience. I guess there are certain expectations when we walk through that door into out therapist's office...for example, we expect (or at least, hope) that we will trust the therapist. Or that we are knowing allowing the therapist to rummage through our psyche.

But it sounds like maybe you had a really bad experience with a therapist?

[Argonautomobile]

It's always weird when people expect you to do **** that wouldn't be even remotely acceptable in any other context.

"Howdy. My name's Dr. Barb and I'm going to palpate your organs now."

[BudFox]

Originally Posted by *Laurie*

But it sounds like maybe you had a really bad experience with a therapist?

I did. But what I said above is not about that. My experience is largely interchangeable with dozens or hundreds I've read about. Only the details change. All involved some level of psychological penetration, questionable trust dynamics, one way exposure, weak or absent consent, etc.

[feileacan]

I'm just wondering what you are going make of the experiences of those many people who have experienced life transforming therapy (in a good way), where all those same boundaries were present and perhaps played an important role? Just shove them under the carpet and declare as invalid/irrelevant/non-existent?

[Sarmas]

I know that in my case my therapist has the upper hand in session. I have to abide by the rules that she sets in order for our session to run smoothly. Sometimes I don't mind it but it's like walking on eggshells at other times. She has clearly created boundaries which she enforces well. I'm unclear at times as to what's acceptable or not based on those boundaries. I feel like I'm dancing my way around things at times.

She runs the session on her time and it starts when she chooses to start. im not sure if this is the norm with most therapists but this is what I've experienced. Basically her boundaries are not negotiable.

I've found that boundaries have been entirely collaborative. His boundaries are 'good' in the sense that he consistently keeps to what we decided together. Touch was my decision, he has been flexible to my needs on out of session contact and I have always set the boundary with him that I don't want to hear about his life outside therapy. (He has said that if I were to ask him questions he would usually answer, but I choose not to ask).
He certainly never expected trust without earning it. It took me well over a year to trust him and I always told him that I didn't. He was fine with that.
Explaining the risks wasn't relevant to my therapy as I always knew therm all-too-well.
He never pushes me to expose myself (on the contrary he often says things like "you don't have to say anything you don't want to"). I don't find him voyeuristic at all and he doesn't give advice.
So while I think some of what you say may be true of unskilled therapists, or those of particular modalities, it's certainly not true across the board. And my autonomy is in the fact I was able to choose one who met my needs. I appreciate that's not an option for everyone, but I know from experience that with the right therapist, therapy is not only helpful, but life-changing.

[here today]

Sorry, but I think the whole “boundaries” thing is a crock.

The important thing is a sense of self, an authentic ego, a psychological skin. And when one has that it comes with a sense of . . .well, boundary – my feelings, wants, and wishes are mine and yours are yours, and I have a sense of where I begin/end and that I don’t have to do what you want, need, etc., although I can pay attention to that when I pick up on it and can do something about it IF I want to.

I don’t have any credentials but I researched a lot about that, partly because I was interested, and then later because I became aware that I did not have a functioning authentic sense of self and I could intellectually/cognitively tell that I was shot in trying to live my life without one. Very desperate situation, so – true to my temperament and adaptation – I did a lot of research.

It’s great if some people have had experiences in therapy that have led to their enjoying and participating in life in ways that they never could have dreamed of without it.

My experience has been somewhat different.

But I used Heinz Kohut’s ideas from his book “Restoration of the Self” to try to generate a sense of self where mine had been lacking, and I can now “feel” my ego, boundary, like a bubble around me. Previously I “lived” underground in a concrete bunker. . .that was what I had instead of a flexible, translucent “skin”.

I understand that this post will leave most people cold, thinking “huh” if anything at all.

We need a science of the ego, folks! Heinz Kohut started it, his ideas could be tested if anybody in psychology had some curiosity and a bent toward “real” science.

I’m taking some classes in theoretical physics for the general public by a retired professor of theoretical physics. What physics has shown by theory and experimentation is that “color” doesn’t exist “out there”, and neither does space and time.

But people need a sense of who we are in relation to others in order to function well!
I sure wish somebody would try to do some research and creative theorizing about that!!

I’m almost 70 and so. . .don’t have the time to do it myself. I DID try. All the coursework for a Ph.D in psychology but . . .long story.

Nobody talked about “boundaries” in life or in psychotherapy 50 years ago. It’s a current fad, like so much of psychology. It’s really, truly too bad.

[Oliviab]

Originally Posted by here today

Sorry, but I think the whole “boundaries” thing is a crock.

The important thing is a sense of self, an authentic ego, a psychological skin. And when one has that it comes with a sense of . . .well, boundary – my feelings, wants, and wishes are mine and yours are yours, and I have a sense of where I begin/end and that I don’t have to do what you want, need, etc., although I can pay attention to that when I pick up on it and can do something about it IF I want to.

...

Nobody talked about “boundaries” in life or in psychotherapy 50 years ago. It’s a current fad, like so much of psychology. It’s really, truly too bad.

My T does talk about boundaries fairly often and it's often been confusing to me. Thank you so very much for framing it this way--it makes so much more sense to me now! Boundaries are not something one just "puts" out there, installs, or instills...they are a natural outcome of having a good sense of self, of where I leave off and he begins (which is, admittedly, a huge problem with me).

It helps for me to reframe the "boundary" as simply the behaviors that don't intrude on his sense of self or mine (or what ought to be mine).

This was extremely helpful and I think you're right that all this attention to boundaries is obscuring the underlying issue which is so much more important.

[Moment]

I'm sorry you had a bad experience. But not all therapists do the things you say. For example, my therapist said explicitly that he knew I would not trust him until he had demonstrated that he was worthy of trust.

[BudFox]

Originally Posted by feileacan

I'm just wondering what you are going make of the experiences of those many people who have experienced life transforming therapy (in a good way), where all those same boundaries were present and perhaps played an important role? Just shove them under the carpet and declare as invalid/irrelevant/non-existent?

I find it helpful to try to establish the true nature of therapy, independent of the effects. But if you're suggesting that the dodgy approach to so called "boundaries" is justified by a smattering of anecdotal successes, i'd disagree, not least because it's easy to find abject failures and outright disasters. Also ends don't necessarily justify dubious means. Someone could say... my therapist beat me regularly and look at me, i'm healed! Not denying good outcomes, just trying to cut thru the tidal wave of bulls**t on this topic (and to support myself and hopefully others who feel similarly).

[satsuma]

Originally Posted by Moment

I'm sorry you had a bad experience. But not all therapists do the things you say. For example, my therapist said explicitly that he knew I would not trust him until he had demonstrated that he was worthy of trust.

Mine said this too. And I think it helped me to trust him! I think he has always been honest, and realistic in a lot of ways.
It takes me a long time to trust anyone.

[feileacan]

Originally Posted by BudFox

I find it helpful to try to establish the true nature of therapy, independent of the effects. But if you're suggesting that the dodgy approach to so called "boundaries" is justified by a smattering of anecdotal successes, i'd disagree, not least because it's easy to find abject failures and outright disasters. Also ends don't necessarily justify dubious means. Someone could say... my therapist beat me regularly and look at me, i'm healed! Not denying good outcomes, just trying to cut thru the tidal wave of bulls**t on this topic (and to support myself and hopefully others who feel similarly).

That's the thing - I'm not convinced at all that you are in any way establishing the true nature of therapy. You are just focussing on some details you personally have bad experiences with and try to generalise them to the whole concept of psychotherapy without any logical chain of arguments. At least you don't present such logical chain of argument (the argument that all your therapists were bad doesn't really count as evidence that psychotherapy is inherently bad or dangerous). I'm sure you disagree with me but I'm fine with that.

Also, I don't think the successes are anecdotal. Surely, the successes are probably more rarely talked about for obvious reasons - if everything goes well what's there to talk about?

I understand the motivation to support yourself and others who feel similarly but I don't see how you will achieve this support by trying to make generalisations that clearly aren't true.

[atisketatasket]

Originally Posted by feileacan

That's the thing - I'm not convinced at all that you are in any way establishing the true nature of therapy. You are just focussing on some details you personally have bad experiences with and try to generalise them to the whole concept of psychotherapy without any logical chain of arguments. At least you don't present such logical chain of argument (the argument that all your therapists were bad doesn't really count as evidence that psychotherapy is inherently bad or dangerous). I'm sure you disagree with me but I'm fine with that.

Also, I don't think the successes are anecdotal. Surely, the successes are probably more rarely talked about for obvious reasons - if everything goes well what's there to talk about?

I understand the motivation to support yourself and others who feel similarly but I don't see how you will achieve this support by trying to make generalisations that clearly aren't true.

Both sides of the story are anecdotal. The problem is that the effects of therapy cannot be measured objectively: all evidence is self-reported.

It's also not a sure thing to assume that only successes are under-reported. Failures can be under-reported too, for various reasons - think of how crimes, especially sexual ones, are often not reported by the victim because of shame and other personal reasons.

I think one of Bud's basic points is absolutely true - this is a flawed system, and in the wrong hands it is ripe for abuse. That does not mean everyone is negatively (or positively) affected. Some people can never exercise and overeat but have no weight problems. Some people can exercise a lot and watch every mouthful and still be overweight.

I've been thinking so much about this boundary stuff lately, and I can't see any absolutes or conclusions because there are just too many variables and combination of variables.

Examples:

• Someone who is more constricted and controlled might feel safer with a therapist who doesn't disclose and keeps a distance.
  
• Someone who had intrusive parents might feel safer with a therapist who closes themselves off.

Even a therapist-client dyad with the same traits, with one variation, can make a huge difference:

• Someone masochistic and with a 'i'm not deserving' traits (that are ego syntonic) might align with a therapist who is stingy because it is within their world view.
  
• Someone masochistic and with a 'i'm not deserving' traits (that are ego dystonic) might align with a therapist who is stingy because it is within their world view, but have a huge conflict and be in turmoil about it.

And boundaries really represent one's personality for the most part. No matter how hard a therapist tries, their personality is going to impact things. It would be exhausting to evaluate every motivation, action, and word you are taking, every day, all day long, in your decision making. You couldn't even do therapy.

These examples are just a grain of sand in the the whole mix of things.

At any rate, I think it's good to talk about this stuff and don't see how it can be a bad thing.

Nothing in the world would have ever evolved if we didn't question things!!

I pretty much adore my t (most of the time) but there is one thing I do wish had been explained more at the very beginning and it's one of the things you mentioned budfox "failing to explain risks before rummaging thru your psyche". I do wish she had explained this a little bit more.... not enough to scare me away, because on the whole this therapy experience has been the best thing I've ever done for myself, but certainly with more than one little sentence that said something like "difficult feelings can and often do emerge". that was about it as far as explaining the risks.

[velcro003]

Originally Posted by atisketatasket

Both sides of the story are anecdotal. The problem is that the effects of therapy cannot be measured objectively: all evidence is self-reported.

It's also not a sure thing to assume that only successes are under-reported. Failures can be under-reported too, for various reasons - think of how crimes, especially sexual ones, are often not reported by the victim because of shame and other personal reasons.

I think one of Bud's basic points is absolutely true - this is a flawed system, and in the wrong hands it is ripe for abuse. That does not mean everyone is negatively (or positively) affected. Some people can never exercise and overeat but have no weight problems. Some people can exercise a lot and watch every mouthful and still be overweight.

I bow down to you, oh wise one I agree 100% here. (the red text being especially in agreeance)

[BudFox]

Originally Posted by feileacan

That's the thing - I'm not convinced at all that you are in any way establishing the true nature of therapy. You are just focussing on some details you personally have bad experiences with and try to generalise them to the whole concept of psychotherapy without any logical chain of arguments.

This is the standard response to any challenge to therapy orthodoxies. I guess it's a defense mechanism. Therapists do it too. The client must always be seen as a non-expert who only knows their own experience, and even then only through the interpretive filter of their therapist(s).

I've read hundreds of threads on this forum, and other forums too. What could possibly be a better window into the real-time impacts of therapy than this place or others like it? Have also read a lot of professional blogs and books, where therapists reveal their approach and assumptions.

Some of the boundary stuff is self-evident. Everyone knows that therapists disclose little while waiting expectantly for you to reveal all, watching, scrutinizing. Who where has not had the experience of becoming visibly emotional while a therapist just sat there at a distance gaping and peering at you? Some might find this helpful, others harmful, but how can you deny this is a warping of normal boundaries?

[feileacan]

Originally Posted by atisketatasket

Both sides of the story are anecdotal. The problem is that the effects of therapy cannot be measured objectively: all evidence is self-reported.

I agree with that. That's why I think it is absolutely impossible to conclude something about the nature of psychotherapy in general from peoples experiences. I guess we can conclude something about specific therapists, because the human factor is definitely the parameter with the largest variance there, but psychotherapy as a concept - I don't think we can really say much about it.

Originally Posted by BudFox

Some of the boundary stuff is self-evident. Everyone knows that therapists disclose little while waiting expectantly for you to reveal all, watching, scrutinizing. Who where has not had the experience of becoming visibly emotional while a therapist just sat there at a distance gaping and peering at you? Some might find this helpful, others harmful, but how can you deny this is a warping of normal boundaries?

I haven't denied anything. I know fully well that the boundaries in my therapy relationship are different than with my H, for instance. But so are the boundaries in my relationship with my students for instance. I find all these boundary settings normal and proper in their context.

Also, when I go to a doctor because of a medical condition, I am the one expected to talk about my troubles and the doctor is not - seems logical, because I am the one in need of help. Why should it be different in therapy? If I see a doctor who seems unhelpful to me then it doesn't invalidate the whole medical system, but you seem to want to do that with psychotherapy and I don't see it as valid.

[stopdog]

Just because one did not suck does not validate the whole system either

[feileacan]

Originally Posted by stopdog

Just because one did not suck does not validate the whole system either

Absolutely agree! But similarly does not someone's bad experience invalidate the whole system. But it seems to me that this is precisely what the OP attempts to claim.

[stopdog]

I don't find the therapy system to be useful in most ways. Certainly I have not found it to have done anything real. If someone else has, then I have no reason to disbelieve their experience for them. But I do find often the system and its so called professionals as well as some clients who did not have a bad experience clients, blame those for whom it hasn't worked. I also think some people bend over backwards to justify ill treatment by therapists and revere therapists in ways and for reasons I do not understand.

The problem is that the effects of therapy cannot be measured objectively: all evidence is self-reported.

But people could objectively measure clients' subjective experiences captured on tested, reliable standardized forms

Then the aggregate could be looked at and compared with other therapists, say-in the same clinic/organization. One who is a consistent outlier could be a crappy therapist.

Questions-
Do you feel respected by your therapist?
Do you feel you've made positive changes to your life as a direct result from this therapy?
Do you feel supportive?
Do you feel safe with the therapist?
ect

and
Do you feel anxious
Do you feel hopeless?
Do you sleep well?
Do you eat well?
Are you able to perform your daily taks
Are you isolating?
etc
Every day, most days, somedays, hardly at all, not at all

Unlike research, you can just use basic statistics. Look at differences among length of treatment, diagnosis, treatment modality, etc. But have an overall score for each.

If someone's patients answer they don't fee respected, while other therapist's have average answers or above, that could at least identify the therapist might be a jerk.

A client can take a short 60 second questionaire after every visit too about how they feel about the overall visit.

Since depression and similar subjective expereiences, that doesn't meant they can't be assessed objectively

[stopdog]

But what do those questions and the answers have to do with therapy? Do I eat well - in comparison to what? A third world country? Someone who has their own personal chef? Someone who has a victory garden?
And if the answer is yes - why would therapy have anything to do with it?
And what if yes or no is not going to cover one's experience? Just look at how people complain about poll choices on here.

[lucozader]

Originally Posted by Skies

But people could objectively measure clients' subjective experiences captured on tested, reliable standardized forms

These do exist - they're used in the NHS to measure how well therapy might be working, and they're part of the reason that CBT is so popular these days. I think they use the Core Outcome Measure. I have one of those forms with me right now actually, if you're interested. They use them at the charity I work for.

They don't ask specific questions about the therapist, that would be an interesting and worthy addition. They just aim to measure the client's general "wellbeing".

Obviously, for the reasons SD mentioned above and many more besides, they're not a perfectly reliable measurement at all. I've had to fill them in and I found them to be slightly ridiculous - it's very difficult to reduce all your thoughts and feelings down to a tick in a box. But they're an attempt to measure how well therapy might work - and I guess no-one's thought of a better way yet - if a better way is even possible.