So worried about boundaries

My T seems to be so worried about being overly ethical and holding strict boundaries that she forgets to be human. I emailed her the other day about something and also happened to mention I hurt my knee. Never got a response about anything in the email. Not even just to ask how my knee was. Problem is I am attached to her and don’t want to leave but I know she will never change.

Mine is the same, and it makes no difference how patients feel about it. I don't even like being called a "patient" and would prefer to be a "client", but no. For me, it calls therapy into question on days like today, when I am , like you, hurting over what seems like a lack of concern or normal human warmth. It takes a lot of nerve to ignore an email in this day and age, between people who do care professionally or personally. Some T's do seem to have a religious belief in the boundaries, but other's seem really into limiting contact/ exposure to their clients to the bear minimum. I don't know which one my T is, actually. You seem to sense your T is sincere, and does truly feel the boundary issues mean no email? I think therapists who are that dogmatic are going to lose clients who really could benefit. My T though would probably replace me in ten minutes if I left.

Is it possible that she just hadn’t got a chance to respond to your email yet?
I know it does hurt when they ignore us but if your t cares maybe she is waiting until she has the time to respond both compassionately and ethically.
I think ethics get in the way a lot and stop two people from relating as two human beings.

I agree. This is one of my main issues in therapy and at times why i hold back

I know she was just ignoring because she responded to one from a couple days later. I think she ignores my emails to discourage me from writing. She told me a couple of weeks ago to follow my safety plan. I emailed her asking for the details again because I couldn’t remember. She never answered. I am hoping that one was just an oversight though.

Same here, it’s really hard to be vulnerable with boundaries.
I like my t because she thinks ethics are important but they get in the way.

I think this is an extremely unethical and unwise thing to say.

Like the idea of following the spirit but not the letter of the law - i like to think that ethics would prompt a person to follow the spirit of the law, and stop them from harming the other person.

I disagree! How can it be harmful for a client to say that?

I hope it is an oversight of hers too

The original quote just said "ethics stop two people". I am focusing more on wanting to throw out ethics and just fulfilling the desires of random people.

Oh, now I get you! That’s what I said my t said that you were quoting!
I imagine that everything in therapy and about therapy could be harmful so throwing ethics out the window won’t make much difference but that’s just my opinion. Not all of the ethics just the ones that stop two people just being two people in a room together talking to each other as equals.

As someone who’s been done some harm by therapists’ questionable ethics, I’d much rather they stay in the room.

OP, I know it hurts, and I’m sorry. Is she useful otherwise?

Except there is,nothing equal or balanced about the therapist -client interaction.

And having witnessed the horrific fallout that results when therapists throw ethics and code of practice out the window, I would rather too careful than not careful enough every time.

I don’t think it’s just ethics that are the problem. I think the whole unequal ness of therapy is at fault and therapists taking advantage and abusing that.
Some therapists who are ethical abuse their powers, other therapists who are unethical do too.

I don't know, I feel like an ethical therapist would not abuse their powers, at least not intentionally. That of course doesn't mean they won't hurt a client...I suspect many clients are harmed by good intentions of generally ethical therapists as well. Or therapists that are ethical most of the time, but have a slip or two.

Have you asked her about it and told her that you're not happy with the way she does therapy? You might not get the answer you want but at the very least you can have it out with her and tell her how you feel.

I can totally empathise.

I don't see what's ethical about coaxing people into trusting you with their secrets and stoking emotional dependency, and then responding mechanically or not at all. That's deviant behavior.

Calling this ethical is arbitrary. If the client finds such a dynamic distressing or damaging, then it's hardly ethical, even if the textbooks say otherwise.

And that's not even getting into the patronizing assumptions behind ignoring a client's email in order to teach them a lesson.

OP -- has your therapist discussed email guidelines?

I wont email my therapist anymore because we've got to the 'ignore me' point of it. It's frustrating but I also realize I'm not a priority so I wont sit and beg or whatever for a reply. Just backed off, it is all I could really do.

I would for sure bring up your concerns/frustrations of this.

I think therapists are mainly responsible in maintaining boundaries, and would bring up contact between sessions. It's the lack of consistency that would bother me- why are some emails okay and some not?

One of my last ruptures with my T was about him ignoring an email. For me I've always needed to know that he was "there", not replying made me feel like I wasn't worth replying to and brought back stuff from when I was 14. He was defensive at first , but later apologized and said that he could see why it was important for me. I send one email over the weekend if I need to. So far he has been on the ball with it.

I think this is a real problem with the way that most psychotherapy is set up and while there isn't an easy answer to it, it would be a huge start if the problem were at least acknowledged as such within the field. I cannot imagine that if the best minds in the industry got to work on this, they would not be able to figure out a somewhat more satisfactory way to address the phenomenon of heightened distress between sessions associated with the activation of attachment anxiety or other retraumatization.

It seems like their main strategy for coping with this is simply to further pathologize the person experiencing it. The irony of course being that the modality of therapy that does tend to offer the most between-session support (DBT) is specifically designed for the most pathologized group of patients (BPD) but is also among the coldest and least humanistic. It seems to work for a lot of people though.

One of the aspects of this that strikes me as especially egregious and distinct from other types of healthcare is the lack of informed consent. Specifically, I have never had a therapist sit with me at the outset of therapy and say "so there's a thing you should know about called transference, it can be exceedingly painful especially if you have a history of insecure attachments. Even if this becomes a huge problem, I will not really be there for you more than an hour a week. You might want to give some thought as to how and whether you want to proceed."

One strategy might be to offer access to support groups, group therapy or on-call therapist networks. Also there needs to be lots of access to teaching and coaching on wellness, mindfulness and centering techniques all the way through. Like someone you can call to talk you through it when you're losing it. I think any solution has to support the client in their distress while not overly nurturing the fantasy of the therapist as perfect parent. The therapist needs to be protected from burnout but the client needs to be protected from freakout. As it stands, only the therapist's needs are really considered in this equation.

Exactly, this is a great post and I think whilst ethics are apparently to protect both client and therapist- really, we all know that they are more about protecting the therapist from burnout.

Most of the distress from clients is inconsistent boundaries and why are they inconsistent because the therapist can decide to change them at any time cAusing great distress to the client, who doesn’t understand what they did wrong.
Some therapists are ok with outside contact and the client using them as an emotional regulator when they are distressed but they give no thought when texts and emails get too much and they take away the emotional regulation without putting any other coping skills in place- to me this is unethical and selfish of the therapist.

I had one therapist who explained transference in the first session and encouraged me to talk about it especially if the feelings became quite strong, I was very distressed and didn’t really understand the concept as it was very early on in my therapy journey. I think that was ethical if her and really considered the clients feelings.

"ignoring" isn't a boundary. If you've checked and the T has said "yes, I was ignoring you" then run.
Boundaries aren't abusive. Boundaries aren't walls.

She says she is a rule follower. It has gotten her this far and made her successful so she won’t change.

if my T talked about transference in the first or second session, i would have thought she was off her rocker.

Very well stated. I am desperate just for 'this is what you do to heal from it' (attachment/transference) but my T can't seem to do that. All we get as clients are pushback and even more distancing from the T.