Boundaries in Therapy
Do you remember your first counseling sesssion? Chances are you were a little activated. Everyone is. We confer a certain authority over any of our health care practitioners when we approach them with our problems. It is for this reason that competence in a therapist is so important.
A competent psychotherapist recognizes how to maintain good boundaries in the therapeutic relationship.
Seeing a counselor is a rather unique experience. You generally don't meet outside the therapy office (unless it is a planned field trip and part of your treatment); your therapist is not your friend; and, typically great care is taken by the therapist not to engage in any role that might have a dual purpose, thereby confusing the boundaries between you.
Boundaries and Your Counselor
Boundaries in psychotherapy refer to the limits placed on the relationship between you and your therapist, i.e., you meet at a specified time and place. There are also specific boundaries placed on the communications that take place.
For example, as a psychotherapist I donít share my life with my clients. Except for well-timed and discreet disclosures on my part to enhance clients' understanding of their situation, I focus on the problem that they have rasied. This constitutes one of the boundaries of good psychotherapy.
When choosing a therapist a good understanding of boundaries will help you to determine if your therapist is competent.
To learn more about this subject, you might enjoy Jessica's question posted below.
10 Signs of a Wonky Therapist - here are a few boundary slippages you don't want to see with your therapist.
Psychotherapy and Touch
Touch is not often discussed among clinical circles as far as I know. However, given what is emerging from neuroscience, it seems like the dialogue should begin. It certainly has been a hot topic among folks in therapy.
Click below for Shrinklady's latest offering:
From the Counseling Psych Cafe:
Therapy Lingo Article?
Boundaries create the caring relationship
Hi, I would like to thank you for this very informative site. It has ignited a real desire to 'let go' in therapy so i can really move forward. I am experiencing transference feelings towards my older, male therapist and your valued site has put these difficult, yet 'addictive' feelings into perspective.
I am fortunate to have an experienced and finely attuned therapist who put me at ease from the first session. Now i understand how common transference is in therapy, and how important it is to 'bite the bullet' and explore the feelings towards my therapist unreservedly.
Regarding the boundaries in this therapeutic relationship, well, they did initially feel like a barrier. It has become clear to me that these boundaries are, in fact , the 'invisible' caring hands that encompass the client/therapist rapport .
I understand that it is the clarification of boundaries that underpins the development of an open, trusting, and safe relationship, in which complex emotions can be expressed and explored. I would like to say thank you once again, to everyone who has contributed to this site.
Nicky, Lancashire, England
With regard to Ronald M Master's comment Sage has said it all, and I heartily and 100% agree with every word.
It is almost as though Sage is speaking on my behalf as well! In my opinion, and many others it seems, myshrink.com is one of, if not THE most helpful sites of it's kind, and there are many many sites out there. Without this website myshrink.com and all it contains and has helped me with, heavens above knows where I would be. I was stuck in a serious rut re therapy, miserable, floundering, actually desperate and not understanding what the whole nightmare (ie therapy) was about.
I am now much better informed, interested, more relaxed about it, and so wanting to help myself within my therapy. I am so grateful to Dr LaCombe. What I have learnt from here and from her, (and not ONLY with regards to actual therapy either), has turned my life around completely.
Oh for sure.....I am very very grateful! Sandra
Sage (Small town, USA)
My comment is in response to Ronald M Masters comment. I do not have any expertise concerning the code and conduct or licenseur requirements to practice psychotherapy. But I do know what is right for me. I have at no time felt I was recieving psychotherapy from this site. I have recieved a whole lot of knowledge that has allowed me to understand and evaluate my therapy. With knowledge comes understanding and with understanding enlightenment.
My Shrink is a site thats time has come. As for the format, the relaxed, humanistic, (and reptilian) theme has allowed me to get past the stigma and dark mystery of psychotherapy. We (clients, patients, nut cases......) are entitled to be informed consumers, and we are entitled to have a sense of humor.
My Shrink has given me the tools and knowlege to make informed choices as to the type to therapy I choose to participate in, to understand the process, and to recognize and celebrate my progress in therapy. Don't get stuck in the past Ronald. The field is evolving, the science is evolving, the patients are evolving. Only the reptiles remain:)
Ronald M. Masters (San Leandro California, USA)
You forgot the 11th way to identify a bad therapist, 11. The therapist calls herself the Shrinklady. When I found this site from a google search and began reading I was really hoping this was a spoof on psychology. I was shocked when I realized this is serious. I would encourage you to consider reviewing the Ethical Principles of Psychologists and Code of Conduct provided by the American Psychology Association effective June 1, 2003.
Do you realize you need a license to practice psychology in every state, provence, or country you offer "crisis counseling"? This site is in, and of itself a boundary violation. I have never seen anything in the field of mental health presented so unprofessionally. The science and clinical practice of Psychotherapy is not a consumer product to be sold like a used car.
Ronald M. Masters
Ouch! I'll have to get back to you on that one Ronald.
Ronald, You need to chill out dude... This website has been a godsend for so many. Welcome to the 21st century and the cyber world, it's all global now you uptight freak...
And a harsh slap in the face left in a comment box? Hardly an appropriate way to share your concerns... Send the lady an email...
Why are boundaries so important in therapy?
I feel like they're a put down, like I can't be trusted with "knowing". They leave me feeling "lesser than" the therapist.
Hello there Itshardtosay,
It's hard to comment without knowing the details but when I'm working with a client we always talk about boundaries as they are an essential aspect of healthy relationships inside - and outside - of therapy. They let us know where our "stuff" starts and stops and whose "stuff" is whose.††
And that's often a confusing concept because for the most part we never experienced healthy boundary setting growing up. For many of us, when mom was upset, so were we, so we tried to make things better for mom.†† This wasn't our job as a kid, but it started to feel like it was.
So, fastforward to the present...and now a therapist is setting boundaries with us. If we're real fuzzy about them, a clear boundary can feel like a shut-out and we can feel like there's something wrong with us - we're "lesser than" or not trustworthy.
Our emotional patterns get laid down via our connection with parents and later with peers. The brain requires similar conditions in order to unlearn or to develop new patterns.
In other words "wounded in connection, healed in connection."
uncomfortable this is, and it sure can be, it is so important for you
to let your therapist know what's happening for you. This is how we
learn about boundaries and then we start to "get" what therapists mean
when they set boundaries with us.
In fact, healthy boundaries provide safety to clients. For instance, they know the therapist isn't going to ask them for anything in return, other than being paid.
Just as a side note Itshardtosay, some therapists work at such a distance from their clients, they end up providing no containment for the client to settle into. I think this behavior is rooted in the therapist's own stuff, and not in any theory they subscribe to. (I think it's impossible to prevent who we are from coming into our work with clients.)
So, what's optimal Itshardtosay is having a therapist who can set boundaries while still staying in connection with you - so that you can experience your "stuff" and know that someone is there for you - that's how change and healing happen.
There is certainly more that can be said on the subject. I hope that clarifies it to some extent.
Thanks for your question,
Hi, today, I brought my mother and sister in for one of my therapy sessions today. They wanted to discuss the fact that I don't take care of myself.(physically, meds). Somewhere along the lines, my therapist started talking about her own problems, in a sense comparing herself to me. Is this appropriate for a therapist to compare herself to her patient? Thanks for your response.
Hi Jessica, there's two issues here. Is it your stuff or the therapist's stuff? We're trying to trouble-shoot the possible dynamics but without all the information we can only hypothesize. So please take what we say with this in mind.
What's interesting to consider is the notion that having your mother and sister present in your session was in a very real sense, a situation of being compared. We assume that they were comparing themselves to you and felt that your self-care was lacking.
So let's consider your perception of your therapist's response. It too was a "felt" comparison. However, was it one of a dismissal? A minimizing? Or, an offer of support?
Just so you know, it can be helpful to a client when a therapist discloses something of herself in a session. It may help the client feel that they are not alone. It can also normalize their experience. For instance, I have often offered disclosures on my own healing to my clients at specific times so they can feel hopeful about their own recoveries.
Moreover, when a client has brought family members to their session, I've noticed that he or she can sometimes feel "ganged" up on. I'm wondering if your therapist was feeling some of this. For example, she may have been trying--perhaps unconsciously--to "level the playing field" by communicating to your mother and sister that indeed your concerns are understandable given her own personal experience.
The issue you've raised is so important for the therapeutic process. We recognize that therapists' disclosures can be ill-timed and/or they can be "too much information" for what's being worked on in the session. It certainly sounds that for you your therapist's disclosure was at minimum, confusing.
In some cases, a therapist can inadvertently allow the weight of their own issues to be felt by the client. This is clearly a challenge to the boundaries of the therapeutic relationship.
And yet, all is not lost. It is in these moments of rupture that the greatest healing takes place. For misattunements, once rectified, provide the means for a closer connection with another.
The take home message is that all of this is "grist for the mill", therapeutically speaking. In other words, how you experienced this interaction is important for you and your therapist to talk about. The only way to know truly where the therapist was coming from and/or to undo the feelings that got triggered in the therapy session is for the two of you to address them.
Jessica, we hope that you will consider our musings and bring them into your therapy for further exploration.
Shrinklady and Dr. Carole