"Breaking Boundaries"...But, but...my Therapist is my Friend?!

Boundaries and what the fuss is about?

I have had the good fortune of having been exposed to the importance of good boundaries and several good clinical supervisors in my course of training in Australia, have been kind enough (and knowledgeable enough) to take me under their wing, reminding me that if we can't keep good boundaries, we become useless to our clients. 

Imagine that our clients have interesting and difficult experiences in their own lives and they expect certain patterns of relationships with us (i.e., transference; expectations of others toward them).  Either way, we learn from our own life experiences isn't it?  Hence, it is reasonable to expect (pun intended) that if there were pathological and dysfunctional patterns of relating existent, we may reliably predict that there would be clingy or distanced clients that may think of us (i.e., therapists) in particular ways, even extreme ways.  Besides, decades of psychotherapeutic process research have demonstrated that these issues are existent and can be a crucial part of how we maintain the quality of our therapeutic boundaries (psychological, physical, unconscious, ideal, etc).

The literature on boundaries is massive, and you'd most likely have heard of it in the course of your training or heard of this discussed in the process of treating clients.  To zoom in on the essentials, look into what differentiates boundary crossing versus boundary violation. Whilst these are out of the scope of this article, my advice for budding psychotherapists - learn these basics well, and manage these fundamentals, as these become your bread and butter areas you will inevitably have to deal with in the room.  Why wait?  

For more on my own writing on maintaining healthy/adequate therapeutic boundaries, check out my article on the Therapeutic Frame, my article on How we Become the Persecutory Therapist, and my free book chapter on "Frieda" - Lessons on Transference and Countertransference.

Let's focus on a useful article 

Online psychology mag, PsychologyToday, posted on 14 Sep, an article entitled, Sorry, Your Therapist Can't Be Your Friend, by the American Psychoanalytic Association - Psychoanalysis Unplugged, says that "maintaining therapeutic boundaries are are vital to your mental well being." The article mentions useful concepts and an introduction on understanding transference and countertransference, as well as enactment.  Read on for more.

The article gives a good summary of a number of points that describe the fundamentals for good ole psychotherapy, down to brass taxes:

  1. No physical contact with a patient.
  2. No relationship with a patient outside of the consulting room.
  3. The therapist should not treat close relatives or friends of the patient.
  4. No practical advice to a patient.
  5. Maintain objectivity and neutrality toward the patient and avoid excessive worrying/thinking about the patient.
  6. Seek supervision if you are tempted to, and before you do violate any of these rules.

What do you think about these issues on boundaries? Have you ever experienced some interesting dynamics in therapy with your own clients, or have thought of your own therapist in a particular way?  Come on, out with it. We're all humans, and we all have desires of our own.  It's only a matter of time that we would eventually be wrapped up in it.  To manage these, learn more about them, and learn to be aware of them when it does present itself.

Share your thoughts and bring it up in clinical supervision today.