Location: Deep inside my mind and somtimes allover the place
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Boundaries in Psychotherapy & Counselling
I have recently talked to a hypnotherapist who held the view that counsellors/ psychotherapists could become friends with their clients. I was absolutely gob smacked.
I am not sure whether hypnotherapists have to stick to a code of ethics but he obviously didnt.
Many clients do not understand, or wonder, why therapists can not become and should never become friends with their clients.
I have a few interesting links on that subject. Hopefully it will bring a little bit of insight.
A therapeutic rationale for careful boundary maintenance. An argument relative to the import of maintaining boundaries in psychotherapy might be outlined as follows:
Psychotherapy is a powerful tool that can evoke powerful emotions.
Reported victims of therapist-patient sexual involvement often tend to be women and the perpetrators men.
Psychotherapy patients tend to regress to infantile and vulnerable states.
This regression places the patient in a situation which is reminiscent of a family, in which the child is vulnerable to the parent.
Consequently, the male therapist, as metaphorical father, must insure that the vulnerability of the female patient, his metaphorical daughter, is not exploited. (This is equally true regardless of gender of patient or therapist, although most litigation involves this metaphorical “father-daughter” dyad (e.g., Pope, 1990a, 1990b).
Steps must be taken to give the patient clear messages that any vulnerability will not be exploited.
These steps include establishing boundaries between the therapist and patient, and between the professional and the social. These boundaries include clearly demarcating starting and stopping times of sessions, having no social contacts with patients, not touching patients, not disclosing personal information to the patient, always billing patients, and doing all related activities to continually remind the patient and make abundantly clear that this is a professional, rather than social or sexually intimate, relationship.
Patients, because of their regressed and vulnerable state, may attempt to initiate behaviors that are more social or sexual than therapeutic. The therapist always bears the burden of preventing this from occurring. Because the patient’s judgment may be impaired, the therapist bears the exclusive responsibility for setting limits.
Some patients, because of a prior history of childhood or adult sexual abuse may become confused regarding the difference between that which is therapeutic and that which is social or sexual. Consequently, even apparently harmless forays into social or personal activity, which are not part of treatment, must be avoided to avoid confusing the patient as to the nature of the relationship.
In light of all of the above, even seemingly trivial “boundary violations,” such as giving a patient a ride should her car be broken, can indicate a disregard for the import of boundaries and can be a sign of negligence. Such negligence can approach metaphorical incest considering the father-daughter metaphor which is attributed to these therapeutic dyads.
From this point of view, one of the most significant curative aspects of psychotherapy may be that the patient undergoes his or her initial lifetime experience of an interpersonal relationship in which boundaries are adequately maintained. By virtue of this, the patient comes to learn that the therapist is a separate person, not dependent on the patient for love or any other emotional needs, and that it is possible for the patient to have other, mature, adult, independent and non-exploitative relationships. In addition, the patient learns that there can be healthy relationships such as psychotherapy in which the stated goals which gave rise to the relationship are in fact carried out without manipulation, hidden agendas or abuse. While this approach shares many elements with the ground rules of classical psychoanalysis (Greenson, 1967; Gutheil and Gabbard, 1993), it is also informed by modern concepts such as family dysfunction and the incest survivor movement (e.g., Russell, 1986), feminist therapy (e.g., Brown, 1994), and has become a cornerstone of the addiction-recovery movement (e.g., Katherine, 1993). http://drmwilliams.com/SAdocs/bv.html
An “I and Thou” experience with a psychotherapist is nice, but unless this experience is grounded in solid psychotherapeutic skills it will do nothing except lead you into the same illusions and problems that you entered psychotherapy to overcome originally.
An old topic, but recently I noticed that a charming ex-client of mine, who I saw for several years, has her photo come up wondering if I want to be a friend on a social networking site.
Tricky one. I have not replied. I will have to put a public post on explaining I don't do the friends thing, it's purely for family. I don't want her to feel rejected OR exploited.
Thing is, she knows I am not her friend. We have discussed it, as I do with all my longstanding clients. But then, most facebook friends aren't either.
I agree with the OP. Once a client, never a friend, is the rule. Anything else is not giving a proper service.
This is a deep and fascinating subject. I quite agree that healthy boundaries are essential in the therapeutic relationship, and it's unlikely that a friendship would ever be either possible or appropriate.
Yet there are also issues for therapists around control and the desire to hide from relationship, and some therapists use boundaries in ways that I consider inappropriate. I once had a therapist who wouldn't say a single word after announcing time was up - not even "Goodbye, see you next week." I later learned things about him that conformed my suspicion that he had issues around relationships.
I wonder why you haven't replied to her personally and apparently plan to not do so in favour of a public announcement? That is not what i would choose to do - I'd answer her personally. But then as a humanistic practitioner I use boundaries rather differently to, say, a psychoanalyst.
Quote:
Originally Posted by David100351
An old topic, but recently I noticed that a charming ex-client of mine, who I saw for several years, has her photo come up wondering if I want to be a friend on a social networking site.
Tricky one. I have not replied. I will have to put a public post on explaining I don't do the friends thing, it's purely for family. I don't want her to feel rejected OR exploited.
Thing is, she knows I am not her friend. We have discussed it, as I do with all my longstanding clients. But then, most facebook friends aren't either.
I agree with the OP. Once a client, never a friend, is the rule. Anything else is not giving a proper service.
A We have discussed it, as I do with all my longstanding clients.
Quote:
Originally Posted by Richard Lawton3
I wonder why you haven't replied to her personally and apparently plan to not do so in favour of a public announcement? That is not what i would choose to do - I'd answer her personally. But then as a humanistic practitioner I use boundaries rather differently to, say, a psychoanalyst.
Hi Richard,
a lot of reasons, the first being that this is what was in my contract with her, and what we discussed, but also:
an unfamiliarity with what she had to do to get that issued on facebook: look at my profile (understandable) or issue an invitation (tricky). Also, I believe that I could not send her a message without befriending her.
My main strategy is because I have had many hundreds of clients, and I wouldn't like there to be any bad feeling about it with others who innocently wonder how and what I'm doing.
Like everyone, my history of relationship has had it's difficulties. I've read such writers as Brian Thorne, Carl Rogers and Fritz Perls, as well as Jung and Freud, all of whom had to one degree or another relationships with former and current clients which would be several steps to far for me. It is a personal choice designed, I suppose, to protect my clients and myself.
I would also consider myself a humanistic therapist, Actually, I believe most psychodynamic/analytic therapists consider themselves humanistic too. It's a broad church.
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