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Re: here you go... the ethics thread

Posted by DAisym on May 28, 2007, at 16:14:06

In reply to Re: here you go... the ethics thread » Dinah, posted by twinleaf on May 28, 2007, at 14:26:29

I think one of the areas that therapists lack training about is around attachment. I believe this is changing, as we have more and more research about it, but many of those in private practice today see adult attachment as pathological and something to be avoided. They structure their boundaries based on this view, and this gets reinforced when the client pushes their boundaries. Instead of examining their decisions in the context of this client and this therapy, the "one size fits all" mentality kicks in and/or the "give an inch, take a mile..." worry flares up.

Therapy can cause an attachment crisis for adults. It is a painful splitting apart of defenses and at its worse, you feel completely fragmented and exposed. It is in these really raw times that a good therapist will think about how his/her boundaries are hurting or helping a particular client. Otherwise the client now feels bad about yet another thing - breaking the rules of therapy by wanting some flexibility in the boundaries. Again, holding tight to a boundary might be the most beneficial thing - but it might not be. For example: if the separation anxiety is huge, talking about it and working on ways to manage it seems a lot more beneficial than "just" clamping down and tightening up the boundaries. Do therapist really think that the feelings will just go away if they don't respond to them? I often wonder why so much psychological literature gives thought to how not to be taken advantage of by the client. This hardly feels strength-based to me and I think it sets up a dynamic between client and therapist in which everything is suspect - do all words, actions, noises and sneezes have double (and negative) meanings? (Freud would say yes...)

It must be scary for the therapist on some level to really feel the client's pull to merge; I can understand why so many therapists work hard to not allow these "regressed" feelings into the room. It truly can be dangerous for some people, because letting go of those defenses at the wrong time, or under the wrong circumstances, could result in a psychic break.

I guess I'm thinking that boundaries change from therapist to therapist, depending on whether it is short or long term therapy and whether it is CBT or psychoanalytically driven -- but that basic ethics don't change. Ethically the therapist understands the power imbalance and keeps this well in mind when making decisions. Sexual liaisons are usually harmful, so an ethical therapist avoids them, even if they know of cases when it was helpful not hurtful. Who can know ahead of time? Ethical therapists do what they say they are going to do and mean what they say. And I believe the bottom line is that ethical therapists strive to be helpful and take their role seriously. They don't have some secret pocket of contempt for the "weakness" of clients whom they judge to all be manipulative in some way or another. Instead they see suffering and the potential for change and they respond with hope and kindness.

 

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poster:DAisym thread:759943
URL: http://www.dr-bob.org/babble/psycho/20070525/msgs/760026.html