![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 42. Go back in thread:
Posted by Dinah on February 1, 2004, at 12:46:25
In reply to Re: My therapist sometimes refuses to answer me, posted by Karen_kay on February 1, 2004, at 12:23:45
No, I'm not worried about my therapist not responding. I'm worried that so many therapists seem to be violating boundaries established by the profession to protect clients. In each case, it might appear that a special exception was made in the best therapeutic interests of the client. But taken together it is worrisome to me.
Of course we want our therapists to answer our questions. It makes us feel special, it makes us feel like they care about us, it makes it feel like more than a professional relationship.
My therapist is even more Southern than I am. I think that's why I bonded so well with him. He understands the conventions of gallantry and nonconfrontational confrontations. When he is at his most genuine and most emotionally engaged, he drawls the southern drawl that it would appear he has carefully tried to minimize. I try for that drawl. I feel wonderful when I get that drawl. It makes me feel special. It makes me feel like he's emotionally connected to me, even if he's angry, and I like that. I think that's natural.
But is it in our best interests? Really? Does it lead us to think that we have a different sort of relationship with our therapists than we really do? Does it affect our behaviors with them in an artificial way? Does it burden us with knowledge that we shouldn't be burdened with in a relationship that is entirely for our own benefit, with monetary compensation as the only benefit to the therapist. Are the rules really bad? Is it really good for therapists to bend them, or do we just like it?
I'm not talking about any one in particular Karen. Although your therapist's talk of his supervisor telling him that he might need to transfer his long term clients to someone more experienced is an example of the sort of fallout that can happen from boundary crossings.
I have always been a huge supporter of telling our therapists anything and everything we think or feel, in the expectation that they will handle the knowledge appropriately. I just am seeing a trend where therapists are handling the knowledge, perhaps not appropriately, but enough out of generally accepted professional norms to cause me concern.
Posted by Dinah on February 1, 2004, at 12:47:38
In reply to Re: My therapist sometimes refuses to answer me » Karen_kay, posted by Dinah on February 1, 2004, at 12:46:25
Do you know of a guest expert who might be able to throw more light on this subject and might be willing to make himself available?
Posted by fallsfall on February 1, 2004, at 13:22:32
In reply to Re: Dr. Bob, A special request?, posted by Dinah on February 1, 2004, at 12:47:38
I think that there are absolute boundaries for therapists (they shouldn't sleep with their clients). But inside those boundaries, I think that each therapist needs to establish their own boundaries - what they are comfortable sharing with their clients. This will differ from therapist to therapist, and probably between orientations, too. It may also shift for an individual therapist over the lifetime of their career.
Once the therapist is clear about his own general boundaries (i.e. will they be upset if a client drives past their house?), I think that they need to apply their knowledge of each individual client before making decisions on how they will act. A therapist may choose to be looser with their boundaries if they feel that a particular client (someone like Karen) might feel more trusting with more disclosure. The same therapist may choose to be stricter with their boundaries if they feel that the disclosure will be disconcerting to a different client (someone like Dinah).
I think that the profession has absolutes (i.e no sex). I think each therapist should know their own personal absolutes (For one, don't tell patients their marital, parental, sexual orientation status or age. For a different one, all of those may be OK to talk about, but they don't want to talk about things that happened in their childhood). Once those rules are established, I think that the therapists need to use their judgement every single day with every single patient to see if a particular response will be helpful to the client.
Since there are so many different kinds of clients, I'm glad there are different kinds of therapists. That lets each of us find a therapist who we can FIT well with - who will be best able to help us.
Posted by terrics on February 1, 2004, at 13:33:55
In reply to Re: My therapist sometimes refuses to answer me » Karen_kay, posted by Dinah on February 1, 2004, at 12:46:25
I was wondering what you all would think of my therapist. I think I know more about her than she does about me. Probably big boundry crossings. Maybe not though. I just don't know. We often talk about her family [many times she ties the discussion in with a problem I am having???], her hobbies,her mother [which again she ties in with problems I have with mine,]her past problems with drugs[I do not have a drug problem.] She has hugged me without my expecting it, and she has said she loves me.[that was when I was considering suicide.] Do you think these are therapeutic techniques, or boundry crossings? terrics
Posted by Karen_kay on February 1, 2004, at 13:46:02
In reply to Re: My therapist sometimes refuses to answer me » Karen_kay, posted by Dinah on February 1, 2004, at 12:46:25
But, again we aren't cookies... Each therapist has to establish a certain set of guidelines for each client. And those guidelines (boundaries) must shift when needed. Looser or stricter. (The case with mine, I believe has nothing to do with my therapist's boundaries. It has everything to do with finding a therapist more "equipped" to handle longer termed clients.)
Of course it makes us believe we have a different relationship with our therapist then we really do. I like to believe that Bubba and I are really friends, that we are truly connected in some way. But, in reality we aren't. Once therapy is over, I'll never see him again. I'll give him the occasional phone call, as well as a card every once in a while. That's the illusion of therapy. You can make believe that you have some sort of "friendship" or relationship and you divulge all of you feelings to a stranger. A stranger who helps you sort things out. But in reality, there really isn't a friendship or realionship at all. Sure, you may be the favorite client, but there really isn't hope for much else in the future.
A like to think of my therapist as an actor. He play the role of my friend. My friend who I will eventually lose contact with in the future. I know it will be hard, but he's helping me to be a better person. So, the fact that I'll lose him doesn't seem so bad. At least he will help me while I have him here now.
I think that therapists have to bend the rules for clients. We aren't all the same. They aren't seeing the same clients with the same problems day after day. If he treated me that same way he treated you, what hope would I have of getting any better? His personal disclosures burden me only to the effect that I allow them to.
And what's the harm in feeling special? Isn't that what everyone wants? I hope that he makes all of his clients believe that they are his favorite clients. I don't mind that a bit. Everyone deserves to feel special, as everyone is. (Uh, oh... The real Karen is starting to show.... Must push her back...) I just think that every client needs something from their therapist and his/her job is to find out what that something is.
I had a thought that therapy is just a person replaying every relatioship that a person ever had and saying just the right thing that the client needed to hear at that time. A therapist needs to break the rules at times (IMO) to say what needs to be said.
Posted by gardenergirl on February 1, 2004, at 14:01:52
In reply to Re: Therapist honesty » Dinah, posted by fallsfall on February 1, 2004, at 13:22:32
I think fallsfall made a lot of good points. I just wanted to add something. This is a self-selected group of people on this board. We are here to ask and answer questions. It makes sense that there would be a lot of questions about boundary crossings, because when it happens, it's confusing. You wonder if your sense of it is correct, and you want other opinions. When T's maintain boundaries, there's really nothing to question. So to add to the data points of T's and boundaries...Bear never crosses boundaries except if we shift into talking about psychology in general. He always prefaces that with, "this isn't why you are here, but..." It's just really hard for two people in the same field, especially when one is learning, not to talk about what they have in common. I don't really consider that a boundary violation.
When I was working in a hand therapy clinic (in another career), I worked with people who had carpal tunnel surgery. I swore I would *never* have the surgery myself if I developed carpal tunnel because it was so difficult afterwards. My supervisor at the time reminded me that we were seeing only the complications and failures, not the successes, of which there were at least 10 for every one patient we had. I'm guessing that there are at least 10 people who don't experience boundary violations such as we have discussed here for every one we have.
gg
Posted by Racer on February 1, 2004, at 14:20:50
In reply to Re: Dr. Bob, A special request?, posted by Dinah on February 1, 2004, at 12:47:38
Posted by Karen_kay on February 1, 2004, at 14:23:46
In reply to special request? Second the motion, Dr Bob (nm), posted by Racer on February 1, 2004, at 14:20:50
Posted by Racer on February 1, 2004, at 15:32:35
In reply to My therapist sometimes refuses to answer me, posted by Dinah on February 1, 2004, at 9:11:53
(Since I haven't been to this Babble Board long, you all may not know I ramble and rant. After this, though, you'll be forewarned.)
I've read all the posts, think there's a lot of good thought in this thread. It's hard to think of what I really want to say, so I'm going to cut and paste and respond to some of what's already been said. More rambly, but maybe more clear? We'll see...
From gardenergirl:
I think fallsfall made a lot of good points. I just wanted to add something. This is a self-selected group of people on this board. We are here to ask and answer questions. It makes sense that there would be a lot of questions about boundary crossings, because when it happens, it's confusing. You wonder if your sense of it is correct, and you want other opinions. When T's maintain boundaries, there's really nothing to question.
Response:That makes a lot of sense. All of us here belong to a specific subset of the larger group of All Those In Therapy. We're the ones who're willing to discuss these things on a public bulletin board behind our board names, and disclose personal details to strangers in the safety of semi-anonymity, and we're all computer literate enough to have found this board and figured out how to use it. We may also be more introspective, and thus more likely to question boundary crossing and other therapeutic issues.
From Karen_Kay:
You can make believe that you have some sort of "friendship" or relationship and you divulge all of you feelings to a stranger. A stranger who helps you sort things out. But in reality, there really isn't a friendship or realionship at all. Sure, you may be the favorite client, but there really isn't hope for much else in the future.
Response:
I don't see it that way. I see my relationship with my therapist as a real relationship, within preordained boundaries. I'll never invite her to dinner or a movie, I'll never babysit her kids, we won't get together for lunch, but it is a real relationship nonetheless. It's just that it exists within a limited set of boundaries to which we've agreed in advance. Does that make sense?
OOOH! It's a Formally Structured Relationship, how's that? I think that's what I'm trying to say.
More from KK:
And what's the harm in feeling special? Isn't that what everyone wants? I hope that he makes all of his clients believe that they are his favorite clients.
R:
Absolutely! And here's something from my Real World Experiences, that I think supports it. I used to teach computer classes, and I used to teach horseback riding lessons. Both involve a student-teacher relationship that somewhat parallels the therapist-therapee relationship. I know that a lot of my students wanted to believe they were special to me, my Favorite Student. And you know what? You wanna hear what makes it so peculiar? Most of them really and truly and sincerely and genuinely *were* my Favorite Student. Simultaneously, each of them was my favorite, I couldn't possibly have chose between them. I hope that's true of most good therapists, too.
From terrics:
We often talk about her family [many times she ties the discussion in with a problem I am having???], her hobbies,her mother [which again she ties in with problems I have with mine,]her past problems with drugs[I do not have a drug problem.] She has hugged me without my expecting it, and she has said she loves me.[that was when I was considering suicide.]
RR:
I absolutely possitively think that that's both boundary crossing and unhealthy for any sort of therapeutic relationship. It shocks me so much I can't even think of anything else to say about it, beyond that.
From fallsfalls:
I think that the profession has absolutes (i.e no sex). I think each therapist should know their own personal absolutes (For one, don't tell patients their marital, parental, sexual orientation status or age. For a different one, all of those may be OK to talk about, but they don't want to talk about things that happened in their childhood). Once those rules are established, I think that the therapists need to use their judgement every single day with every single patient to see if a particular response will be helpful to the client.
RR:
Absolute agreement from the peanut gallery, and a kudo for expressing it so well.
Thank you.
From Dinah:
But is it in our best interests? Really? Does it lead us to think that we have a different sort of relationship with our therapists than we really do? Does it affect our behaviors with them in an artificial way? Does it burden us with knowledge that we shouldn't be burdened with in a relationship that is entirely for our own benefit, with monetary compensation as the only benefit to the therapist. Are the rules really bad? Is it really good for therapists to bend them, or do we just like it?
RR:
Heheheh, that really is the question, ain't it? It's a good question, and one I think is worth exploring directly with our Ts. Are we both on the same page regarding this issue, at least, and what is the benefit to the patient from using this boundary or that one?
Personally, I want to know enough about my therapist to get a sense of what he/she will understand. Most of the information I perceive myself as needing to make that assessment can be found in the T's body language, clothing, speech patterns, etc. The few remaining, I may ask, or I may not, but if I do ask them I always preface it with a lead in like, "You know, I'd feel better discussing this issue with you if I were sure you had some experience or background that would allow you to understand it from my perspective. In order to reassure me that you will understand, I'd like to ask you [insert question here] If you're not willing to answer the question, that's OK, as long as we can discuss why I asked it and why you don't feel it's appropriate to answer." That way, when I do ask a question outside the boundaries we've established, something productive still comes out.
On the other hand, when I'm in the worst of a depression, often I just hold back without asking the questions or discussing the issues at all. Then, getting anything out of me is like pulling teeth.
(Digression: one therapist I saw briefly did tell me a personal story once, though: it was our last session, because I was moving away. One of the topics we'd worked on was my self image problems, and that I look so different from the rest of my family. One of those differences is that I have small feet for my height, and everyone else has enormously long feet. The T told me about her father owning a shoe store, and bringing shoes home for her. He knew that women with small feet were considered more attractive, and that most women wanted to have smaller feet, so he'd switch the labels in the shoes for her. She didn't know what size shoe she really wore until after college, when she discovered her feet were two sizes larger than the labels in the shoes from her father. That crossed the boundaries by my standards, but I'm still glad she told me!)
Back to Dinah's original post:
Did Clinton answering the boxers vs. briefs question really inspire trust?
When our son asks how much money we make, we answer that we make enough money to take care of him properly. That's all he needs to know. To know more is to put grown up things on his shoulders. And I think there is something trustworthy about a therapist who can do the same. Who can realize that there are things that we may want to know, but that might burden us if we knew. Even if it's not positive they'd burden us, even if we don't think they'd burden us, if it's possible they'd burden us, it's their job to have the strength to refuse to answer.
RR:
I agree and disagree. The Clinton observation is a direct hit. That part not only hits the mark, but it also gives a very, very concise illustration of the debate: does knowing something totally unrelated to the matter at hand add anything to the process?
The part about not wanting personal information from a T or pdoc, that one I struggle with -- fortunately I can come here and tug at it with you guys -- because some of my own unique pathology really is unique, aside from being unique in a larger sense. I have some physical problems that impact the psychological problems, and that makes it harder to define the limits of treatment in a lot of ways. On top of that, I have a lot of information that I want placed in context for reassurance, and that leads to larger issues of my need for reassurance, and all of it needs to be done without allowing my fluency to deflect the real emotions. For example, I've worked with animals on and off most of my life, give shots, question everything any vet tells me, loved Bio in school, and have read a great deal about science and biology and medicine and especially about issues surrounding depression. When I walk into a doctor's office, I want to get at least as much information as I'd get from a vet. In animals, the first rule is engraved in stone: when a behavior changes, FIRST rule out physical causes. If a doctor denies that as a good idea for people, too, I have a really hard time trusting that doctor. (OK, that's going off target, so I'll get back on track. Suffice it to say, I'm a real pain in the @$$ as a patient!)
So, I do want some reassurance that the T or pdoc is someone I can trust, and sometimes the only way I feel safe is asking a personal question. I try to frame it within the larger context, and I try to remain open to the idea that I may not really need to know the answer. Sometimes that's enough.
Nevertheless, I wouldn't ask my pdoc if he fantasizes about me, because I think it would be quite damaging to both of us. (You only know me through my typing skills or lack thereof. A lot of men find me very frightening in person.) I might, however, be inclined to discuss the question of disclosing to each other our fantasies. Does that make sense?
Oh, dear me, look what I've gone and done. Ranted and Raved for way too long. Here it is, for what it's worth. If anyone has any questions, please submit them in triplicate using the official form...
Posted by Racer on February 1, 2004, at 15:33:36
In reply to My therapist sometimes refuses to answer me, posted by Dinah on February 1, 2004, at 9:11:53
This is a great topic for discussion. Thank you for bringing it up.
Posted by Karen_kay on February 1, 2004, at 16:21:13
In reply to Rant in Response to All (very long), posted by Racer on February 1, 2004, at 15:32:35
Wow! That was quite some rant! But, I did enjoy it :) And I hope very much to see more in the future, if you don't mind.....
The thing is, that we, as clients, tend to see the relationship for more than it really is. Or am I wrong?? Or am I the only one? Is there something wrong with me??
Or maybe we don't? I am his favorite client, after all. And that's where I get throw off. Because I feel I run the risk of being needy. [And I am truly sorry if this is off target, but it has to do with the "relationship"] I fear that I don't have a healthy attachment to my therapist. That I am far too attached to him than I should be. That I have more invested in this relationship than he does (well, of course I do, this is only his job, and IT IS my life, for crying out loud!!!). So, I try to counter that with aloofness during sessions. And I think that perhaps he tries to counter my aloofness with his openness (???? possibly, maybe). So, it's a constant struggle. A tug-of-war of sorts. I continually keep him at arms length because I feel I have more invested in this relationship than he ever will, so I have so much more to lose than he does. All he has to lose is my beautiful face, my charm, and a paycheck of course. I have my sanity at stake. That's a pretty big risk to be putting in the hands of someone I've only known for a short amount of time.
His openness has a lot to do with my inquisitiveness. I'm rather known for asking endless questions. I'm also known for setting people up to fall into my traps, which he does. And I delight in the fact that he does it. But, it also makes me realize that he's human. He makes mistakes. He's entitled to. He also calls me on the fact that I'm rather manipulative (who? me?).
I do have a question though... Why not tell a client their age? I asked Bubba his age, but only because he kept mentioning that we were close in age, yet I'm so bad at guessing ages I finally said, "I can't tell if you're 25 or 40. How old are you?" What's the harm in answering if asked?
Posted by Dinah on February 1, 2004, at 18:29:15
In reply to Rant in Response to All (very long), posted by Racer on February 1, 2004, at 15:32:35
Ok, I knew I had this information somewhere. K.S. Pope is the person who does a lot of research in this area, and he has a website. The following survey results comes from:
http://kspope.com/ethics/research4.php
Question Number 15. Telling client "I'm sexually attracted to you"
Results:
Occurance in your practice:
Never: 78.5%
Rarely: 16.2%
Sometimes: 3.5%
Fairly often: .2%
Very often: .2%
Is it Ethical:
Unquestionably not: 51.5%
Under rare circumstances: 33.1%
Don't know/not sure: 5.5%
Under many circumstances: 6.8%
Unquestionably yes: 2.4%Question #75. Engaging in sexual fantasy about a client
Results:
Occurance in your practice:
Never: 27.0%
Rarely: 46.3%
Sometimes: 22.4%
Fairly often: 2.4%
Very often: .7%
Is it Ethical:
Unquestionably not: 18.9%
Under rare circumstances: 15.1%
Don't know/not sure: 26.8%
Under many circumstances: 13.2%
Unquestionably yes: 21.9%Of course, 4.2% of those who answered the survey thought it was at least occasionally ok to disrobe in the presence of a client (question 78).
My research also shows that there is no ethical prohibition against telling a client that you are sexually attracted or fantasize about her.
I still have to question whether or not it's as therapeutically valuable, or if just would be nice to think it was.
Posted by gardenergirl on February 1, 2004, at 18:54:19
In reply to Re: Rant in Response to All (very long), posted by Dinah on February 1, 2004, at 18:29:15
Dinah,
This guy sends out stuff on a list serv I'm on. It's nice to recognize the name. And he is a very good compiler of research. Now to the real reason I'm posting a response...
>
> Of course, 4.2% of those who answered the survey thought it was at least occasionally ok to disrobe in the presence of a client (question 78).OMG! I would run screaming from the room and straight to the telephone to report him to the ethics board if Bear should do this. I would also wonder what the heck is wrong with him as I can't imagine him EVER doing something like this, but still...4.2%?????
That's frightening. do they practice some kind of special nudist therapy?
Holy cow!
gg
Posted by Dinah on February 1, 2004, at 19:04:39
In reply to Re: Rant in Response to All (very long), posted by gardenergirl on February 1, 2004, at 18:54:19
Well, it's a self report survey, so I doubt there would be any incentive to overreport. To be fair (?), 3.3% of that number thought it would only very rarely be ethical. Still.....
Posted by Racer on February 1, 2004, at 21:03:34
In reply to Re: Rant in Response to All (very long) » Racer, posted by Karen_kay on February 1, 2004, at 16:21:13
> The thing is, that we, as clients, tend to see the relationship for more than it really is. Or am I wrong?? Or am I the only one? Is there something wrong with me??
>You know, I was thinking about this after my long post, and here's what I wanted to get across and I think didn't:
That the therapeutic relationship has defined limits does not make it less *real* than any other relationship. Those boundaries make it different, but not less real. It is still a real relationship in every sense, but one of the limits is that most of the flow goes in one direction. That is, we open up to them, we talk about our pains and our gains, and they validate those pains and gains, but do not offer up their own.
> So, I try to counter that with aloofness during sessions. And I think that perhaps he tries to counter my aloofness with his openness (???? possibly, maybe). So, it's a constant struggle. A tug-of-war of sorts. I continually keep him at arms length because I feel I have more invested in this relationship than he ever will, so I have so much more to lose than he does. All he has to lose is my beautiful face, my charm, and a paycheck of course. I have my sanity at stake. That's a pretty big risk to be putting in the hands of someone I've only known for a short amount of time.
>Absolutely. This is the Carousel of Trust I've been on with my pdoc for some time. Of course, I'm much more Complex than you could ever be, so mine's much more complicated than just the attachment. [blows on nails, buffs nails on lapel] Seriously, I have just started trying to deal with my trust issues regarding the pdoc this past week and it's really, really hard. I finally managed, after a special session with the T, to tell pdoc (why do I keep trying to type pdiddy?) that I mistrusted him. Nearly cried, nearly wet my pants in terror. It's a big issue, because T or PD, we're putting ourselves at risk. In fact, we are putting our SELVES at risk. That takes a leap of faith, and it takes a lot of courage.
>
> I do have a question though... Why not tell a client their age? I asked Bubba his age, but only because he kept mentioning that we were close in age, yet I'm so bad at guessing ages I finally said, "I can't tell if you're 25 or 40. How old are you?" What's the harm in answering if asked?
>
>OK, I cut out the manipulation part, for a couple of reasons, but I'll take this one on. It's another one about my pdoc, though not my T: my pdoc looks about 12. I know he can't be, know when he graduated from med school, but he looks very young. I've overheard conversations about him at the clinic, other employees giggling together about him, and one saying to another, "{{giggle}} you'd never believe it, but he's not nearly as young as he looks..." When I said something about thinking he was "significantly younger" than I, he looked at my age on the chart, and said, "um...no." (Wha?? You're insignificantly younger? Infinitessimally younger? You can't imagine ever having to admit to being as ancient as I am? Wha?)
That said, I don't necessarily think that knowing the answer to a question like that would be damaging. I just think that reviewing your reasons for asking the question in the first place can be of more long term value. (And I wanna know so much how old my pdoc is, you just don't know. Problem is, I know why I really want to know, and it goes back to the fantasy thing, and since I know that the fantasy is only a fantasy, that he will never in this universe lay an erotic hand on me, I really don't need to know the answer. See what I mean? I know why I want to know, and that helps me see that not knowing is OK -- especially since it gives me so much more flexibility in creating fantasy situations... yummmy!)
>Now for the short version of my manipulation rant: manipulate -- it only means to shape by hand. Shaping by hand can mean craftsmanship, artistry, many good things. There's a negative connotation attached to the word, but try to look at what it means constructively: you're trying to shape the world into what you need it to be. Whether that need is real or perceived, you are trying to improve your ability to function within your world. The point of being aware of manipulation is to learn to see when you're being constructive and when you're not, so that you can shape your world for your longer term benefit.
There. Good luck, and another Rant will be along soon, no doubt... (Since this isn't out loud, it can't really be called "verbal diarrhea," can it?)
Posted by terrics on February 1, 2004, at 21:51:14
In reply to Rant in Response to All (very long), posted by Racer on February 1, 2004, at 15:32:35
Hi Racer, Your ranting was very interesting. I enjoyed it. I do have opinions on this stuff, but am usually to lazy to post them. p.s. I know my therapist breaks all the rules, but I like her. She is hetero and I am not so we won't have that problem. Well thanks for the ramble. terrics
Posted by DaisyM on February 2, 2004, at 0:32:18
In reply to Re: Therapist honesty » Dinah, posted by fallsfall on February 1, 2004, at 13:22:32
I've read through this twice, trying to put into words what I feel. I'm not sure if my Therapist holds "tight" boundaries...he is not a blank slate and does answer questions like: yes, he has kids, he told me his sign (we were talking about my birthday) he told about an author he met that we both have read, etc. He has refused to answer questions though, but we explored why I asked and he tells me why he won't answer. We start and stop on time, but he encourages calls in-between as needed and extra sessions (these are paid for, of course.) But it feels to me like he knows how to be personable without being too personal -- does that make sense?
I also appreciate his humor and wit - and the fact that he appreciates my intelligence. I don't want someone who treats me either as immature or as unobservant. (He told me once that he was aware that I missed NOTHING.) But he doesn't tell me his problems, ever, and I wouldn't engage in "his sexual fantasy" conversation with him for a number of reasons but mostly because I want to keep him in the role of someone I respect professionally. Otherwise I would quickly move into the authority role, taking over as the one in charge, as the one teaching and leading and remove any vulnerability that might be present. Maybe the best way to put it is that he seems very mature and secure with himself so we can focus on me.
So, I guess I think that while each Therapist should be flexible about disclosure, they should know themselves and their personally selected boundaries very well and be consistant about adhering to them. I think a lot of the pain and confusion I've seen posted has to do with boundaries that move-- either suddenly tighten up or get too loose.
Dinah's right -- Disclosure should be done when it is either inconsequential or theraputic to do so -- but never lightly and without fore-thought. And it might be that we don't like it, it might be painful (Racer's analogy of hand-therapy - painful but necessary to get better) but ultimately it is what we need.
It makes me think, in some ways, of being the boss. You want everyone to like you, you'd like to be their friend but most of the time you can't be. You have to "enforce" the rules. This doesn't mean that we don't apply the rules individually but most of the time the rules were created to protect both of you. Ignoring the rules in favor of "being nice" usually backfires...lessons learned the hard way.
Posted by Racer on February 2, 2004, at 14:44:58
In reply to Re: Therapist honesty, posted by DaisyM on February 2, 2004, at 0:32:18
That was so well stated and clear, and I agree absolutely. This is something that I struggle with a lot: I'm the trainer, I'm the one with the answers, I'm the one in charge, I'm the one who can't delegate because it wouldn't be done right if I didn't do it myself. In order for the therapy to be successful, I have to be willing to accept my vulnerability to the therapist, thus allowing her to play her role in the process. And that's damned hard for me to do, because I am The Boss and In Charge.
Ironically, that's what my last session was about: being able to cede control, and the fears involved.
So, here's my developing theory on this matter:
Ethical standards mostly fall into a sort of bell curve, where many things are appropriate under many circumstances, and a few things are always appropriate or inappropriate no matter what the circumstance. That means that for some of us, the PowerChargers amongst us, the therapist might be most effective by enforcing the boundaries quite strongly. For someone more inclined to be passive, stretching the boundaries might be more productive.
I liken it to child rearing. A child who is given strictly enforced boundaries, with immediate and substantive consequences for crossing them, will learn to feel secure. That's because the parent is acting as a sort of external conscience, exerting control in order to help the child learn to control himself or herself. Not control in the micromanaging sense, but control in the good sense -- like having working brakes in a car. A good parent gradually widens the boundaries as the child grows, so that the security the child has learned can grow into self confidence and an ability to adapt to new circumstances, out of which process comes autonomy, and a healthy adult.
A good therapist, in a sense, is being a Good Parent. For the individual who is locked in the helpless stage, the therapist helps define boundaries and assists the patient in learning to live within them comfortably; moving towards reassuring the patient when the time comes to start getting more independant. For another individual, someone who's learned not to trust anyone else, and that our needs can only be met by our own actions, the same Good Therapist might be more inclined to act as a safe depository for our trust, while strictly enforcing the boundaries in order to minimize our instinct to push on every potential weak spot.
OK, that got longer than I intended, and much more convoluted than I had intended. Boiled down, I agree with what you said, and see in it a starting point for defining a good therapeutic relationship.
Phew, I'm out of breath...
Posted by terrics on February 2, 2004, at 16:06:16
In reply to Excellent! » DaisyM, posted by Racer on February 2, 2004, at 14:44:58
Daisy and Racer seem to have rapped up what a good therapeutic relationship should be like. Yet in a strange and very loose-boundry way I think my therapist is good at what she does, but she sure as heck does it differently. terrics
Posted by DaisyM on February 2, 2004, at 16:19:49
In reply to Re: Excellent!, posted by terrics on February 2, 2004, at 16:06:16
And, we are back to Fallsfall's point of something for everyone is what we need, not the "one-size fits all."
I'm glad she is good for you. That is what counts.
Posted by fallsfall on February 3, 2004, at 17:31:36
In reply to Excellent! » DaisyM, posted by Racer on February 2, 2004, at 14:44:58
A very wise friend told me the other day:
"Please don't take this amiss, as it is meant in all kindness, but I do think you have a strong tendency to want to "fix the therapist" -- ultimately un-useful, except as it provides clues about you. Who you really want to fix is your parents and the trauma from way back then -- that's the core work. Turns out only thr trauma from way back then can be fixed. Very harsh reality."
Maybe we should start a "Fix The Therapist Club" - the FTTC!
Posted by Dinah on February 3, 2004, at 17:48:56
In reply to Who is in charge? » Racer, posted by fallsfall on February 3, 2004, at 17:31:36
I dunno. My therapist has improved immensely under my tutelage. (grin) Even he admits it, though in slightly different terms.
Posted by Karen_kay on February 3, 2004, at 19:59:03
In reply to Re: Who is in charge? » fallsfall, posted by Dinah on February 3, 2004, at 17:48:56
Weeelll. not to brag or anything but if anyone's taking home an award for helping improve their therapist... Well... I WIN... Gimme gimme gimme... He was expaining something to me today and I grunted and he said, "Well, you sound displeased." I said, "Heck yeah I do. You make me sound so clinical. Like you just read 'my case' straight from a text book." He never before realized that he did it. Hello, pin a bow on my head.. I'm going to the county fair..... I've helped future clients today to not feel like some clinical case when he later refers to how they aren't &^^*& able to form emotional attachments... And yes I'm still a bit upset about this... :) (But, to make matters worse, after I pointed it out he tried to retell me in a different way so it didn't sound quite so clinical. Well, I already understood it the first time he said it. He didn't have to tell me a second time... I was just upset that he told me in such a way that I was rather "removed" from the situation, as if we were talking about someone else. But, to retell me again! Oh, the nerve!!! Hello, I understood the first time. I'm not so dense that I can't understand you when you say it in a removed fashion.... Don't give me bad news twice!)
Posted by Dinah on February 3, 2004, at 20:27:12
In reply to Re: Who is in charge? » Dinah, posted by Karen_kay on February 3, 2004, at 19:59:03
Ahhh, but I taught mine how to handle clients when they quit so that they feel free to come back.
And patience. Lots of patience. :D
Posted by Racer on February 4, 2004, at 9:31:31
In reply to Re: Who is in charge? » Karen_kay, posted by Dinah on February 3, 2004, at 20:27:12
OK, obviously not a T here, but one of my clients "fixed" me once, and I'm forever grateful to her. As a riding teacher, I'm pretty tough. I will tell you you're not working hard enough, and I will tell you that the horse is not a sofa you get to lounge on. Oh, and some days I get so frustrated at getting students who've been allowed to move ahead faster than they should simply because their old teachers never took the trouble to ask them to work harder.
So, one day, one of my students said to me, "You know, you're a really good riding instructor. Just try to remember to tell us what we're doing right..."
That was like the 2x4 to get my attention. It made me a better teacher, and I've been profoundly grateful to her ever since. I'd bet we do the same to our Ts more often than we think, and I'd bet they're grateful for it, too.
(Acting on that theory, I always tell my T when she says something that really resonates for me. Maybe it doesn't help, maybe it does, but at least she gets more clues to working with me from what I point out.)
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