Posted by twinleaf on May 28, 2007, at 11:29:46
In reply to here you go... the ethics thread, posted by gazo on May 28, 2007, at 9:52:06
I think that the different schools of therapy, such as the interpersonal and interactive versus the more traditional ones, are not as important as the relationship that develops between a particular therapist and a particular client. There are some basic givens- the type of person each really is is probably the most important; we all have to work within that- a rather introverted, cautious therapist is not going to change very much in the process of conducting therapy, although the client may. We are so lucky if we happen on a "good fit".
Things like gift-giving, and even phone calls, e-mails and notes, as well as spontaneous affectionate comments, might be considered "boundary crossings"- not violations- by some therapists, and not at all by others. It's so clear from a number of posts here that all of these things can be very meaningful in therapy- to both therapist and client. All the good things that happen seem to arise out of a relationship which is already strong, trusting and warm (or at times when it may not be, the possibility is there to talk it all out so as to get back on track.)
I have been to two psychoanalysts, and, although I think they as a group are gradually becoming more interactiive and spontaneous, I do think they are the ones most likely to have been trained to not receive gifts, notes, e-mails, etc. I have never had the impulse to give a gift, as I kind of know they won't receive it, and will want me to talk about why I wanted to give it. That's a little sad, as they become so important to you, and you want to find ways to let them know how much you appreciate your relationship with them, and what they are helping you to do. One thing, by way of compensation, is that, with all their training, they are the world's best listeners- whatever on earth you find yourself feeling or saying, you feel that they are listening with their entire minds and hearts- and that is very validating- being so deeply heard. Of course, analysts don't have a monopoly on that; I'm sure all good therapists, whatever their training and point of view, do that.
I think, too, that each therapist has to make careful judgements as to what is best for each cient, and it will probably be slightly different for each. For example, a therapist will have to be very careful about allowing regression to occur with clients who have had very inadequate or neglectful mothering early in life. Each boundary crossing, such as gift-giving, spending extra time, etc., may cause the client to, consciously or not, hope that that terrible early situation will be made right by the therapist. He/she can do this partially, and to an extent, in good therapy, but never entirely. It's not going to help, and may even be damaging, if the client comes to feel that it can be.
Another area which can be quite tricky: clients who have low sexual self-esteem often feel the need to have everyone in their environment consider them sexy, so maybe they'll be able to, also.. A little bit of implicit sexual interest and regard by the therapist can be helpful - he's standing in for the unappreciative father- but if it goes too far, it will lead to inevitable feelings of disappointment, rejection and even lower self-eseem. I won't comment on sexual affairs with therapists here, as those are outright boundary violations, which we all know are very wrong. I think this topic- what constitutes a boundary crossing, and when they are, or are not, helpful- is a great one. I hope lots of people will contribute!
poster:twinleaf
thread:759943
URL: http://www.dr-bob.org/babble/psycho/20070525/msgs/759967.html