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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by JayJ on September 18, 2008, at 16:50:20
I just saw this article on dual relationships with Ts (non-sexual). It's more on the question about what we can and can't ask/hope for from our T. I feel conflicted about some of what it is saying. It sounds reasonable and very interesting (if long), but on the other hand, it sounds like some of this is over the line? Is this out in left field or how seriously can we take it?
http://www.zurinstitute.com/dualrelationships.htmlJayJ
Posted by lucie lu on September 18, 2008, at 17:25:29
In reply to dual relationship with therapist?, posted by JayJ on September 18, 2008, at 16:50:20
Hi Jay,Interesting...I'm just reading through the article. It is long and does require some thought. What do you feel conflicted about? What sort of therapy are you in right now? I think that does make a difference.
Lucie
> I just saw this article on dual relationships with Ts (non-sexual). It's more on the question about what we can and can't ask/hope for from our T. I feel conflicted about some of what it is saying. It sounds reasonable and very interesting (if long), but on the other hand, it sounds like some of this is over the line? Is this out in left field or how seriously can we take it?
> http://www.zurinstitute.com/dualrelationships.html
>
> JayJ
Posted by lucie lu on September 18, 2008, at 17:34:37
In reply to dual relationship with therapist?, posted by JayJ on September 18, 2008, at 16:50:20
Actually, Jay, I did read it through although I didn't go to any of the links. I have to say that I found it a realistic and responsible, pretty clear and detailed treatment of the subject, sensitive to the boundaries of both Ts and patients/clients. I agree with the distinction between boundary crossings and violations. My T, who is psychodynamic in his orientation, has done some boundary crossings - which have turned out to be been extremely helpful - and no boundary violations, no slippery slopes. I know he would subscribe to these guidelines.
But it sounds, Jay, like you have some concerns in this area. Would you like to talk about them?
Best, Lucie
Posted by lemonaide on September 18, 2008, at 18:44:32
In reply to dual relationship with therapist?, posted by JayJ on September 18, 2008, at 16:50:20
I believe duel relationship are not a good idea and should be avoided at all costs. In that article I was on a medium level with my T, and it does changes the views of the relationship on both for both sides.
Even doing business with friends or family, or dating someone within the same company, could also lead to disastrous outcomes.
Posted by lucie lu on September 18, 2008, at 19:30:35
In reply to Re: dual relationship with therapist?, posted by lemonaide on September 18, 2008, at 18:44:32
The article was not suggesting those sorts of dual relationships. The author was including things like living in a small community (does the T stop going to church if it's the only one in town and his patients also go?), being in the military (ditto), a professional relationship (supervision?), and other settings (gay communities, sports communities) where extra-therapeutic contact is unavoidable. In some settings, eg police, apparently it is even mandated.
The author correctly points out the distinction betwen boundary crossings and boundary violations. Lemonaide, your T was guilty of numerous boundary violations, from what I remember. That is very different from boundary crossings, which can include very healing things like accompanying a patient to an appt or somewhere else where they should go, but can't without help from their T, taking a walk with a depressesd patient, etc. Is that wrong or untherapeutic?
I would be among the first to condemn any exploitative relationship (including some that have been discussed on this board). But I have to agree with this author on most points, which seem to be presented responsibly, including:
"There is a prevalent erroneous and unfounded belief about the 'slippery slope' that claims that minor boundary crossings **inevitably** lead to boundary violations and sexual relationships. This somewhat paranoid approach is based on the 'snow ball' effect. It predicts that the giving of a simple gift likely ends up in a business relationship. A therapist's self disclosure becomes an intricate social relationship. A non-sexual hug turns into a sexual relationship.
A rigid attitude towards boundary crossings stems, in part, from what has been called 'sexualizing boundaries." This is another distorted view that sees *all* boundary crossings as sexual in nature."Note - boundary crossings, not violations.
I have to say, and many of you who also share a *good, caring, and health-promoting* relationship with your Ts -- the giving of a small gift, one (or more) non-sexual hug(s) when the occassion called for it, or a few (solicited) items of self-disclosure -- were these in any way exploitative? Or were they therapeutic, and done with only your best interests in mind? Those are examples of boundary crossings.
This paper condemns in no uncertain terms ALL sexual and exploitative relationships between Ts and patients. So I don't see what is objectionable about what this author has written. It seems very thoughtful and responsible to me. I think that, especially with our histories where it might be a temptation, we need to take care to avoid knee-jerk reactions without looking carefully at the facts.
Lucie
Posted by seldomseen on September 18, 2008, at 20:20:58
In reply to Re: dual relationship with therapist?, posted by lemonaide on September 18, 2008, at 18:44:32
"I believe *duel* relationship are not a good idea and should be avoided at all costs."
What a freudian slip! That's one of the best I've seen on the boards. LOL!
Any way, to a certain extent I agree with you. I think a therapist should no more enter a patient's life than a basketball coach should enter a game.
Now, having said that, my therapist has given me gifts before and I have given him stuff.
I simply can not imagine my therapist going to the doctor with me, or anything of the sort. I just don't see that as his role. We can talk about my trepidations about going, but this is my life and it's mine to lead.
The goal, I think, is to internalize the therapist such that the feelings about them are "with" you all the time.
If I ever marry, however, I think we will both be so shocked that he would want to come just to see if miracles really can happen.
Seldom
Seldom.
Posted by JayJ on September 18, 2008, at 20:55:26
In reply to Re: dual relationship with therapist?, posted by lucie lu on September 18, 2008, at 17:34:37
I'm still working out a lot of this stuff in my head. My T is mostly psychoanalytic/psychodynamic in approach, at least with me so far, although it seems like he will throw at the problem whatever he feels will work best. I don't think he is a purist in his approach, which is fine by me. I already have complicated feelings about him, who doesn't with their T? I find solid boundaries very reassuring in some ways, but keep wanting to push them - hopefully in an OK way. It worries me some, which is why I was poking around the web on the subject of what's OK. I like to try to read up on everything. I never want anything to get like what Sassy has had to deal with. Just posted this link here to get a sense of what people who have been in therapy for a while thought about this view of things. I think I still have a lot more stuff to figure out in my own head before I can move forward. I just like to come here to read how other people deal with all these issues, it's kind of reassuring. - JayJ
Posted by antigua3 on September 19, 2008, at 6:40:04
In reply to dual relationship with therapist?, posted by JayJ on September 18, 2008, at 16:50:20
Thanks for the article; I found it very interesting.
I think I have (or at least have had) a dual relationship w/my T. Our kids went to the same small school and I had to learn how to deal w/running into her. It was difficult at first, but she helped me tremendously. Also, I can identify with several of those boundary crossings--regular hugs, sending cards, giving gifts, etc. (In all the years, I think I've only given my T flowers one beautiful day last year. She gave me gifts when my children were born.)
I don't know if it would work for everyone, because as you said, some people feel more comfortable with the rigid boundaries (my pdoc, e.g.) because then they know exactly what is expected of them. I'm usually like that, but my relationship w/my T is just different.
I also agree that there are distinct differences between therapeutic crossings and boundary violations, and that the crossings don't have to lead down that slippery slope. But maybe I'm wrong.
thanks again,
antigua
Posted by sassyfrancesca on September 19, 2008, at 12:53:03
In reply to dual relationship with therapist?, posted by JayJ on September 18, 2008, at 16:50:20
>
> I just saw this article on dual relationships with Ts (non-sexual). It's more on the question about what we can and can't ask/hope for from our T.I read Dr. Zur's articles years ago. I agree with him.
I feel conflicted about some of what it is saying. It sounds reasonable and very interesting (if long), but on the other hand, it sounds like some of this is over the line? Is this out in left field or how seriously can we take it?
Some of the therapy rules (to me)are kind of ridiculous; like not having a relationship with a t at least for 2 years upon leaving.
I have been having a dual relationship with my t for over 4 years.
Works for me.
> http://www.zurinstitute.com/dualrelationships.html
>
> JayJ
Posted by JayMac on September 19, 2008, at 14:17:46
In reply to dual relationship with therapist?, posted by JayJ on September 18, 2008, at 16:50:20
A few weeks ago, I spoke with my T about dual relationships. At the time, I was desperate to form a stronger connection with her. I want(ed) to know her inside and out.
I asked her: Why can't we have a relationship outside your office?
To paraphrase, she said: Because that sort of relationship requires that both parties meet each other's needs. Having a relationship with me would require that you meet some of my own needs. You would lose your therapist. The beauty of the relationship that we have now is that I can meet your needs, and you don't have to worry about meeting mine.
I then asked: That makes sense, but what about after therapy, can we have a relationship outside the office then? (By the way, I asked because we have a lot of similar interests, there's a chance I may attend the school where she teaches, plus I can't imagine working with her for so much time, and not having a reciprocal relationship after therapy.)
Basically, she said: I don't know. There is no way to know that right now. But for right now, our relationship in here is real (I had previously expressed concerned that our relationship feels to me to be too one-sided and unreal) and this is all a part of the process. I'm a real person in this very real setting. Most importantly, I'm here to meet your needs.
I was/am impressed with her response. It was hard to swallow at first, but from her perspective and mine, I understand her stance. She said she is protecting me. She said that the ethics revolving dual relationships is to protect the patient.
Everything the therapist does should help the patient AND protect the patient from harm.
Posted by JayJ on September 19, 2008, at 14:22:57
In reply to Re: dual relationship with therapist? » JayJ, posted by sassyfrancesca on September 19, 2008, at 12:53:03
Thanks for your replies, it's very helpful to hear different peoples thoughts. I suppose ultimately it comes down to different strokes for different folks. I know it doesn't have to go that way, and I know in some cases there may be no choice (small towns etc), but it seems to me that there is a greatly increased risk of the slippery slope once you start crossing boundaries. I know I have my fantasies, but the thought that the relationship could really slide down there makes sure it all stays in my head. I know I should talk to T about it, but not ready yet. Maybe I'm just very risk averse - sounds like me.
JayJ
Posted by lucie lu on September 19, 2008, at 15:26:50
In reply to Thanks to all, posted by JayJ on September 19, 2008, at 14:22:57
Hi Jay,
I think the last thing you said is the most important... what really matters is how you feel in therapy and whether your T's efforts and actions are therapeutic. I think everyone is agreed that boundary violations are BAD. But boundary crossings... well, one person's crossing is another person's therapeutic breakthrough. And a good T may do something under special circumstances (even allowing you to call their home in an emergency could be viewed as a boundary crossing) and then gently lead you back to more usual behavior. A good T is committed to keeping you both safe from harm by boundary maintenance. A bad T will not. I think the whole issue is that there are unethical Ts and these have to be stopped dead from pursuing those slippery slopes. But those ethical ones - our good Ts - who really have only our welfare and healing in mind, may choose *with the consent of the client* to bend things now and again.
The truth is, Jay, there really isn't a standard against which boundary crossings can be measured. Hugs? Anethema to Freudians and yet very common, even endorsed in more humanistic therapies. I think the latter would be very offended if they were seen as "unregulated" Freudians! Refusal of a small gift would be considered untherapeutic in most types of therapy. And phobia deconditioning Ts often accompany patients out to places they are phobic of. That is just part of what they do clinically. Boundary crossing? So boundary crossings are almost impossible to quantify because there is no one standard way to conduct therapy.
That said, I think it's widely agreed that there is no sex with clients. Period. That's the ultimate boundary crossing. Friendships outside of therapy, common business interests, both usually no-no although, as mentioned before (very small town) there may be obvious exceptions.
But Jay, there's one thing that applies no matter what - and that's that if you feel uncomfortable with something your T is doing, speak up immediately! This could include a lot of things that are well-intentioned but just don't work for you. If you find yourself in that situation, talk honestly with your T. Remember, therapy is something that is done with you, not to you. You are an equal partner in your therapy.
I really have to apologize for getting so aerated about this subject! It's because, while I understand that some people on this board have had disastrous experiences with terrible or unethical Ts, others of us are lucky enough to have very caring, loving, thoughtful Ts who would never dream of hurting us. I get upset when I hear them being tarred with the same brushes as their unethical colleagues. So I do resent any suggestion that their kind efforts are potentially slippery slope behaviors. I really think the location and steepness of that slope depends critically on the T.
OK off the bandstand!
Posted by lucie lu on September 19, 2008, at 15:31:20
In reply to Re: Thanks to all, posted by lucie lu on September 19, 2008, at 15:26:50
Posted by JoniS on September 20, 2008, at 22:12:41
In reply to Re: dual relationship with therapist? Protection, posted by JayMac on September 19, 2008, at 14:17:46
JayJ
I love how your T explained all that. She sounds great!
thanks
Joni
This is the end of the thread.
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