Psychotherapy Perspectives

Sunday, September 03, 2006

Boundaries in Psychotherapy Practice

(Excerpts from workshop on “Boundaries” at Children’s Bureau presented by Margy Davis Mintun on August 31, 2006)

By Margy Davis-Mintun, LCSW, ACSW

Boundaries in Psychotherapy practice are established to create safe, reliable and useful platforms for the work to take place, and are the most fundamental responsibility of the Psychotherapist in client relationships in order to establish the ground for therapeutic work.

Boundaries define personal space and can be characterized as physical, behavioral, verbal and emotional. Boundaries can be strong and healthy, rigid and inflexible, distant and fused (lacking definition).

Two aspects of boundaries are going to be discussed,
- Boundaries within the Psychotherapist
- Boundaries between client and Psychotherapist

Boundaries with self include the somatic base of experience, the sensations of our body, and the awareness of our own emotional responses, our belief system, and our interpretation of our history. These define our experience with distance and proximity and reflect how we each navigate levels of connection and distance in our own relationships.

In the process of knowing our own boundaries, we become aware of our body sensations in relationship to others. This knowing helps us to gauge the comfortable and uncomfortable.

The distance at which each of us feels comfortable/uncomfortable, often reflects our personal experiences with levels abandonment or control. Our early childhood experience with our primary caregivers, and our notion of safety and danger in relationship, also reflect our history of boundary violations. These factors have shaped the level at which we are comfortable with others, our own boundaries, and the line at which our personal preferences are drawn.

The Psychotherapist who ignores their own needs in the service of the client runs a great risk of becoming vicariously traumatized and/or traumatizing the client. This occurs when we ignore our own experience of distress or boundary discomfort and don’t take action to address our internal or external conflict and it mixes with our perceptions of the needs of the client. Our lack of awareness of our own personal boundaries, and/or self care can lead to resentment and/or unconsciously blaming the client. This can create situations that adversely impact self, the client, and the relationship.

The ability to identify behavioral boundaries begins in childhood in a secure attached relationship where cycles of arousal and relaxation lead to appropriate self regulation. This is as simple as when a child cries and someone picks them up, feeds them, or changes their diapers.

The ability to self regulate emotional states is established as we learn to replicate for ourselves the experience of arousal and relaxation. Learning how to pay attention to internal signals of discomfort and distress in our body sensations and respond to the unmet need by self soothing or taking action.

The ability to have connection to our own personal experience in the context of doing our work allows us to have the means with which to attend to our reactions, so that we can regulate our emotional responses. This means that by attending to the signals from body sensations, emotional responses, and physical comfort, we are addressing our own comfort level and thereby decreasing the possibility of confusing them with client experiences.

Another area of boundaries involves the social context that often informs us of what is acceptable and unacceptable in our social environment. Examples are the secrets we keep, the intimate details we might reveal to specific persons, and the honest ability to say yes or no or to express an opinion. We are influenced by our experience as to what is acceptable, including how much room we have to be honest, authentic, and genuine in our relationships. When we can validate for ourselves what we feel and think, we can more fully sort out our experience. This allows us to be more honest and experience integrity and a sense of connection with others. If we pay attention to the signals in our body and emotions, we can be informed about what is right for us at a specific interaction/time. If we says “yes” and are unaware of the “no” in our body, we may be in contradiction to our true feelings and may be at risk for compassion fatigue. This does not provide healthy modeling for clients.

Boundaries also define the space with our bodies. This space has an intangible but physical energetic quality. Physical boundaries may extend beyond our body varying in size of radius and sometimes may be larger or smaller.

You may notice times when you feel a particular person is too close at a specific time and you feel uncomfortable. Another time, you may experience the person’s proximity differently. Unlike defenses which are rigid, boundaries are flexible and can change depending on the person and or situation.

Another area of boundaries that can arise is around the spiritual beliefs and how these relate to our interactions. For example, if I believe in fate or free will, how does this belief system play out in my decisions and my expectations and interpretations of events, and my relationships? If I believe life is predestined then I may understand my life experiences as part of a greater whole and may have a sense of acceptance about the events and relationships that are in my life. Whereas if I believe in free will, my interpretations about how my life unfolds will have a completely different meaning as will my belief of my ability to influence the events in my life. The awareness of these beliefs will have some effect on how I also interpret the events in the other’s lives.

We as humans tend toward two responses to boundaries with others. Either we tend to hold back and not travel to the edge of our boundary with others by being somewhat cautious and tentative, or we tend to cross over the boundary and notice later down the road in the relationship that the boundary had been passed. In this case we have to back track to a more comfortable place.

What is important in our relationships with clients is that we find a way to be able to either stretch to a more expansive boundary which allows for more full contact with another, or to contract from the spaciousness that creates boundary confusion because we have gone to an unsafe place in our relationship.

9 Comments:

  • Boundaries in psychotherapy and counseling also refer to boundaries between therapists (i.e., touch, language, self-disclosure, gifts, distance) and clients and boundaries around the therapeutic space (i.e., confidentiality, bartering, dual or multiple relationships. As my article at http://www.zurinstitute.com/dualrelationships.html describes there are boundary violations and boundary crossing.
    Ofer Zur, Ph.D.
    Zur Institute
    http://www.zurinstitute.com

    By Blogger Ofer Zur, At 12:34 AM  

  • In my experience clear boundaries are crucial and create the safety which enables the client to test the relationship.

    By Anonymous Christine Bonsmann, At 2:16 PM  

  • Christine is correct, clear boundaries are important. However, clear boundaries should not be equated with rigid boundaries. Some clients and situations require more structured therapy and consistent and clear boundaries. Then they are clients who can benefit from flexible application of therapeutic boundaries. As my article at http://www.zurinstitute.com/boundariesintherapy.html asserts, rigid boundaries can be harmful and clinically ill-advised.
    Ofer Zur, Ph.D.
    Zur Institute
    http://www.zurinstitute.com

    By Anonymous Ofer Zur, Ph.D., At 1:06 AM  

  • Important post, thank you. I think both inner and outer boundaries need to be very firm and clear. Agree also with the first comment about boundary violations/crossings... we must keep these in check.

    By Anonymous Psychotherapy Melbourne, At 12:46 AM  

  • I am in therapy and just starting to understand "boundaries", I googled the word and this came up. It's been a helpful read - thanks!

    By Anonymous Anonymous, At 9:42 PM  

  • As a psychotherapist in London I find that this question of boundaries is essential for a good therapy to happen. My experience is that it can be sometimes difficult to maintain the boundaries, especially in private practice. Working in an institution provides a bit more containment, as you have the institution itself to provide some of the boundaries. But private practice is a bit more exposing, and the therapist must always have internal and external boundaries in the mind when working with the patients.
    Thanks for writing about this topic. All the best!

    By Anonymous Allan Gois, At 4:37 AM  

  • I am curious what folks would have to say about boundaries with respect to an experience I had with a therapy cult. I'd be interested in people's thoughts. You can read a piece I wrote about it on BrooWaha: http://www.broowaha.com/articles/14106/the-politics-of-therapy-and-the-therapy-of-politics

    By Blogger Unknown, At 6:37 PM  

  • Thanks for sharing! Most newly qualified counsellors and psychotherapists are clear about is the importance of therapeutic boundaries. They may not necessarily be very good at maintaining them, but they know that doing so is essential.


    Psychotherapy New York City

    By Anonymous psychological counseling services, At 1:17 AM  

  • Thanks for sharing, There are many reasons people can experience emotional psychological distress.Psychotherapy and Counselling can address concerns of self medication, and support and address the emotional distress and life issues, which most often lie underneath habitual self medication.psychology.ws | Psychologist NJ

    By Blogger Unknown, At 4:40 PM  

Post a Comment

Subscribe to Post Comments [Atom]



<< Home