Crossing Therapy Boundaries?

[katiekat]

I had a very awkward experience in therapy yesterday and I am hoping someone can help me sort out how and why I feel so freaked out by it.

The conversation started with my therapist asking me if there is any reason that I can think of as to why my previous therapist would not call her back. I signed a release form and she submitted it to his office, so it's technically legal for him to disclose information to her because I signed off on it. It has been 2 months since she has first tried to make contact with him. I told her I am not sure why he isn't calling her, that him and I had a closing session when I stopped going to him (though I did go back one time after that to get some quick advice since I hadn't found a new therapist yet). He gave me referrals to other therapists to look into, and even sent me an article that he thought would be helpful for me about a month after the last time I saw him. I do not know why he won't call her back.

In that same conversation, she asked me if he had ever touched me inappropriately (no), and if I had ever given him gifts. At this point, my face was starting to turn red and I was getting really uncomfortable because I had give HER a gift a few weeks ago. It was a small plant and a homemade cookie. The plant was a start off one of my plants, and I have given many of these to friends and coworkers over the years. She told me it is extremely rare for a client to give a gift, and that most of the time, ethically, she has to give them back. She asked why I gave it to her and I said "Because I wanted to show my appreciation for how you are helping me."

She then brought up the fact that I email her between sessions. I had told her previously that my other therapist would encourage emailing between sessions and would respond, or send articles or TED talks that applied to me. She asked if he charged for that, I said no. She told me that gift-giving and emailing outside of sessions like that is crossing therapy boundaries. It made me feel extremely uncomfortable, almost like she felt I was taking advantage of her time. When her and I talked during our second session about how my therapist allowed me to email him, she said I could email her, but that we would talk about it in the next sessions. So, I have sent her one email each week, nothing super long or crazy, but just feedback on our sessions or things I wanted to talk about.

I find it really hard to swallow that sending emails and giving a small token of appreciation is crossing boundaries, especially since she runs her business out of her home-I would think THAT would be crossing the boundaries even more so. I find this part of therapy confusing because I have told her things no one else knows, yet there are these unspoken boundaries that are not to be crossed-which makes it feel like I can't be 100% open to her because she isn't open to me. Does anyone else struggle with these unspoken boundaries, and why are they in place? I mean, I get it to a certain extent, but I feel like I did something "bad" and it's making me not want to go back to her.

 

[shandemonium]

My first gut reaction to this is she has a giant stick up her you-know-what and she needs to take it down a notch.

A plant and a cookie is nothing but a sweet gesture and would be an appropriate gift for anyone in your life! You could give that to your mailman and it wouldn't be weird!

Maybe she is fresh out of school? Sounds like she is lacking some wisdom and she is nervous about where the boundary is supposed to be for her profession. It's also shitty that she asked you about the gift in a hypothetical way instead of just telling you directly that your gift made HER uncomfortable. Gross.

I know how hard it is to find therapists, I'm in that grueling process right now. But I would rather find a good one than waste any of my time and energy on a bad one. Just my two cents. It's totally your call.

Sending you support! And remember, therapists are people too and can be just as crazy as anyone else.

 

[shandemonium]

One more after-thought..

In my entire experience with therapy and healing, if I feel like the person does not genuinely care for me (like if I'm just a cold "client" or source of money) I can feel that very much and those people can't help me.

I believe there has to be heart present for any healing to happen. They don't have to intensely love us, but love has to be present. That is the difference between a true healer and someone who took a bunch of classes... (in my opinion!)

 

[Justmehere]

She sounds like the one who needs to work on boundaries, not you. She is expecting you to read her mind and know her boundaries without communicating them. She is expecting you thread his mind about why he is not calling her back.

Nothing about this indicates you did anything wrong. What you did was sweet and she had the opportunity to return the gifts if she wanted to, but I don't see any harm in what you did at all.

If all else is going well with her, I would take this as a miscommunication, and even possible projection by her of her own failure to keep theraputic boundaries.

Not your fault at all.

 

[sun seeker]

The therapist should be the one to initiate telling you what her boundaries are. You should not have to guess. She sounds new and inexperienced to me, and maybe not entirely clear on her boundaries so maybe she is adhering to the rules more rigidly than someone with more experience would.

In a therapeutic relationship there is a clear imbalance of roles where the client is more vulnerable and the therapist in a more powerful position, which is why they have to be so careful not to overstep guidelines that could make things weird between you. But it's because of that imbalance that it's the therapist's responsibility, not yours, to define where that line is. Just like it's a parent's job and not a child's.

I just started with a new therapist and was pleasantly surprised when she told me the rules right away; I've never had this happen before: she's not allowed to receive gifts, it's fine to call between sessions but it might take a while to get back to me so if in crisis call the crisis line, if we run into each other on the street she won't initiate contact in case it's awkward for me but if I want to say hello that's fine, and if I have a complaint the process is such-and-such. It really helped to have it all spelled out and I don't know why not all therapists do this. Could you ask her to define what her rules are in case there are more that you don't know about?

 

[digger]

Slightly different angle.

I think it depends how she was saying these things to you, and how long you've been seeing her. I don't think you've done anything wrong, but I'm not sure from what you've written that she has either, or that she is suggesting that you have. It sounds to me that she is just letting you know what/where her boundaries are, perhaps having realised that they are quite different from your previous therapists boundaries. I don't know your history, but I do know that I have a tendency to take things personally, and as personal criticism, that often aren't, and have to check myself for that. Not saying that is what's happening for you, but do you think she was actually being critical or maybe just clarifying things?

Reading through threads on here, it becomes clear quite quickly that different therapists work in different ways and have different places they draw their boundary lines. I don't have email contact with my T between sessions, lots of people here do. I don't think there is right or wrong with that, it's just different boundaries and different ways of working. I don't think my T has ever gone through a list of boundaries with me, we address things as they come up. Maybe your T just works in a similar way to that. If most clients don't give gifts, then it's perhaps not something she thinks she needs to address unless it comes up as it has with you.

Asking if you know if there is a reason your previous T hasn't responded to her seems reasonable to me too, and was also maybe a way of allowing an opening for you to share if there had been problems with him.

If unspoken boundaries are a problem for you and you need more clarification then could you ask her for that - although it kind of reads to me like that is what she was doing.

 

[katiekat]

Thanks everyone for your thorough replies, that means a lot to me. My therapist has been in practice since the early '90's, so I am not sure I can pass it off as inexperience like some of you suggested. I am having a hard time getting over how I reacted when she talked to me about this (major blushing, embarrassed) and it bothers me that she saw that. I feel like I should bring it up to her next time and tell her I felt uncomfortable, but then again, maybe that will just make me feel uncomfortable talking about it again with her. I can't help but feel her sudden reinforcement of boundaries is going to affect how open I am willing/able to be with her in the future, if bringing a plant to her is considered crossing a line.

This situation brings up a whole lot of stickiness for me in terms of how therapy works and how unnatural it feels. And especially since my last therapist who I saw for a whole year was so much more open to communicating outside of sessions and it was never an issue. I do like her and have had an easier time trusting her than my last therapist, not to mention have told her so much more already about my trauma than anyone has ever heard, so I don't really want to have to switch therapists over this-it seems silly. But I still feel icky about it and am not sure how to move past that and not let it affect my level of trust with her.

Is there some kind of "client code of conduct" that is typical that I need to know about? How are you supposed to know these things if it isn't discussed upfront?

 

[moonbeam]

Hmm based on my experience with my therapist I don't think its inappropriate. Last year I gave my T a snowflake ornament I knitted myself. I made a bunch and gave them out and made her one. I could text or email her if I wanted but I don't. In fact she has gotten upset with me for struggling with SI and not calling her. And if I see her in public (which has never happened) its up to me if we say hello.

The only thing I could think is if your current T is concerned that your previous T may have crossed the line. I think the fact that your previous T isn't responding now, and since you gave her a gift she may have been concerned that you may have given him gifts and it may have crossed the line with him. Especially since therapy can make people feel vulnerable. That might explain why she asked about inappropriate touch. She could be concerned that the reason he isn't answering is because he crossed the line and doesn't want to be discovered. So she may just be concerned for you. Just a thought.

But either way I think its her responsibility as your therapist to set the clear boundaries with you. However, I would advise speaking with her about the issue if it's upsetting you so that it is covered and no longer bothering you so you can get down to the real issues.

 

[Jane.l]

Your therapist should have made the way she works clear at your first appointment and then this wouldn't be an issue. As @digger said different T's work in their own way and different therapy models may also make a difference - which is all fine if you know which rules you are playing by !

I give my T gifts when I feel it's appropriate to and he's fine with that but in my volunteer helpline role neither we or the counsellors are allowed to except gifts. Again it's fine if you know where you stand.

Boundaries can seem harsh and unfeeling but actually can create security and consistency which are ultimately the things that provide a safe place to share.

 

[Suzetig]

The therapeutic relationship is unlike just about any other relationship we're likely to have, different from friends, colleagues, peers etc - I can appreciate it feel unnatural, but the fact that is different is what makes it helpful and can cut ally free you up to share your deepest thoughts and feelings. It may help to think of it as a container for all of that stuff, separate from your day to day life, where you can dump stuff and pick through it with a supportive other who will help you pack it away again when it's time.

I have a lovely, warm relationship with my therapist, no contact between sessions other than for scheduling, I don't give gifts, we don't hug or touch but she gets me in a way that other people simply don't. Sometimes people make the mistake of thinking the therapist is a "professional friend" but that's not really their role. Ideally you'll be able to talk to her about how you felt when she talks about gift giving, emails and boundaries - I hear you're upset she saw you embarrassed but there's no one better to see that and help you unpick the reason for feeling embarrassed.

It's a professional relationship, you're part of her working life, which may sound harsh but honestly that's what creates safety - she doesn't need anything from you and you don't owe her anything. That doesn't mean she doesn't care about you, just that you're not part of her personal life. If she doesn't want to accept gifts, that's ok, same with contact between sessions, she may not want her woking life to spill over - she does need to communicate these boundaries to you but there's nothing wrong with her having those boundaries.

 

[Justmehere]

I've worked in a profession where I was helping vulnerable people and couldn't accept gifts. It's actually done to protect the client, and it actually helps keep the relationship in place where the client is more safe to share. That's the heart behind it.

But I can understand how weird it feels. To be asked about the gift giving and then asked about being touched inappropriately kind of seems weird if she didn't explain it all to you why she was wondering - almost like an unspoken message of "did you do this because of that?"

She should have handled this by making her boundaries clear from the get go and gently telling you at the time of the gift. Boundaries don't mean we are wrong. They are only a limit about what the other person is and isn't willing or able to do.

It's somewhat inevitable that we eventually bump up against boundaries or limits of the profession and it is painful. Terribly painful. It pulls on what we want to have but can't have.

I hope you stick it out, because as someone who has had to keep professional boundaries around gifts and etc, it wasn't because I didn't care or deeply appreciate the gifts and heart behind them. I did really deeply care about my clients. So much. But there were things I couldn't do due to the job or my own personal stuff.

You made your heart vulnerable and it's hard to not have it received in the way you want, especially in such a one sided kind of relationship that therapy is. But, it doesn't mean you are bad or that it's unsafe to share. It means you have a therapist who cares about staying ethical.

I hope you keep talking to her about it, and especially about what feels uncomfortable about it and that it makes it harder for you to share.

 

[Friday]

There are ethical considerations as well as personal preference in play.

In both cases, accepting gifts and contact outside of session, can be seen exploitative, a conflict of interest, and a few other things (that I'm too tired to source out). Which are against the code of ethics of several governing bodies.... Aka are grounds to lose one's license. There are differences between governing bodies even here in this country, (APA, AAMFT, ACA, ANSW), much less abroad.

However, how professionals handle & interpret their codes of ethics, varies wildly. Many simply say "no gifts, no contact outside of session hours" just to keep things simple, direct and above board. Others write outside contact into their fee schedule, or include it in their base fees, or only accept gifts up to XYZ amount (dollar amount, or percentage of their client's income... As a homemade food gift may cost a poor client "more" than a wealthy client giving them a car or flying them overseas), or limit gifts by type (homemade vs bought is one common one). Meanwhile some only allow clients to message them/ do not respond if they don't believe there is a reasonable expectation of privacy, while others have no qualms about being unable to verify it is indeed their client texting/emailing or that either or both may be monitored. Privacy also enters into play in reverse, say a T is diabetic & allergic to wool. Yet has a client who brings truffles and scarves? This just scratches the surface. But, as you can see, it's complicated. Moreover, the exact rules, wording, etc. vary some between agencies. Again, it's complicated.


APA Link Removed

3.08 Exploitative Relationships
Psychologists do not exploit persons over whom they have supervisory, evaluative or other authority such as clients/patients, students, supervisees, research participants and employees. (See also Standards Link Removed; Link Removed; Link Removed; Link Removed; Link Removed; Link Removed; Link Removed; andLink Removed.)

3.06 Conflict of Interest
Psychologists refrain from taking on a professional role when personal, scientific, professional, legal, financial or other interests or relationships could reasonably be expected to (1) impair their objectivity, competence or effectiveness in performing their functions as psychologists or (2) expose the person or organization with whom the professional relationship exists to harm or exploitation.