Boundaries in the Therapeutic Relationship
Within these categories there are various types of boundary styles, consisting of strong, healthy boundaries, rigid, inflexible or distant boundaries and boundaries which are lacking in definition or are fused. Spatial, behavioral and verbal boundaries are the most commonly considered characteristics of boundaries.
Energetic boundaries are more somatically based and less commonly described. Attending to and using the body in psychotherapy makes boundaries clear, allowing both therapist and client to participate in the relationship more comfortably and can help to prevent vicarious traumatization in the therapist.
Navigating the levels of connection and distance is done through the practice of boundary formation, which is how physically close or distant the therapist and client must be in order to be comfortable with each other. Spatial boundaries refer to the concept of having someone either in ones space or too far away to make a connection.
For instance, where the therapist and client sit in relationship to each other is an aspect of this. Often, both think they should sit closer than they actually feel comfortable. A therapist who is aware of her own body can sense her level of comfort or discomfort, and
adjust herself accordingly. She can then encourage the client to do the same.
One way optimal distance can be felt is through breathing room. A sign of discomfort may be a tension in the body or an awareness of holding the breath, which indicate that the therapist and client may have been sitting either too close or too far. Once optimal distance has been reached, it is not unusual for both therapist and to indicate this by taking a breath.
The therapist must be able to discern whose needs are actually being met. Maybe it is the therapists need for more closeness or distance. The distance at which each is comfortable may reflect the levels of abandonment or control each has experienced in the relationship with early primary caregivers. Many therapists believe that to be compassionate, they should sit close to their client. While this may be true some of the time, often there is a need for more distance, because of a history of boundary violations, daily stress, or just personal preference, regardless of their history.
When a therapist has a strong preference for one or the other, it is important for therapist and client to discuss their boundary preferences, as most of the time issues of closeness or distance in the intersubjective field are implicit. Making these boundaries explicit and concrete can be a critical aspect of developing and maintaining the therapeutic relationship and can help to prevent re-traumatization of the client and vicarious traumatization of the therapist. Daniel Stern (2002) reminds that therapeutic boundaries often remain implicit because the therapist and client are, in essence, tied to their chairs. Remembering that people and chairs can physically move may free both client and therapist of this limitation.
Behavioral boundaries include knowing when to stay and when to leave, or taking an action in ones own behalf. The therapist who ignores his own needs in the service of the client runs a great risk of becoming vicariously traumatized.
A common example occurs when a practitioner needs to cancel or re-schedule an appointment, but decides it is more important for the client to see him/her. This can lead to resentment, and even unconsciously blaming the client, which is not good for the therapist, the client or the therapy itself. Having clear boundaries for appointment scheduling, models for the client the importance of self care.
The ability to identify behavioral boundaries begins in childhood in a securely attached relationship, where cycles of arousal and relaxation lead to appropriate emotional self-regulation. Affect attunement is the ability to monitor the level of ones affects.
Schore (1994) discusses the infants attachment to the mother being based on the mothers healthy support of the babys Autonomic Nervous System (ANS) cycles, and the mothers ability to self-regulate emotional states. The same is true of the therapist/client relationship, and is accomplished by attending to body sensations. The
therapist, who can adequately identify her own levels of affect regulation and attune to those of the client, understands the meaning her own bodily reactions. Reactions of both therapist and client can be made explicit by verbal descriptions increasing good communication within the therapeutic relationship, explicitly the ability to take care of himself.
Verbal boundaries address the concept of social space; for example, the secrets one keeps, or how intimate a detail one might reveal to an acquaintance or even in a marital relationship, refers to the honest ability to say yes or no, or to express an opinion. How does the therapist know what she feels in order to answer the clients questions honestly, as opposed to giving answers which will satisfy the clients needs? Often the response to the question might be known by an awareness of the presence or absence of discomfort in the body, such as tension, a headache or stomach ache. This depends on the practitioners ability to feel in her body what is comfortable, and what is not, called somatic markers (Damasio, 1994).
It is the professionals job to know, by the signals in her own body, what is right for her at what time. If she says yes, and is unaware of the no in her body, she may be in contradiction to her true feelings and may be at risk for compassion fatigue (Figley, 1995). Verbalizing preferences (what I like or dont like), values (what is okay or not okay) are examples of setting verbal boundaries. Failure to do so in the therapeutic relationship can make the therapist vulnerable to vicarious traumatization.
Boundaries define the space around our bodies. This space has an intangible, but physically palpable, energetic quality. Physical boundaries may extend beyond the body, varying in size or radius, sometimes larger or smaller. Think of a time when you have felt uncomfortable when a person was standing too close to you. In that instance, you were aware of your personal space and the other person encroaching on it. It may have been a particular person at a particular time who made you uncomfortable, but the same person did not at another time. Unlike defenses, which are rigid, boundaries are flexible and can change, depending on the person or situation.
About Marjorie Rand, Ph.D....
Marjorie Rand Ph.D. has been a practicing psychotherapist for nearly 30 years. She is now an International Trainer and Supervisor of therapists. Dr. Rand has had extensive training and trained others in many disciplines: Reichian Therapy, Bioenergetics, Radix, Object Relations, Yoga, Dance Therapy, Pre and Perinatal Psychology, Self Psychology, Somatic Psychology, Gestalt Therapy, Sensory Awareness, Art Therapy and more. She is sought after International lecturer to both the public and the professional communuities and present at many National and International Psychology congresses and conferences. Dr. Rand currently has a supervision group for therapists as well.
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