Wednesday, June 18, 2014
Boundaries: Stop Guessing!
I care for my therapist. That's a hard sentence to type. I grew up with the belief in firm boundaries with providers. Therapists and doctors are meant to help with specific problems. As I grew up, I fell very hard into black and white thinking. Either you are in control or you are not. Either you are living or existing. Either you are professional or you are ineffective. School reinforced this- don't care for your teachers. Don't make friends with them. I tested this out and was able to find comfort in my "inappropriate" relationships with teachers, but there was always a time limit. Eventually, you move on, graduate, and make "real" friends. The problem with my therapist is I'm not moving on anytime soon. I enjoy self exploration and don't foresee that stopping anytime soon. I'm embarrassed to admit this comforts me. I enjoy my relationship with my therapist and I feel that this is bad. I still can't quite figure out why, but every fiber in my being seizes up and wants to retract when I begin talking about my therapeutic relationship. The discrepancy between the "rules" and practical application of a therapeutic relationship has created a confusion that is very frustrating. It's even more vexing because I have been lead to believe that mentioning these boundaries is a taboo subject. I started off with very simple boundaries for therapy: go, talk, leave it at the door. However, life's problems are not so accommodating. They refuse to just be left at a therapist's office. Everywhere I went, there they were! The first few therapists I had never made an attempt to extend their services beyond the therapy room. In fact, when I went inpatient they wouldn't attempt to allow for contact until whatever follow-up program I was sent to was completed. The lack of consistency lead to frustration when each therapy team member had different goals for my progress. Around my fifth hospitalization someone finally realized the inconsistency and insisted on me starting with a therapist willing to work with the team the college I was attending had set in place for me. I would have no clue what kind of life-altering event this was until years later. This therapist, who is my current therapist, started changing my views on boundaries nearly immediately. The first text I ever received was sent to me at the beginning of 2004. It was one simple line, "we're meeting at 5 on Tuesday, right?" and it blew my mind. I replied, sending my very first text, with a simple answer of "yes." Suddenly I didn't know what to think. My therapist was using an alternative means of communication. This lead me to a very scary realization: my therapist is human! She challenged me a few months later when I had had a late-night crisis. She asked why I didn't call and I couldn't form the words to say, "because I'm not supposed to." She recognized my discomfort with the subject, but continued to encourage me to attempt to call her when I needed to. Eventually, I called. I'm still not 100% comfortable calling her, but now it's a viable option. Calling gave way to emailing her when I moved cross-country. Not only did she reply, but she continued to counsel me while attempting to find a therapist, and then again when my therapist broke up with me while I was inpatient. She emailed/phone coached me until I was settled. When I returned to my home state, she was still there, willing to take me back on. Email became an option for non-emergent crisis and telling parts of my story I was too embarrassed to bring up during therapy. The lines kept blurring for me, as I felt these were positive interaction, but I was being taught by my degree program that these out of the office interactions lead to dreaded "dual relationships" with clients. I kept my mouth shut, silently trying to rectify this discourse within myself. Eventually my social media found her social media, as I began to find my voice in the social media world as a psychology student and advocate. This lead to a quick discussion on the fact that it was "ok" for me to friend her professional twitter account. Even though my twitter account is also professional, I still haven't followed her for fear of crossing a line that, I'm pretty sure, is just in my head. I've pressed my own limits a few times: she and I exchanged gifts when I left for OR and she has given me CDs and books to help feed my ever-growing appetite for self help sundries. I've given her a book or two along the way as well. All of this has muddled the gray area for me and left me uneasy as to where the line is. Last year I breached what I felt was a very firm barrier only to find my therapist sticking to her firm stance of non-judgment and unconditional care . I expected to be let go because of my actions, which included sending a very upsetting suicide note to her email, but instead I was given the opportunity to speaking freely about how I felt. I sincerely did not want to, afraid admitting to what I wrote would end up being held against me. Ironically, it wasn't the things I wrote about death, dying, and self hatred I was terrified to admit, but the tender sentiments I wrote to my therapist about her place in my life. Why can I say "I care for you" when I'm nearly dead, but can't admit to saying that when I'm in my right mind? Recently this came up again and my therapist wasn't having the attempt to gloss it over. She confronted it head on, wanting to understand my embarrassment and other emotions that speaking about our relationship brought up. She actually said the words "I care for you" and I thought I was going to pass out. Not in a good, excited way, but more in a fully mortified and I-want-this-couch-to-eat-me-now sort of way. She's not supposed to say stuff like that! I'm not supposed to be cared for like that by her! Up until now I've gone with the idea that I could be anyone and my therapist would do the same. In my head, I'm not special, she's just a special and caring person. But perhaps I am special. Maybe my care is very person-centered and the extra time in sessions when I needed it, and the out of office support, isn't just a generic service, but based on what my therapist can give and what I need. What then? Well then I have to admit that we do have a relationship, she does genuinely care for me, and I am worth spending time on. She believes in me. She's advocated, pushed for me, pushed me, and pushed herself (I'm guessing here, but it's pretty obvious that I have brought about some unique and trying circumstances) in order to not just meet my basic needs, but to help me on a much more complex, and humanistic, level. That someone would think of me first and be so selfless baffles me. And yet, I do the same. I can't claim I have the same relationship with all of my residents or that I care for them each in the same way. I don't attempt to. Some residents I am close with, while some I will never develop a strong relationship with, but still care for them, just on a different level. And yet other residents I have developed a strong bond with and do some things, when appropriate, above and beyond, when I can, to help them. Some have even touched my heart in such a way that I am forever changed by our time spent together. It's just hard to translate the bond I have with a kid who needs my help to the bond my therapist has with me. This means I'm the person who needs, and deserves, help and support. After ten years of avoiding boundary talks, I have learned something very important: Not only is it NOT a taboo subject, it's what you SHOULD be discussing with your therapist. This doesn't make it any easier for me to broach the subject, but this knowledge does give me the push I need to not run out of the room screaming. I'm still attempting to define where the line is. Maybe there never was a line. Perhaps boundaries are just about expressing what you need and want out of a relationship instead of making assumptions out of sweeping generalizations. Maybe it isn't about boundaries at all, but about human connections and relationships. Regardless of my inability to accept caring graciously, I have learned that it's okay to discuss whatever I'm feeling with my therapist- that's what she's there for! Too many times have I gone without the care I need because I was too upset/embarrassed/afraid to approach a subject. I'm learning that it's okay to ask and it's okay if the other person, be it therapist, friend, or coworker, is taken aback by it. Part of learning to have meaningful interactions is learning that the reactions of others are not for us to determine or worry about. When the focus is communicating, instead of making everyone comfortable, better understanding can be reached for everyone involved.