Boundaries

Recently on holiday a friend confided in me that he was so relieved to see me, he declared himself to be totally “boundaried out”, that he was “awash with boundaries”. His partner is a psychotherapist and so many of her approaches to people seemed to be influenced by what he thought was a ridiculous over concern with boundaries. He had forgotten that I worked in the same world. He was not complaining too seriously but did raise the question as to why therapists are so concerned about boundaries. The non-therapist is often amused if not bemused by the concern, expressed by some therapists. Most people wonder what all the fuss is about and claim to regulate their relationships and so their boundaries with a minimum of fuss on the basis of common sense, or so they claim. When a friend or acquaintance steps over the acceptable line of familiarity unease enters the relationship, we may say,” that is a bit close to the mark”, or that is none of your business”, or whatever one’s particular style happens to be. The right distance is re-established, and so it is dealt with. If only!

So are boundaries a matter of common sense? Are therapists who drive their friends mad by agonising over getting them right just a bit odd? Perhaps!

We can begin to think about this question by posing a couple of other questions: What function do they perform in human relationships? Are they about control of the relationship? Are they necessary or are they just in the way of people really getting together in a truly intimate and humane way?

Boundaries and borders

Boundaries have a similar meaning to borders. Borders seem to have been around since humans began to live a settled life. Borders demarcate where one sovereign state begins and ends. The people of a particular area/region/country believe they have rights of ownership, the freedom to control all aspects of life that affect them. They believe they have the right to determine who can live within their borders, the right to impose their own laws, the right to control their economy. The right to determine how their citizens should live with each other and with ‘strangers’. History describes the ‘heroes’ who gave their lives to defend the ‘inalienable rights’ of a people to determine their borders from the intrusion of ‘foreigners’.

The word private is heavily inscribed on some doors and gates telling us to keep away unless invited. “Out of Bounds” is probably a familiar word that springs to school day memories for most of us. There were clearly demarcated areas where one was not allowed, under pain of punishment, to go. The rationale for these boundaries was largely about control, sometimes about safety, at other times about repression. At best these rules about where we could and could not go reminded us that we were not free to exercise unconstrained self- indulgence, roam where our will took us. We learned that our fellow travellers had the right to their space and that we had to respect this right.

It would seem that most people display ‘keep out signs’ that warn the uninvited to keep their physical and psychological distance. We only allow those that we can trust to get close to us. These tend to include some family members and some friends. In some sense we have come to believe, either consciously or unconsciously, that these friends and family are necessary for our psychological survival and happiness. They are not just fun to be with.

Perhaps it is important to keep in mind that the word boundary may have different meanings between and within different cultures. The north of this country is often thought of as more ‘open’ and friendly than the south. So often we hear that Latin peoples are much more warm and friendly and ‘open’. In general they have a reputation for inviting others into their ‘close’ space more easily.

As in all relationships boundaries have an important function. Back to the question what role do they play in our relationships? Their main role is to help us to regulate our relationship. They do this in a number of ways, they protect the balance between autonomy and attachment, between dependence and independence, between intimacy and distance. They help us to allow those to whom we relate to be. We want to engage with the life of our friends and family in a healthy supportive way without threat of unwanted familiarity, this at times is difficult.

So what has all this got to with how we therapist relate to our clients? What is so special about this particular relationship and why are therapists so concerned to get it right. The relationship between therapist and client is particularly close and intimate, at its centre is the trust and vulnerability of the client. For some clients their relationship with their therapist is more intimate than with any other. The client takes a huge risk in disclosing their fears, their deepest secrets, their most private feelings. The client allows his mind to focus on experiences, present and past, that hitherto he has blocked, perhaps for a lifetime. These are likely to be disturbing if not frightening. In any relationship where there is a deep trust and disclosure of confidences a special intimate relationship develops which borders on love. When this happens the therapy is given energy and focus. This is positive and leads to healing, but it may also carry a danger. There is a strict code of ethics which is designed to protect the client from exploitation in this very vulnerable place, however boundaries are sometimes broken. Inappropriate sexual relations develop which may be experienced as a natural extension of the intimacy developed in the therapy room. Transgressions of the code leads to expulsion from the professional organisation. This however does not stop every therapist from crossing the professional boundary. When sexual relationships develop between client and therapist there tends to be a collapse of both therapy and the relationship.

I believe that the vast majority of counsellors, at least consciously, would agree that their role is to promote the emotional health of their clients in a safe space. A safe space demands a clearly defined contract mutually understood. This contract makes clear the rules of engagement, in short the boundaries. There is considerable disagreement as to what constitutes good boundaries among the different ‘schools’ of counselling and therapy.

I use my own initial experience of analysis to point to one perception of the appropriate boundary. I began my own therapy with a psychoanalyst who encouraged me to lie on a couch, she remained relatively silent. It was as if she was ‘absent’. She believed that her job was to offer herself as a blank screen onto which I could project the contents of my troubled soul. There were no greetings or farewells, sessions began and ended exactly on the minute. There seemed to be a total absence of humanity.

My particular experience may be thought to have been rather extreme. I am however reminded of an account by a famous writer/analyst who refused to hold the hand of a very distressed female patient who was begging for the reassuring relief of human contact. He agonised over it but decided this would undermine her ability to heal herself, that it would prevent her from reaching into the past and connecting with the person who caused her original pain (the transference would be prevented). The model argues that when this connection is made both emotional and cognitive insight is gained and the client/patient begins to heal.

This is very far from the experience of a good friend. My friend’s wife left their marriage after ten years taking with her their two children, he began to lose his mind, and gradually felt that life may not be worth living. He sought help from a pastor/counsellor. My friend described how on one occasion he broke down in the counselling room, lay on the floor in the foetal position and bawled his head off. His counsellor picked him up and cradled him. The warm tactile presence of another was what he needed at that point in time. This he believes was the beginning of his recovery. He now manages his life very well.

A student on a diploma course that I tutored talked about her experience on a CBT course. Her supervisor told her that the best way to help a socially challenged client was to take him out to a restaurant and teach him by example and instruction on how to deal with a social situation.

In a very popular self-help book, ’The Road Less Travelled’, the author describes how he helped one of his patients to solve a problem with her car. This revelation probably sent shock waves through the universe of the psychodynamic student’s rule book.

The analytic world would be appalled at such gross transgressions of ‘correct’ boundaries, described above. Alternatively there are those who believe in the importance of the presence of a warm, personal, caring interested counsellor/therapist. These therapists are horrified by the practice of what they consider to be the cold distant Psychoanalyst. In recent years there seems to have been, amongst some Psychotherapists, a shift from the blank screen to a position of caring that is akin to love. They argue that without love in the therapy room change is not possible.

It is a little alarming that there seems to be such an array of understanding and practices of boundaries in human relationships in general and therapist/client relationships in particular. The basic question for the therapist is: What works? What is therapeutic? How does one allow the client to find and manage their own inner strength without transgressing their sacred private space? How does one protect the client from the manipulations of one’s unconscious ego, the need of the therapist to be omnipotent, to ‘fix it’? How does one protect the client from the seductive attractions of dependency and the false promise? How does one protect the relationship from the incursions of sexual seduction, that destructive pretender. How does one avoid doing harm? How does one avoid doing anything that might impede the therapeutic process, get in the way of the healing? These are of course complex questions at their core is the concept of boundary. This is an issue that needs to be explored with the client.