Letting Self-Disclosure Mix with the Therapist Persona

Tearing Down Boundaries Between Therapist and Client

Linda Stone Fish

I live in a small city in Upstate New York, and most people in town know somebody who knows me, my husband, or one of our four engaged and energetic sons. So it's no wonder that I sometimes cross paths with my clients in town---if not at the supermarket, then on the athletic field, at the hairdresser's or at temple.

Despite all this, I managed, for two decades, to maintain (in my own mind, at least) a fire wall between my personal and professional lives. In the consulting room and the classroom, I worked to present an air of calm worldliness, an expert with the answers to all sorts of painful therapeutic and family dilemmas. I was at pains not to look like someone who would lose it with her kids or yell or scream---which is precisely what I sometimes did when I got home to a house full of hungry boys ranging in age from 4 to 16.

Then, late one spring afternoon four years ago, I walked into Wegman's, the huge supermarket on the east side of Syracuse. (It's the kind of place with a dry cleaner and a cafe as well as acres of gorgeous fruits, breads and vegetables.) With me was my youngest son: 4 years old, tired and whiny. I'd been teaching and seeing clients all day. There was nothing in the house for dinner. I was having babysitter problems and I was due at another son's baseball game in less than an hour. In short, I was fried.

Near the yellow and red peppers, I pried a shopping cart loose and asked---or rather told---my son to get in. He refused. In no mood to fool around or cajole, I grabbed him by the shoulders, lifted him up and tried to force him into the cart. He stiffened and began screaming.

It was one of those moments when other shoppers look over and think, "That is the worst mother in the world. That poor child!" I wanted to yell at my son at the top of my lungs or just leave him screaming on the floor while I shopped, but instead I managed to bend his legs into the cart and wheel him forward, still screaming. I was picking up hamburger buns when, out of the corner of my eye, I saw Jan, one of my most recent clients. She was staring at me, and she wasn't the only one.

I did the only thing a professional could do under such circumstances---I pretended she did not exist, kept my eyes straight ahead and wheeled my screaming child toward the meat section while acting as though I was on a cruise drinking pina coladas.

All that week, I waited for the call canceling Jan's next session and letting me know what a joke I was. But on Friday at 4:30, Jan appeared with her daughter Sarah to tell me that, for the first time, she (Jan) had done the homework I had given her. (I had asked her to stand up to her daughter and make sure she did a schoolwork assignment, even if Sarah tried to distract her by being mean.) Jan had also made an appointment with a school administrator to get an evaluation of her daughter's learning problems. Her passivity had disappeared.

"Linda, I hear what you have been saying," Jan said. "I needed to do something different and I was resisting it!"

"You were a myth to me," Jan went on. "You had it all together. How could you understand how overwhelmed I felt? Then, I saw that you, too, are overwhelmed, but you just keep putting one foot in front of the other. I can't tell you how empowering it was."

My face turned bright red in the presence of truth. I had been caught being myself. Jan was being helped not by my fake professional calm, but my humanness.

After that, I came to a decision to consciously bring some of the wisdom and skill of my profession into my life with my children and husband at home. And I started bringing into the office the honesty and imperfection I had once tried to sequester in my personal life. Nowadays, I'm much more likely to tell a client that a teacher once told me how much she hated one of my boys, for instance, or that another son still does something with his shoulders that I think makes him look retarded and I sometimes yell at him to get out of the room.

I still think back on the moment Jan saw me in the grocery store, and I continue to be freed by it. In my office, I no longer work so hard to project tightly wound calm. Clients who haven't seen me in a while sometimes comment on how much more relaxed I seem. And I do feel less tense, having stumbled onto an old truth: it is me, not the image of professionalism I once thought I was conveying, that people find helpful and healing.

This blog is excerpted from “Nightmare in Aisle 6". Read the full article here. >>

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Topic: Children/Adolescents | Ethics | Parenting

Tags: ethical issues | boundaries | ED | family | HEAL | kids | learning | psychotherapy | TED | therapy | Psychotherapy Networker | clients | truth | Linda Stone Fish | therapist's office

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Monday, April 27, 2015 11:44:55 AM | posted by Monica
I really enjoyed reading this article and thought of some words I wrote in a longer article about the divide between clients and professionals that have the same sentiment. I'll share:

"I think that expanding the concept of peer counseling may help bridge the divide between clinician and patient. When we meet those we are helping from a place of vulnerability and equality, we can bring about healing. I noted that once I publicly acknowledged my frailty, my humanity, the healing relationship often became stronger with those I interact with. Some of the connections and healing relationships I’ve made via my work at Beyond Meds have been astonishingly deeper and more honest than any work I ever did as a social worker when I relegated significant parts of myself as off limits to my clients. Clinicians are taught to do this, of course.

Authenticity is often trained right out of mental health professionals and instead a vague and subtle superiority replaces it. I too was tainted and saw it in myself, as a professional, even as I saw it in my colleagues around me. I also experienced it as a patient/client, I was actively made ‘other’ by the people I saw professionally. These parts – that of the knowing superior vs the ignorant inferior – are in all of us too, regardless of training! I suggest those in mental health circles who have taken up the mantle of helper become acutely conscious of this so that they might minimize the harm it can cause in relationship with others.

We are all, every one of us, in this wonderful and mysterious thing called life. And all of us are struggling in various ways to make sense of it. Is there really such a difference between someone trained as a clinician and a client? If those trained to help were also trained to remember that their role as helper was because they have much more in common with their patients/clients than not, then we will start to see a flattening of hierarchy. We all have incredible capacities and learn very particular things in our own individual idiosyncratic ways. Most of it is not learned in school or training regardless of level of education.

This begs the question: Is it possible that identifying with a client might actually be a good thing? This is surely exactly why “peer counselors” are effective. I would like to make the argument that as human beings we are, indeed, all peers. A peer is an equal. I understand the word is used in other ways. This is a challenge to consider a broader context. We are all on this planet trying to figure out what the heck we’re doing here…every last one of us. In that process we all suffer. And the reality is it’s a conundrum for every last one of us. We are all the same that way. The manifestations change but there is a universality in the nature of suffering that make a lot of mental health professionals very uncomfortable and the result is projection. Putting all that ugly stuff on the client “other.”

Tuesday, April 21, 2015 1:06:07 PM | posted by Enthusiastic
I loved every single line you've wrote. Thank you for allowing yourslef to be vulnerable and share this. I, too, have felt challenged at times with kids, school and clinic, and I can relate 100% to what you're saying. I've read the above comments, and I don't think the word "retarted" was used in any way to be unconsiderate of people with disability. Rather, I think it was used to show that every mom has challenges, and we might not use the vocabulary or manners that we are so highly held up to use, regardless of the profession we're in, and we don't always like our children, and sometimes we are short with "reflective listening". I loved the article! and I hope to read more about yourjourney of navigating both professional and personal life. I love your writing style.

Saturday, April 18, 2015 10:20:35 PM | posted by Margaret Peterson
I, too, was startled by the use of the word "retarded" in this article, which was otherwise so disarmingly vulnerable. To be honest, it felt like a sucker punch. If the author has lived in the same small city for decades, she must know many families that include a member with a developmental disability. I wonder whether she has ever listened to any of them talk about their associations to this word?

Saturday, April 18, 2015 8:57:21 PM | posted by Dotty Decker
Being authentic is important. I like your article and the points made. . But I was surprised by your use of the word "retarded" in the way you did. and surprised that an editor didn't bring this to your attention.

Saturday, April 18, 2015 3:07:08 PM | posted by Teri
Linda you hit the mark with this article . I recall my moment of revelation in this area !
Honestly and beautifully created.
Further confirmation of my need to exhale.
Thank you so much '