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. 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. Until one day, I was caught being myself, and everything changed.

Therapists aren't supposed to discuss personal problems, or even acknowledge having any. While preaching congruence, who among us has never pretended fondness for a client we actually disliked, didn't understand and didn't trust? But on at least two ticklish occasions, with a minimum of strategic deliberation, I opted to step out from behind my own well-cultivated facade of inscrutability to tell clients the unvarnished truth---with surprising results.

Before it happened to me, I had never heard even my closest colleague talk about falling in love with a client. In our consultation group, the subject was once broached purely theoretically, and everyone became uncomfortably quiet. The message we gave each other was clear: Whatever you do, don't talk about having a crush on a client. Yet, I want to break our conspiracy of silence so that we can get help when we need it. And believe me, when it came to Scott, I did.

I believe that some elements of our ethical codes have become so needlessly stringent and rigid that they can undermine effective therapy. Take, for example, the almost universal taboo on "dual relationships," which discourages any connection outside the "boundaries" of the therapeutic relationship, such as lunching or socializing. These "boundary crossings," are rarely harmful and may even enhance the therapeutic connection. My experience with Mark and Sally was one such boundary crossing.

We know that our primary initial responsibility as a therapist is to listen intently to what the client says, giving them our undivided attention. But being only human, there are times when we get distracted and are no longer focused on what the client is telling us.

There’s a big difference between being a generally nice person with good intentions and an ethical professional. So how do we bridge that gap?

Long held under a shroud of formality for various ethical reasons, psychotherapy has had some growing pains in trying to adjust and adapt to the new laid-back way of life.

Of course, all good therapists want to bring their clients to a place where they've met their therapy goals and achieved the necessary growth to feel comfortable ending the therapy relationship. But therapists and clients may not always be operating on the same timetable.

As clinicians, we try to prepare ourselves as best we can for any ethical issues that could arise with clients. But while we know the answers to the obvious dilemmas, where does that leave us with the endless list of ethical issues that fall into the gray area of ethical ambiguity?