Love, Dr. Lagerfeld

Sometimes It's Okay to Trust Your Instincts

March/April 2002

We therapists tend to worry a lot about boundaries, sometimes to the point that we forget that sharing our humanity can be a gift, not a distortion. Most of us have sometime or other been moved to share a personal experience, or quote a famous Zen story or Bible passage or maybe simply laugh or cry with a patient. We're connected and in sync. But when is it okay to go with our impulse and when is it wiser to hold back? And how helpful are all our therapeutic models in helping us decide? I remember sitting in a seminar 20 years ago with Erik Erikson listening to a therapist go into a convoluted analysis of the transference-countertransference dynamics of one of his cases. Finally, Erikson interrupted the theoretical discussion to ask, "Have you ever thought that maybe it's just reality?"

Consider the case of Bill and Maria, a Portuguese American, working-class, Catholic couple in their late fifties with whom I worked for several years. I initially met Maria, who sold cosmetics at a local department store, when she came to our HMO clinic distraught and depressed by the recent and tragic death of her son, who had died at the age of 20 under ambiguous circumstances. (His gun had somehow discharged while he was alone at a hunting cabin.) Maria was grieving terribly, of course, and kept questioning whether the death had been a suicide and what she could have done to prevent the tragedy. This was a natural human response, but Maria added, "I'm always feeling responsible…

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Topic: Ethics

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