Therapists are expected, of course, to treat all clients with respect, dignity and consideration, and to adhere to the spoken and unspoken rules that make up our established standards of care. Many of these rules are necessary and sensible, but 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, socializing, bartering, errand-running or playing tennis. Naturally, sexual conduct falls into this forbidden category, and so do relationships involving conflicts of interest, such as a professors' serving as therapists to their own students.
But the blanket disapproval of "dual relationships" in some circles draws no distinction between "boundary violations," which can harm a client, and "boundary crossings," which produce no harm and may even enhance the therapeutic connection. For example, what would be so appalling if a therapist said to a client whom he has just seen from 11 a.m. until noon: "We seem to be onto something important. Should we go and pick up some sandwiches at the local deli, eat them here and continue until 1 at no extra fee to you?"
During the past 40 years, I have seen thousands of clients and have deliberately engaged in "dual relationships" with no more than 50. I have asked a…