How to Find Pathways to Empathy
Given their arrogance, condescension, and lack of empathy, narcissists are notoriously difficult clients. The key to working with them is being direct and transparent about the roiling emotions they trigger in us.
Boundaries in an Age of Informality
As the status of therapist has shifted from an oversized figure with Svengali-like powers to an overworked and underpaid service provider at the mercy of the client-consumer who might sue him or her for some infraction, what are we to make of our traditional ethical codes.
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Think Before You Get Personal
The ways we disclose, read cues from our clients, and dialogue about what’s been divulged are the keys to whether therapist self-disclosure helps clients’ therapeutic goals or gets in the way.
- Is therapist privacy a thing of the past? - Creating networks of therapists - A cautionary tale about self-help books - The new DSM's take on personality disorders - The brain-scan wars
Cosmetic Neurology * Another look at APA's stance on torture * The effects of internet porn * In praise of older meds * Sexual attraction in couples therapy
Let's End the Conspiracy of Silence About Ethical Dilemas
One way or another, all therapists face similar questions about therapeutic boundaries: Should we accept the gift? How much do we self-disclose? What do we do when a dual relationship can't be avoided? How do we safely negotiate the currents of sexuality? Moved by our best instincts, our weaknesses or simply by the sheer ambiguity of the situation, we can often find ourselves striking out on our own and coloring outside the lines.
A Therapist Caught in the Act of Being Herself
After the incident, 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.
Violating the Ultimate Therapeutic Taboo
I doubt that I would fit many people's image of a therapist who would violate sexual boundaries with a client. Before it happened, I certainly did not fit my own. On the day I first met Cara, I was a well-respected social worker at a venerable psychiatric hospital in the Midwest. I viewed myself as a caring and conscientious professional. Yet, over the course of two years, I progressed from sympathizing with Cara, to over-sympathizing with her, buying her groceries, paying her rent and, finally, sleeping with her.
Challenging Our Culture of Avoidance
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. Nobody shared a personal experience. The message we gave each other was clear: Whatever you do, don't talk about having a crush on a client! And that may be why I would rather write about being seen naked by a client at the health club, or dealing with anti-Semitic remarks in session, than describe to you what happened.
When Does a Rule Become a Straightjacket
When I was young and only three years out of graduate school, one of my first private clients came into a session carrying a small package simply wrapped in brown paper and string. The memory of that package and how I reacted to it haunts me still.
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