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Dear Dr. Saltzman:
 
First, let me thank you for a wonderful site that is both interesting and helpful.
 
I am a 45-year-old woman from the southeastern US.  I have been seeing a male psychologist who is a few years older than me for about a year now for what began as a need for help with a specific incident, but has become a deeper look into my history growing up and how that affects me now.  I have found the therapy to be most helpful and comforting.

I have never felt threatened in anyway by him in terms of potential boundary violations, but from the very first session he has always rather freely self-disclosed about various things.  It has never made me uncomfortable (in fact it has done the opposite) but admittedly I was quite curious at first because I had seen two other therapists in the past, and I knew absolutely nothing about them, so this was unique.  I did quite a bit of research on the internet and buying books to read about transference and counter-transference, etc.  While I think that some therapists would consider it inappropriate to self-disclose to the degree he has, I think that in this case it is more a result of our specific circumstances.  He and I have discussed it as well and both seem to agree that our situation is "special."

From the very first session I have felt a significant connection to him on an almost spiritual level, I believe, because when I mentioned that my son had died 4 years previously he shared with me that his son had also died 2 years previously.  Our sons were almost the same age, and though the circumstances of their deaths were different (mine from terminal illness; his from a car accident) I feel a bond from our common experience of losing a child.  We have talked about our sons on a regular basis, and it is clear to me, and he has admitted that our relationship is a reciprocal one in terms of offering comfort to one another.    

I feel like he is the only person I have ever been able to talk to about my son who understands.  I sense from things he has said and shared that he may feel the same way about me, though he has never said so directly, and I have never acknowledged my feelings to him either though we have both shared that our spouses look at things differently than we do.  My problem is this:  I do not want to ever stop seeing him because of this bond I feel we share. I just can't (or maybe I don't want to) believe that this is all just some sort of transference/counter-transference issue though I realize the intimate nature of the therapeutic relationship undoubtedly plays a role.  Do you think it is possible to transition into some sort of mutually supportive friend type of relationship?  Is it unethical or just unworkable for us to have any kind of relationship after therapy terminates?  If so, what can I do to make the break as painless as possible?  


Thank you,

[name withheld]

 

ask dr-robert ask psychologist todos santos ask psychologist dr robert saltzman

 

Hello--

Thanks for your kind comments about my website. My aim is responding to questions in a way that sees life and its problems realistically, while at the same time sharing the insights afforded me by my training and experience in depth psychology. Since I enjoy doing this, I am pleased that you and so many others are finding my approach interesting and helpful. Due to the growing popularity of this site, and the limitations on my time for writing, I am able to answer only a small fraction of the questions I receive. So to those who have written and gone unanswered: I apologize. It is not that your questions are unimportant, but simply that I do not have time to answer them all.

The term "transference" is often misunderstood, not only by the ordinary public, but sometimes even by therapists. As you will have read in my earlier articles, transference means a shift onto another person of feelings, desires, and ways of relating formerly experienced in connection with important persons in the subject's past. In other words, transference is a phenomenon which involves projecting or displacing unresolved conflicts, dependencies, and aggressions which emerged during childhood onto a contemporary substitute as if that person were someone from your childhood. Awareness of the transference is important because by noticing and analyzing the transference, the therapist can gain immediate access and often very deep insight into the rhythms and necessities of the patient's emotional life.

Now feeling that you share a special bond with your therapist is not necessarily an example of transference. Your identification with him as a bereaved parent like yourself does not seem to be about projecting earlier feelings from childhood onto him as if  he were a parent, which would be transference, but more because your own very specific suffering as an adult who has lost a child allows you to see and understand his suffering. This is not to say that you have no transference to your therapist--I assume you do--but that the detail of both having lost children probably is not part of it.

Styles of psychotherapy vary widely. Some therapists never disclose anything personal, while others speak often, and usually too freely, about their own lives. A bit of self-disclosure, when used sparingly and for one specific purpose, can be helpful, but this tool will work properly only in the hands of a therapist who is already so comfortable and at peace with his own conflicts--having already chewed them up and digested them thoroughly--that he can refrain totally from using self-disclosure as a backdoor way of receiving sympathy or understanding from the person who is supposed to be the client. When I say "chewed up and digested," I mean that therapists should have had their own therapy before they begin to offer it to others. Unfortunately, many have not had such therapy, or not enough of it, and so, in my opinion, should not be practicing. By the way, asking about what therapy he or she has had is a fair question to put to a potential therapist in the initial interview.

Because self-disclosure is so delicate a method, I believe that withholding personal details is best unless there is a very specific  reason why sharing them is necessary. As an old teacher of mine once told me, "A psychotherapist should always be asking himself or herself this question: 'who is putting what into the therapeutic space, and why?'" So if I, in my social role as psychotherapist, begin to hear myself talking about details of my own life, my own suffering, my own relationships, as if the client were a friend of mine to whom I can confess and who can confess to me in turn, I would want to ask myself why I am putting my experiences into the therapeutic space when the therapy is meant to be about the client's experiences, and her understanding of them. And, if part of the answer is that telling my client about my life gives me comfort, I would find that to be a serious failure both of technique and, even more importantly, of my responsibilies to my client. At that point, I would want to discuss my need for self-serving self-disclosure with a colleague who could help me either to get back on the right track with this patient, or else refer her to someone who would be able to handle the case properly.

To put this a bit differently, an hour of psychotherapy should not be a time for the therapist to receive anything personally except a fee for services, along with the impersonal joy of helping a fellow human being. So in this regard, as I see it, your therapist has failed you, beginning with having told you about his child's death which, after all, has absolutely nothing to do with you and your situation, and which has obviously complicated and confused the doctor/patient relationship. Further, if the comfort you bring, and the "specialness" of your relationship is so important to him, how will he be able to maintain the non-judgmental, disinterested point of view which is the very bedrock, in my opinion, of this work. This is the reason why sexual or other secondary relationships with clients are forbidden by the ethics of our profession; they split the focus of our interest in two when we should be working towards a single interest: the absolute good of the client. Unlike ordinary human friendships, the therapeutic relationship is not a two-way street, but a one-way street, or at least should be. The time for two-way street relationships is outside of the office with family and friends, not clients.

As I see it, your therapist should never have told you that there is anything "special" about your relationship. There should not be anything special about a doctor/patient relationship. Or else, all of them are special. But to select one as "different" is to put an unfair burden upon the patient who may not benefit at all from being "special," who may need, in fact, simply to be herself.

And even if he, on his own time (not when working as a therapist, I mean, but in his non-professional, private moments), feels strongly that you and he have something "special," why would he put that into the therapeutic space? How would hearing that help you? How would hearing that help the work? It could not help the work in any way that I can imagine, but simply muddies the waters with his feelings, and his needs, when therapy is supposed to be about you and your situation. In fact, I imagine that he spoke those words simply to help himself to feel less lonely, less misunderstood (he has, unfortunately, already let us know that he and his wife don't see eye-to-eye). So all this inappropriate self-disclosure seems to me to have been about his needs, his comfort, and probably not at all helpful to your self-understanding or your therapeutic progress. That is why I call it inappropriate. Not to mince words: his loneliness, his loss, his disappointment with his wife's attitudes, should not have become your problem. In fact, in my professional opinion, you ought to know little about his life, and nothing about his wife--or even, really, that he has one.

And that is the worst of this. Why would he ever tell you how his wife feels about anything. Why was that put into the therapeutic space? What is she doing in the room? Judging from this detail, along with the rest of your letter (and please remember that all I know about this is what you wrote), your therapist, while he might be a nice guy (and I know you like him), is a loose canon badly in need of advice about how to conduct a style of psychotherapy aimed only at helping the client, not himself. I think you already know this in your heart, and that is why you have written to me for advice.

Since you like this person, and would like to keep on knowing him, I suggest that you ask him for a referral to a new therapist. In my opinion, you should do this soon. Perhaps you will want to show him this letter in order to begin that conversation. I assume that once he is reminded of his real responsibilities here, he will agree with my point of view, and will see that he needs to get off the case. Then, once you are in different, less conflicted, much more impersonal hands, you and he will be free to carry on any kind of personal relationship you desire.

Be well,










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page last modified November 4, 2007



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