1/ Online therapy: I've heard therapists comment on how difficult it is for some patients to create a private/safe space for their therapy appointments. (I’ve heard same about some therapy students/trainees). They don't close door, close it but let others to intrude, let children
2/ interrupt, let pets disrupt, etc etc. I've likewise heard pf patients being relatively oblivious to therapist boundaries, for example bringing therapist with them by camera into their beds or even toilets. (To my horror, I even heard of a student therapist conducting
3/ therapy session with clients from their beds). These kinds of privacy/boundary difficulties may be sign that something is amiss in other areas of life as well, with respect to ability to set & maintain physical or emotional boundaries with others, or recognize and respect
4/ those of others. Regular interruptions or intrusions into the therapy space are not something to “work around” in teletherapy. Rather, it should become a focus of the therapy work. Patient’s relation to the therapy boundaries is a window into their relation to boundaries
5/ elsewhere. @DrIsaacsRussell writes, “It is unreasonable to expect the patient to be able to provide a safe setting for themselves, if they have never had that basic experience of safety and cannot even imagine it. So many pts come into therapy having experienced early
6/ impingement.” (article link at end). In other words, the patient may not fully “know” their mind or body truly belongs to them & that entry & sharing of either occurs by invitation & mutual consent. Likewise, they may not fully appreciate that *other’s* minds and bodies belong
7/ to the other. Difficulties may begin in the earliest years, with a parent who treats chid as an extension of self, or denies them right to the privacy of their own minds and own thoughts. In some cases, a parent inserts themselves relentlessly into child's experience. In
8/ others, a parent/caregiver may be so needy that child's normal strivings for separation/individuation/independence feel intolerable. Such patients need our help to know that safe boundaries are even possible— and what it feels like to have them. This understanding and the
9/ lived experience of safe boundaries begins in the therapy relationship itself.
A sample of some useful lines of therapist responses: "I notice that your [husband/child/roommate] entered your room several times. It seems like it's difficult for you to protect your privacy
A sample of some useful lines of therapist responses: "I notice that your [husband/child/roommate] entered your room several times. It seems like it's difficult for you to protect your privacy
10/ during our meetings."
"It's impossible for us to go more deeply into this emotionally-difficult experience when your dog jumps up on you each time you begin to speak about a sensitive topic."
"I'm not comfortable having our therapy session when you are lying on your bed with
"It's impossible for us to go more deeply into this emotionally-difficult experience when your dog jumps up on you each time you begin to speak about a sensitive topic."
"I'm not comfortable having our therapy session when you are lying on your bed with
11/ your shirt partially unbuttoned. Why don't you take a minute to get yourself straightened up & move to a more suitable location, & we'll resume our session then. I think perhaps you are wanting to communicate something to me, and I'd like to be able to hear about it in words"
