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Boundaries in a therapeutic relationship.

I have been spending time today, and at other times over the last 12 years, thinking about a client of mine back in the 90’s. I have no idea why today, but she is someone I think about, wonder about every now and then. Now I am no longer working, and therefore have no need for supervision/therapy, I cannot really work this through with someone. It would have been nice to although not desperately important. I realised that this could be a place for me to do that, since you don’t really know me, and she can remain an anonymous client. Just to add to that, I shall change a few facts to maintain her anonymity.

She was/is (I don’t know whether she is still alive) an intelligent woman of my age, with children the same age as mine. She had a long, long history with psychiatric services, and a long history of sexual abuse. We, after her initial reluctance to engage with any health professional (due to abuse in some of those relationships) had a very good rapport. Sometimes our sessions would be about her current issues (she could turn up in a very regressed state) and sometimes they were about religion, or other things that were important to her. She disclosed a vast amount of stuff to me over the years, much of it harrowing to be hearing. Sometimes in her regressed states, she would see me as her abusive mother or one of the health professionals who’d abused her (negative transference), these were difficult sessions. As well as our individual sessions, she was a member of a closed group I facilitated. The group was populated with several other survivors of sexual abuse, so was really helpful for them, yet a tough group to facilitate.

About 18 months before my partner and I moved away, my clients 20 year old daughter committed suicide. She had also been a psychiatric patient for several years, and had overdosed many times quite likely a cry for help every time, but this time she didn’t survive. As a team we were all shocked and saddened, as Jules had been a patient at our place of work too. My next appointment with her mother was the most harrowing I have ever experienced. She knelt at my knees for most of the 50 mins, sobbing and clasping my hands. Of course there were many more very sad and harrowing sessions, but I particularly remember this one.

Some people use the word privileged when describing sharing such an intimate encounter with someone. I’m not sure that word fits here, but I know that I was so pleased that our relationship was such that she could do this and I could just sit with her, not needing to intervene, not needing her to stop what she needed to do. In fact, I don’t think I felt impotent in that moment, even though I couldn’t do anything to bring back her daughter. I will never forget it, and I never forget her.

The complication of a therapeutic relationship is you can never be your client’s friend. When your work with them finishes, so does the relationship. And, if you’re a good and boundaried psychotherapist that means forever. This is often a tough part for the client, the letting go and the ending. Of course, it can be tough for the psychotherapist too and sometimes it can be a relief. I know my client was a very a ill woman, and I know that to carry on a friendship/relationship with her would be inappropriate and fraught with massive issues. However, I miss our discussions, our chats, and explorations of her religion and my agnosticism. Hell, I can’t even tell her this, can’t tell her I miss her, or now and again ask her how she is. It’s frustrating…..and that is the boundary.
I just have to hope that she has found some peace and that her life is better than it was when our paths ran alongside each other for a while. There is a saying I’ve seen recently about people leaving footprints in your heart. She did.

Close the gate quietly, it’s late.

Kathy the sane.


About kathythesane

Content to be Lefty, Libtard, Snowflake, TreeHugger, DoGooder, kind, generous and sane. This Atheist will say potent prayers for you Trumpettes.

3 responses »

  1. Hi, just read this post.
    It reminded me of an experience (one of many) yrs ago with a client who lost her only child – a 21 yrs old yg man, the passenger in a drunk-driving accident. Both he & his friend were high – yet the driver survived. Of course it took yrs for her to get over the worst of the pain, but in the first few weeks she spent several sessions sobbing on the floor, devastated. I had no problem with her process because I’m such an intensely emotional person & am very comfortable with my own feelings. Sometimes I even cry a little with some clients in empathy, which they appreciate.

    I agree with your overall points – especially with someone so ill – but have a slightly different experience. Over my 25 yrs of p.p. a few clients have become ‘sort of friends’ but with definite limits. Occasionally I’ve given some free sessions when someone couldn’t afford to pay at all, & have seen them use the help to blossom. Also, a long time ago 2 clients offered me specific kinds of help for the first month after the devastation of my apartment burning down around me.

    My excellent therapist/supervisor for 20 yrs (the only ‘good mother’ I’ve ever had) has become a sometime-friend since we stopped working together. It all depends on the client – how good their boundaries are as well as their ego strength. There have been other clients who have asked to keep in touch after they moved on & I gently declined.


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