“Hi Mark! Have you got a minute?”
The voice on the phone was friendly but somehow insistent. Paul was a client who had taken to calling me every other day. It was now Sunday morning – a time for reading the papers, walking the dog (well, if I had one), messing around with the family. The day of rest. But not for me.
A flood of anxieties came down the line at me. In less than a minute my brain felt it had been whipped around in a wind tunnel of neediness.
“Okay Paul, I hear what you’re saying. We’ll take a look at all that and work out what’s to be done. We’ll talk about it tomorrow, during your actual session.”
He let me go.
That was twenty years ago. I was just starting to learn how to set boundaries with my therapy clients. It can be tricky at first. You’re a decent, nice person and some of your clients really need help. Empathy and wanting to help people is what brought you to this work, and it can feel tough to be cruel to be kind.
Here are three tips I find useful to practise when negotiating the therapeutic relationship
Tip One: Keep your ‘gratitude’ in its proper boundaries
Back then I was a newly qualified therapist and I needed work. I was still in the stage of feeling amazed that a living breathing person would actually pay me to help them! Paul would happily hand over £50 (a lot of money to me back then) for his session, and I would feel as if I now owed him.
I had made the elementary mistake of saying to him: “If you need to speak to me, you know where I am.” At that point my home phone line was also my work line. He’d inferred from this that he could all but move in with me as his 24/7 therapist.
But that was crazy (of me, not him).
I was charging a fair price for sessions of up to 90 minutes with him. Even if you did nothing other than give someone highly concentrated attention for an hour once a week, that is still worth a lot to them, because few people ever get such a quality of attention.
But I wasn’t just listening to him. I was also helping him relax at meetings in work, de-traumatizing some traumatic memories from his school days (using an early form of the Rewind Technique) and helping him relax sexually with his partner. Yet I still felt grateful he was handing over money to me!
Remind yourself of all you’re doing for your client so you don’t feel you still owe them something, whether that’s in time or being ‘on call’ day and night.
Tip Two: Be clear with yourself where your boundaries lie
I hadn’t really thought it all through with Paul. He was one of my first clients. Paul wanting to speak to me all the time between sessions only became a problem when I realized it was a problem.
It’s good to be generous with our clients, of course, but we also need to avoid coming to resent them, as this will interfere with the therapy.
Nowadays I am very clear about certain things, such as when I can and can’t be contacted. At the end of a first session I might say something like:
“Okay, so I’ll see you next week (if they have booked to see me again, of course). If you need to contact me, here’s my email address.”
If there’s an emergency, they’ll tell me via email and I can phone them if need be.
This is a much friendlier way of doing it than formally announcing before therapy even starts (and when they might be feeling desperate) what I ‘will and won’t accept’ – which I think is very off-putting for a client.
Tip Three: Remain professional
This may sound obvious, but because we are in the interpersonal helping profession it’s easy to forget sometimes that it is a profession.
If you were employing the services of a lawyer (heaven forbid), I doubt you’d be able to have full access to them at all times (unless you were paying A LOT of money). Your dentist won’t talk with you about toothbrush choices on Saturday night and your local fire service personnel probably don’t want to hear about the technical issues you are having with your new TV.
We need to be kind and generous but we can best help our clients help themselves when they can respect that this is a professional relationship. And we do this by drawing the line when it’s necessary. Of course we need to be friendly, but we are not their friend, nor a substitute for a partner or family member.As therapy practitioners we need to be friendly, but remember we are not the client's friend.Click To Tweet
You are a professional just like any other.
When your time with your client is clearly and specifically limited, then your client is more likely to really focus on the therapy they are receiving from you, rather than thinking: ‘Oh, I’ll call during the week to take that last point further.’
Eventually, I had to tell Paul that our time together was going to be limited to the actual session times. I resisted the urge to apologize.
He suggested he pay me for any time on the phone with me. I agreed we could do this, at specific set times. But he never did call me after that, although he continued seeing me for therapy. It was an important lesson for both of us. Just because someone is paying you, it does not mean they ‘own you’ in some way.
When you feel properly respected within the therapeutic relationship, you genuinely have the spare capacity to truly focus on the needs of your client without any low level resentments polluting your therapy.
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