Of course she is…Who else knows more about you?  Who else welcomes you in all your glory…with your good, your bad, and your ugly?  Who is the one person you look forward to seeing when the shit hits the fan?    Or even if you don’t, who else welcomes you to come in and tell her that you would rather be in bed , hiding under the covers, than be here in this lousy office, having to talk about these horrible, shit-hitting-fan feelings?

Yes,  I am happy to be make my office a comforting haven for  my patients.

But there is a real,… make that very real, …danger in therapists who are too invested in the role of best friend.

For one thing, therapists who over-emphasize this part of the relationship with their patients are often self-serving.   Whether we want to admit it or not, some of the Hollywood stereotypes are out there…the lonely or the egotistic or  the very misguided therapist who blurs the boundaries between professional and personal relationships in the service of his or her own needs.

Fortunately, many people can see through the most egregious of these transgressions, …(Think Barbra Streisand).  Therapists who make the most obvious transgressions are usually spotted more easily, and it is usually easy to understand the harm they cause when taking advantage of vulnerable people who have often been similarly abused in childhood.   But more ubiquitous are the subtle forms of boundary transgressions.   Subtle transgressions may seem benign and “helpful”, and this makes them all the more dangerous.

For example, think about the overly-indulgent therapist, one who is available ’round the clock, or one who seldom challenges her patients, or even has frequent out of session contact.  Here is what they are missing….

Maladaptive behaviors and symptoms are frequently traced to feelings of disappointment.   When we are young, we cope with disappointment as best we can,  but we often get stuck in destructive ways of thinking about ,and dealing with, the disappointments in our lives.  In the course of every well-executed therapy, individuals must face disappointment.   It may be disappointment in current figures in their lives, but most frequently, it has earlier roots that are being re-lived in the present.  At some point in time, it is not only inevitable to feel disappointed in one’s therapist, but it is actually desirable because it gives us the gift of exploring the original feelings, current feelings, and responses to them.  Sometimes it emerges as a relatively-pure displacement known as “transference” ie., old feelings displaced onto the therapist, or it may be more “reality”-based in a reaction to something the therapist has just said, done, or not said or not done.  In any event, the individual must feel as safe as possible to explore his/her feelings of disappointment in the therapist.

Therapists who continually blur the lines between friendship and professionalism risk losing a great deal of opportunity for helping their patients undergo real change.    Additionally, they may create a “good patient” who wants to please the therapist as much as the therapist wants to please his/her patient.  Therapy may seem like it’s going along swimmingly, but in reality, nothing much is taking place at all.

How can you tell if your therapist is overly-indulgent or just a nice person?

When choosing a therapist, it’s important to ask about  her theoretical perspective.  This doesn’t have to mean a heady dissertation.  But she should be able to explain , in clear layman’s language, how she understands the human psyche and behaviors, and how this informs how she works with patients.  If she has a clear rationale for her work, and you can understand  her interventions in the context of this rationale, chances are you are on the right track.  Otherwise, she may be more reactive to his or her own whims, which may not always be in your best interest.

Therapy should feel safe.  Safety must mean safety regardless of the feelings that are invoked.  We must be able to tolerate a full range of emotions if we are to feel safe in the world.   If therapy starts feeling like a tea party, chances are you are on the wrong track.

In short, therapy should involve a healthy mix of discomfort in a relatively-comfortable relationship.  Basic trust needs to be there, but if it is feeling too good too much of the time, it may be time to question what , if anything, is going on.

As always, feel free to ask questions…

sb