On the issue of Professional Boundaries: a response to Carolyn Costin

I received the following thoughtful response to Carolyn's post, dated 11/8/07: 

Caroline, you wrote: "The key, for me, is that although there are guidelines, at some point we also have to trust the things that we know. . . . I do my best to keep true to my profession and my humanness at the same time." I almost agree with you wholeheartedly, and now we have evidence based scientific research to back up the use of our humanity in our practices. Appropriate boundaries between patient and psychotherapist are essential in any psychotherapy and particularly in the field of eating disorders.

However, the topic is often discussed in terms of content. I believe that when a patient wants to know about my private life or wants to include me in her private life (weddings, funerals, births, graduations, award events, etc.) the patient wants and needs a particular psychological emotional experience from sharing the experience with me. In other words, it’s not the information or event that is the issue. The sharing of our humanity is the point. Again, I agree with you. There's no need to share "dirty details." The value is in right brain to right brain communication, not content. Allan Schore, http://www.allanschore.com/ in his fantastic research on affect regulation, is showing affective neuroscience, neuropsychiatry, trauma theory, developmental psychology, attachment theory, pediatrics, infant mental health, psychoanalysis, psychotherapy, and behavioral biology that right brain communication is received by the right brain and actually changes brain structure to allow developmental progress. The discoveries revealed by the increased sensitivity of neuroimaging validates what many sensitive clinicians have known for a long time. Honesty, caring, empathy, sharing spontaneous imagery, acknowledging physical responses to clinical material make for effective connection, growth and increase possibilities for healing. http://www.biosynthesis.org/html/allan_schore.html My pause in wholehearted agreement with you, Caroline, is a slight shift of emphasis. I believe, with the backing of neuroscience, that we can’t keep true to our profession without keeping true to our humanness. P.S. As part of my practice, I've attended a wedding, but not the reception. I’ve visited a new mother in a maternity ward. I’ve applauded from the audience when a person received a hard won and well-deserved award. I’ve called patients in fire areas during Southern California fires to check on their well being. I ask to be notified regarding outcome of surgery. Joanna Poppink, LMFT, Los Angeles psychotherapist, specializing in adult eating disorder recovery.
joanna@poppink.com

I'd still love to hear from other professionals regarding this important issue.  Write any time!  Until next time, Gail