Boundaries, Dependence and Interdependence
We often discuss boundaries in terms of the therapeutic relationship but the truth is that all healthy relationships require boundaries. Boundaries are what tell us where we end and where the other person begins; what is our responsibility and what is the others. Boundaries allow us to concentrate on the things we can actually control and not take on things we cannot.
Even though boundaries are present in all relationships, they are more noticeable in therapy for several reasons. The first is that the therapeutic relationship is a weird duck, unlike any other type of relationship we have, although it can take on characteristics of other relationships: parent, friend, mentor, lover etc. Because of the unique nature of the relationship, we run into boundaries in places we usually wouldn’t which makes us take notice. Not being able to know about the other person’s thoughts and feelings can feel very unnatural and therefore is more noticeable. Another reason they are so noticeable is that therapists are trained (or should be in theory) to be very conscious of boundaries and to hold them clearly. The therapist needs to be especially conscious of the boundaries as they do not come naturally in therapy, and in some cases can be a boundary which occurs in no other type of relationship.
Clear boundaries are necessary in therapy to protect both the therapist and the patient. Therapy needs to be all about the patient’s needs. This is especially reparative if the patient did not experience having the relationship with their caregiver at a young age be about their needs. Having only the patient’s needs in the room provides the clarity you need to understand your own unconscious patterns and behaviors. But all human beings have needs, including therapists. The best they are able to do is to put aside their own needs for the time they spend with you, either in session or when making contact via phone, text or email between sessions. To get to know someone is to get to know their needs. Therefore, if a client gets to know the therapist, the client gets to know a therapist’s needs and the relationship is no longer only about the client’s needs. That would be the end of therapy. Hence all the restrictions about how much a therapist is willing to self-disclose; it’s their way of keeping the therapeutic field clear for the work that needs to be done. And it follows that no one can live a healthy life continually ignoring their own needs so a therapist has to have time when he is not in contact with his clients to attend to his own needs, hence the limitations on contact.
It is very understandable to get upset about the boundaries and be upset by them. The boundaries in a healthy therapeutic relationship can actually give rise to a lot of ambiguity in the relationship. How do I know if someone actually likes or cares for me if they can’t tell me? How can I trust this is real if I can’t know what they’re thinking or feeling? However, the fact that they cause discomfort or even in some cases acute pain, does not mean anyone is doing anything wrong. In a sense, the boundaries are the painful thing we have to accept in order to avoid much worse pain and damage. And how we react to the boundaries – Which ones upset us? How do we feel about them? What do they show us about what we believe? – is often very revealing of our unconscious motivations and desires. Which is why they are not only necessary, but also very useful for the work being done.
So an important part of boundaries is so that I can know what I am responsible for, but responsibility is something into which we are supposed to be able to grow. Human beings are born while they’re brain is still developing, our frontal cortex doesn’t really come “online” until around the age of two. Physiologically, we’re an open system, so that being connected with other human beings affects both our nervous system and our brain development. In order to fully develop, all human beings need to depend on a stronger, wiser other, an attachment figure, until they can learn emotional regulation, form a good sense of self and self-worth, and learn to trust in their capability to deal with anything that life brings their way. In other words, we learn to cope by being around someone who can cope and is attuned enough to our needs to show us how its done.
If you are not able to undergo this period of dependency and learning as a child, the developmental needs go underground, usually buried under a wide variety of coping mechanisms which attempt to make up for that which you did not get, but they do not disappear. So in order to heal and finish developing into a complete self-sufficient person, some people will need to depend on their therapists for a while, especially for a sense of security, acceptance and emotional regulation. A good, safe therapist should provide a safe, containing place to express ALL of our emotions, even long denied ones and teach us how to tolerate them and separate our feelings from reality. It’s also an opportunity to experience that making your needs known and moving closer to get them met, is a good and healthy thing to do. A place to unlearn the false lessons of a less than perfect childhood.
There are two types of dependency: a healthy dependency which is a natural part of human development (would anyone look at a three year old and say “you’re too dependent?” OK anyone you’d want to know?) and a pathological dependence when we refuse to take responsibility for our own lives and want to STAY dependent on someone else to tell us what to do, how to live, what to think etc. Which if you didn’t get what you need, is often what you’re looking for. We should have had a time of dependency, when we were looked after and someone did tell us those things. But the problem is that the time for that in our lives is past. There is a fine line between healthy dependency and pathological dependency. What will actually differentiate them is a skilled, self-aware therapist holding the correct boundaries so that a client can depend on them for things they cannot do for themselves (emotional regulation, soothing, security, trust, intimacy, understanding, reality checking) and not having the therapist do anything for them they are capable of themselves. A therapist who will slowly allow the patient to take on more responsibility as they grow and increase their skills. This doesn’t have to be picture perfect but should be pretty consistent. Or as described in the literature “good enough” since no one ever gets it perfect.
In my experience, a lot of healing consisted of running into the boundaries and sorting out what my therapist could provide and what he couldn’t. And when he couldn’t provide something, to discern if the reason was because I was capable of doing it myself (even if I wasn’t sure or believed in that capability) or that it was something impossible for anyone to provide. Talking about how we react to boundaries and the beliefs that underlie those reactions allows us to see which expectations are reasonable and what are not possible to ask for as adults (at least in a healthy relationship). Expectations work in both directions; we often need to learn to expect more in certain areas (our need for comfort and understanding is legitimate and is a reasonable expectation) and less in others (no one can love me enough or hold me long enough or say the right words to erase the loss and deprivation I experienced in childhood. Those losses can only be grieved).
Which leads us to one of the reasons that the boundaries can become a source of almost agony. They are SO painful because they identify for us very real losses we have been avoiding being aware of, let alone mourning, for our whole life. For good reason, we did not have the resources to face those losses when we experienced them, and even though now we do, on a very deep level we believe that facing those losses will destroy us (because at one point they would have.) Not to mention, they’re PAINFUL. Only insane people WANT to be in pain. So we long to be taken care of in a way we’ve longed for our whole lives and it’s the fact of a consistent, caring person NOT being able to provide that perfect love we’ve been looking for that identifies the very real losses. There are expectations which as children are healthy but which become impossible to meet as we achieve adulthood. Our ability to take in and integrate some things on a deep level is compromised. Which doesn’t mean the situation is hopeless. We can form an “earned” secure attachment, mourn our losses and heal. Our therapists can help show us we matter and how to get our needs met (including believing that our needs are legitimate in the first place!) so that we can live a fuller life.
The pain caused by the boundaries is why it can be so difficult for therapists to hold clear boundaries, let alone anyone in a “normal” relationship. There are often things you can do in the short term that would provide relief, but short circuit the process of getting to the source of the pain and actually “clearing” it out. Unless you understand that facing the pain of those losses will heal someone, it’s hard to stay with them while they experience the pain without trying to fix it, even if intellectually you understand it’s impossible to do so. My therapist has often talked about learning the hard lessons of what he could and could not be to his patients as he grew as a therapist.
So boundaries, while they can trigger deep feelings of deprivation and worthlessness, are actually a loving thing to do for someone. It is less painful to hear you cannot have something than to be promised you can have it, only to be failed again. And it is in fighting through this pain that we can learn to understand that what we feel in response to those boundaries is no longer true. That they are not about depriving us or an indication that we’re worthless. On the contrary, we matter enough for someone to put themselves through discomfort to do what is right for us, no matter how it feels to them.
Over time, as we work through all the issues that are invoked by the boundaries, and by being with a therapist in a right brain to right brain way, we implicitly learn the skills we need from our therapist so that we no longer need to be dependent. We can learn to have compassion about our healthy needs, recognize which can still be met, learn how to meet them and learn to trust our ability to face whatever life brings. We often start by looking for a place of perfect safety only to learn that true safety lies in our ability to tolerate hurt and turn to others for comfort. This is a painstakingly slow process, chaotic, confusing, painful and often impossible to recognize while it’s happening.
A skilled therapist will slowly expect more from a patient as time goes by much the way a good parent slowly allows a child to do more for themselves and become independent. Just as a child will explore then return to the parent for reassurance before engaging in more and further exploration, will a patient move further and closer in an ever expanding cycle as they work in therapy.
Which brings us to one of the primary goals of therapy, interdependence. Human beings NEVER stop needing other human beings nor do we stop forming attachments. It is through our connections with other people that our needs are meant. All of us, including the most capable of adults, will occasionally need to depend on other people (ie the death of a parent, finding out you have cancer). But for a healthy adult, there are also times where others can depend on them. We will still have attachment figures (spouses, good friends, mentors, children) whose proximity is important to us but the need shifts back and forth. And when someone else can not immediately meet our needs (due to needs of their own, there are those pesky boundaries again), we are capable of taking care of ourselves and getting through until we can get the help we need. Because interdependence requires the shifting back and forth of needs between being dependent and being depended on, it is impossible to be interdependent with our therapist. The therapeutic relationship needs to focused ONLY on the clients needs. Which is why one of the goals of a therapist is to get you to look outward, beyond therapy. To live as a fully developed human being, you need to be able to practice interdependence, which you cannot do with your therapist. In some ways, remaining a patient in therapy forever is analogous to the adult who never leaves their parents. It’s a legitimate choice, but one that can limit a life.
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