Home > Uncategorized > Friendships with Ex-patients: Why I Say “No”

Friendships with Ex-patients: Why I Say “No”


I thought this was an excellent, compassionate explanation of why a therapist might choose to not have a personal relationship with you. I very much respected his stance of continuing to care for his clients even after they were no longer his clients. I thought this might be helpful for a lot of people to read.

Dr. Gerald Stein

The_Friends_Stage_cropped

I recently received an invitation from a former patient to meet for coffee. This warm-hearted offer came from a man who is as principled and decent as anyone I know. What’s more, he is funny and bright — just the sort of person I’d enjoy having as a friend.

I said no.

Now you might ask, why did I make this decision? This was not the first such request since I retired over two years ago and not the first from a person I thought companionable. I’ve said no to all of them. What I’m about to do is explain how I reasoned this out. I’ll finish with my response to this terrific guy.

First, nothing in the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct forbids me from having communication with former patients. Nowhere does it say I can’t be friends with them. We are, however…

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Categories: Uncategorized
  1. July 28, 2014 at 5:53 pm

    Having read both articles; I am not in agreement with either you or the other person’s statement.
    When one retires and is no longer practicing; the ethics should be completely removed.

    If your preference as a T is not to have a friendship as you do not particular believe you are compatible with the ex-client then that is fine.

    However if this is not the case; then the decision should be a two way process. There is an almighty assumption that the client is somewhat limited in their decision making and therefore your ex T makes that decision. This I believe to be insulting to the client. Please do not assume that this is in the best interest of the client. Equally you are being rather arrogant and still wielding your power. There would appear to be no equality outside the relationship and this I suspect is very undermining to the client.

    The T has the right to make the decision; but please be honest and do not purport this to be your care for the client. This is utter poppycock and T’s need to more open and honest with themselves.
    Thanks

    Like

    • July 28, 2014 at 6:27 pm

      Hi Josie,
      I think “utter poppycock” is a little strong. 😀 I understand that you disagree and I am sure that you are not the only one. I am sure that there are also therapist’s out there who would disagree. From my point of view, I actually do not see this as arrogant at all, probably because I am a client whom I think holds a strong possibility of being hurt by a post-therapy friendship while at the same time being close to certain I would not have the strength to turn it down. I have also had the experience with my therapist of running into a disruption which threatened to undermine so much of our work together. Being still a client, I had the opportunity to work through the disruption and repair the relationship so that the work was preserved. But if I were to start a friendship and have things go sour due to my expectations being too high or even the friendship falling off the way some friendships naturally do, I honestly think it could negatively impact all of the work that we did together. But then, I also believe that equality outside of the relationship is difficult. I don’t mean that in terms of worth or competence or understanding. I know that my therapist is another wounded, struggling human being who is on the other side of the couch in this exchange. But, he also knows my deepest, darkest, most shameful secrets. If we were to have a friendship after therapy, I could not, in all reasonableness, expect to know him to the same level. Without the boundaries of therapy in place, a relationship with another man, who is also married, that intimate would feel inappropriate to me. So there is an inherent inequality of information. Not because anyone is being arrogant or putting themselves above me, its just the nature of the beast. And I think he clearly stated that he did not think this would be the case with all of his clients, but that he was worried about the effect on some of his clients and that setting an across the board rule has less potential to cause hurt. Again, I agree because of my experience. My T has a no hug rule across the board. It’s hard enough at times not being able to get a hug but would a lot worse if I knew other clients could be hugged but I couldn’t. In a sense, Dr. Stein is weighing the risk to all his clients of causing harm against what good would come of extending a relationship and deciding that the benefits do not outweigh the risks. Again, you do not have to agree with him, but at least he has taken a thoughtful approach to how to handle instead of being casual about actions that could cause harm.

      And while you are also entitled to believe that this is not the best way to handle the situation and is even unfair to the client, I do beg to differ that you call his motivation into question. I think Dr. Stein is being utterly honest about his reasons and being focused on the good of his client. Disagree with his methods, fine and even the decision he is making; but I would not go so far as to accuse him of dishonesty. I think he is truly motivated by his concern of not harming people who were once in his car.

      You sound very angry about this Josie, I am wondering what it is stirring up for you? ~ AG

      Liked by 2 people

  2. July 28, 2014 at 5:59 pm

    This was good to read. If hard in its way Thanks.

    Living in a town of 30,000 people I run into MB and know that I will after I am no longer seeing her as a therapist. I figured out awhile ago that I don’t actually want another relationship with her- this works well for me. I don’t wish that she was my mom, for example. But it’s very much a relationship that is based on a precise model, isn’t it?

    It’s so weird both knowing that I am getting exactly what I need to grow and heal and that is what is most important here and feeling sad because I know that the definition of the relationship means that after she retires completely, I won’t be seeing her in such an intense way any longer.

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  3. Ms. Sharkey
    July 28, 2014 at 6:58 pm

    First off, I disagree with Josie’s point that ethics should be removed after a therapist retires. I find that to be a disturbing idea, quite frankly. The therapy relationship is unique among the relationships I have with all my other healthcare providers. My therapist knows far more about me that they do, or ever will. The knowledge gives the therapist a lot power, and even after retirement, that knowledge must still be held ethically and mindfully.

    My therapist has told me that we can’t be friends after I end therapy and I understand why. We’ve built up a certain dynamic in our sessions together, and while there are similarities on the surface to my friendships, there are core differences. I’m always the one making myself vulnerable to him and his whole focus is always on my needs and my safety. I’ve thought about what it would be like to transition from our current relationship to a typical friendship, and I think it would just be awkward. I could see myself falling back into the client role, or always wanting to. Could I handle him being human and faulty and fragile, as my friends are? As we all are? Could I handle him being needy, in a bad mood? I’m not sure and I don’t want to find out.

    I like him as my therapist.

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  4. Ann
    July 28, 2014 at 10:20 pm

    Thank you for posting this article. I figure most Ts wouldn’t want to deal with the emotional complexity that could arise outside the therapeutic relationship. If a T holds out the hope of a future relationship outside of therapy, then the client could become very confused about whose needs were being met! Actually the client is in a disadvantage as they really don’t know what they are getting into and the therapist knows a lot about the client. Ts are human like everyone else and could easily be seduced into thinking they could handle a potential harmful situation. There are enough people in the world to befriend without depending on a former client or therapist to get your needs met. Do I wish my T was the perfect man that would take care of all my needs (rational and irrational) and think I am amazing? Of course! Is that realistic? Absolutely not! Real life is where a client needs to practice what they have gained from the therapeutic relationship! What happens in the room is practice-thank God for therapists who hold that boundary. It would be a rare case where a future relationship would not end in disappointment.

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  5. July 29, 2014 at 3:35 am

    I would just like to respond to your comments. I am going to start off by saying that I do not wish to be disrespectful to you or Dr Stein.
    My first point is perhaps the language used. You say client and the Dr says patient. I think this is a very subtle point; but one that needs exploring. Patient refers to the clinical/ medical mode in the first instance; whilst client implies voluntary seeking support.
    My next point being that when one retires from the remit of therapy; they are no longer constricted by boundaries or ethics. This does not infer that a T is suddenly going to drop their own standards and this I accept. However the therapist is no longer a therapist and the client is no longer a client. This to me is the basic principle.
    Where the difficulty may arise is whereby the client still wants a relationship with the therapist and not the person and this is where I will concede and agree with both you and Dr Stein. Equally the same principles would apply if the T saw the person as a client only.

    Of course the argument would be that you (as the client) have only ever known this person as a T. This I think needs further exploring! Clients do have some insight and do pick up cues and vibes from the T and do at times see more than just the T. They see the real person as well. If this is not the case; then this brings the therapeutic relationship into question.
    The questions that needs to be explored is whether or not therapy is in the real world or in a cocoon? I believe that sharing takes place between the client and the therapist. Therapy cannot all be so one-sided and if this is the case; then clients are living in a false reality.

    I do believe that any information given to the T about yourself within therapy must always remain confidential and this principle must remain whether the T retires or not.

    To ask to meet a T for a cup of coffee; years later is not unnatural and depending on the intent this can be viable for both parties without causing hurt or distress. What you have are two adults of equal footing and to revert to T and client is not appropriate and in some ways perhaps the T is not able to see the client as someone other than a client. This is what i mean by the T needing to examine their own intentions.

    I would say though that the client also has to be honest and upfront and that they do not have a hidden agenda or that they wants their needs met not by the person but by the T.

    An occasional cup of tea or chat with an ex T can do someone the world of good.

    Thanks Josie

    Liked by 1 person

    • liz
      July 29, 2014 at 3:18 pm

      Hi Josie,
      I see your point, but I still agree with Dr. Stein.

      I’ll try to articulate: over the years, my therapist has done a bunch of stuff outside of his office hours, which I eventually came to find out one way or another (I don’t live in a small town, but still). Some of it was work related and some of it was not, and still every time I found out something about his private life I felt awkward, halfway between betrayed and embarrassed.

      My point is, I do see the real person beyond the therapist, and I even like that person (most of the time), but I don’t have to deal with him the same way I have to deal with everybody else in my life. That’s why, whenever something reminds me he’s doing other stuff beside seeing me, even when it’s some really cool stuff, I don’t feel 100% ok with it (on so many different levels). I can’t handle any kind of information about him in a neutral way, and that’s why I probably wouldn’t be at ease getting to know him as a friend.

      I know he is a wonderful guy and, on a hypothetical level, it sounds like it would be awesome to go out and get a beer once (ahem, if ever…) I’ll be done with my treatment, or once he’ll be retired.
      But in reality? I honestly think I would run away screaming.
      Or I would feel awkward, I would probably be disappointed by finding out he’s annoying, or a cheating husband, or a right wing conservative, or whatever. It would inevitably made me think back to all the work we have done and look at it from a totally different perspective.

      So I guess therapy is, in a way, “in a cocoon”, but I don’t see that as a negative thing. If there wasn’t the cocoon (I’m just gonna keep using this word, it sounds great) I wouldn’t be able to express myself freely, to develop secure attachment, to explore my subconscious mechanisms in a safe place, and so on. That’s the reason why, as AG very well explained in some previous post, we pay for therapy.
      This doesn’t mean the relationship is one-sided, it just means (ex) therapist and (ex) client stand on two different levels. It is necessary for the healing to occur, and I don’t see how a transition from that to a regular friendship could do any good to anyone. Sounds like an extremely complex and delicate situation that is more prone to end up badly.

      After several years of crying and getting angry at my therapist (regardless of how flexible and accommodating he is), I am pretty much convinced that boundaries are there for a reason, and they should be considered as a sacred thing instead of dismissed like a technicality.

      Like

  6. Ann
    July 29, 2014 at 1:55 pm

    Josie, I can see your point. There are no absolute rules and each retired therapist has the right to determine their policy. Some are more conservative than others. I also agree that some clients/patients are more attuned to their T’s moods, strengths and weaknesses. However if that is the focus of a therapeutic session, I consider it wasted money. I am very good at deflecting and trying to get the focus on my T, his world and opinions. Fortunately he caught that early on and challenges me when I do it. He knows that I use it as a defense to avoid my own crap. My relationship with him is truely unique. If he held out the hope of a future friendship that would then always be at the back of my mind. It could derail everything.
    Now I personally don’t see the problem of an ” occasional” cup of coffee. But no relationship is static and “occasional” can mean different things to different patients. Also the Dr. likely has patients who consider him their best friend and could become problematic outside the “therapy room”. I understand your confusion with client/patient. I have found that generally psychiatrists (because they are MDs) use the word patient. I see a psychiatrist for therapy and he refers to his “patients” and I address him as Dr. X. I think that since their other medical colleagues have “patients”, then they deserve the same respect. Most psychologists, MSWs etc) have been trained to use the word client.
    I think the concept of power will always make the idea of a relationship after therapy a very controversial subject!

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  7. XXX
    July 29, 2014 at 3:58 pm

    I think that this is such a touchy topic because we are all in so much emotional pain that when we talk about hypothetically not being able to access our T’s its extremely frightening. I still need her to see me like I need air. Honestly not being dramatic but she is the only person in this whole entire world who knows me, knows how I feel, knows what i’ve been through, and actually gives a damn, and doesn’t say well that’s just way too much for me to deal with!!! So when you talk about not being friends I just hear rejection from someone I need to love me right now. Ha, and the right now means every thing!!! Screw dealing with the future when I am struggling day to day. AKA can’t deal!!!! haha

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  8. July 29, 2014 at 4:19 pm

    Liz and Ann; you both made valid points and these I will not dispute. However you note that people become very animated talking about this issue. Each person re client or patient is different and this subject matter does evoke a lot of emotions. A cup of tea/coffee does not imply any romance or any sexual feelings’ with your T, this is friendship on a very loose basis where intimacy of any nature should not be sought.
    Thanks Josie

    Like

    • Ms. Sharkey
      July 29, 2014 at 7:23 pm

      Yes, each client is different. However, it’s important for a therapist to be consistent in their approach. If the therapist turns down an invitation to coffee with Client B, but accepts one from Client B, the therapist is being inconsistent. If Client A were ever to find out, that could add a whole other layer of complication. I understand completely why therapists and other health care professionals err on the side of caution when it comes to forming any of relationship with clients past or present.

      A relationship does not have to be sexual or romantic for it to be intimate. I have many emotionally intimate friendships.

      Note that your reaction was to accuse therapists who maintain these boundaries of arrogance, wielding power and insulting their clients. I’m wondering why you’re assigning such negative motivations.

      Like

  9. Ann
    July 29, 2014 at 5:57 pm

    Liz, I admire what you have to say! It resonates with me. I have to be aware of the reality of my T versus the fantasy in the room. Josie, I wonder if your relationship is not as intense with your T as some. I have had Ts where I didn’t feel like I took any emotional risks and would probably not have a problem with a later relationship. However, now that I am back in my hometown (scene of the crime so to speak :-)), I have been highly emotional. Also my T is male and close to my age. There are too many factors involved in my situation to consider anything other than therapy with him as safe. If he were female or 20 years older (or younger) or maybe if I wasn’t dealing with such a highly emotional subject, maybe I would see no harm in “just coffee”. In my case, I think it would lead to a lot of confusion and disappointment. Josie, what kind of relationship do you have with your T. If that is too personal, just ignore my question!

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  10. July 30, 2014 at 1:59 am

    Think of an ex T whom you knew a number of years ago. They have retired and you are no longer a client. You regain contact out with therapy and invite therm for a tea or coffee. The onus will be on the ex T as to whether they accept or not. Their decision of course needs to be respected. Please do not though make assumptions about ex clients as to why you accept or refuse. This is the point I am trying to make.
    Thanks Josie

    Like

  11. Louise
    July 30, 2014 at 7:50 am

    Can I just hold out hope that my therapist will never retire? Seriously.

    This post really got me thinking because I expect my therapist to retire in the next 15-20 years. And as of now, I could easily see that we would be in some form of therapeutic contact in this time – there’s lots of work to do and it seems it is never done. I may not need twice weekly session forever, but I wouldn’t be surprised at needing some form of contact.

    So the thought of going from this to no contact other than email (or whatever we are using to communist then) fills me with dread.

    Maybe that’s because our relationship is different. It’s not a one-way street and I’m very attuned to her energies. Which isn’t to say that the focus of treatment isn’t about me, or that there aren’t boundaries, but that it is a relationship with two people. We share an overlapping history, one that is uncannily similar at times. Sometimes I need her to tell me about her past and specifics because I don’t have anyone else in my life who so closely shares my predicament. She has actually walked in my shoes, and while my path may differ, it is still helpful for me to know her way through. And she obliges and answers my questions but always then asks what prompted me to ask the question and how I feel about the information offered up.

    Sometimes I feel as if she’s talking to a younger version of herself.

    Maybe I know too much, more than I should. But I read her very closely and can intuit when things are off kilter. If she doesn’t provide an explanation, I’m left to worry that it’s me or something is off with us. She knows me well enough to point it out when she is aware, and I’m getting better at asking for more data rather than assuming it’s me.

    And then there was the impasse that erupted nearly a year ago, when I bumped into an immovable part in her. Perhaps I was (and still am) angry because it made me confront the reality that there were two people in the room, in the relationship, and not just me. And I was angry that she couldn’t put her own shit aside in order to take care of me. Isn’t that the way it’s supposed to work?

    Of course, when I mentioned recently that I wished I had just asked her to meet for coffee instead of making an appointment, her response was “I can take better care of you this way.” And she pointed out that if we were just friends, she wouldn’t fight so hard for our relationship whenever I’m trying to bolt for the door.

    But having said all that, if we indeed get through this impasse still intact, and if our relationship ends up spanning nearly two decades, I would be incredibly hurt to have all of that disappear just because she “retired.” I don’t want to be her best friend or invited over for the holidays, but I would want an occasional walk by the river or a cup of coffee.

    There is intimacy and trust and conflict and reparation in our relationship and it goes both ways. We will have been through too much together, we will have changed each other too much, to just let the relationship go.

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  12. July 30, 2014 at 8:39 am

    I must say I agree with your sentiments Louise ; your last statement sums up all that I wanted to say. Thanks Josie

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  13. July 30, 2014 at 1:11 pm

    Hi All,
    Sorry to have not replied until now, yesterday got a little crazy. I’m kind of glad I wasn’t able to though as I think this has been a great discussion. I want to thank everyone for being very respectful of each other’s opinion’s even while disagreeing, and keeping things so civil. That can be difficult, especially on such an emotional topic and I think you all have done a superb job. Josie I was especially impressed that you retained a clear, but calm and respectful voice while probably feeling like a lone voice in the wilderness until Louise came along. It’s not easy to do.

    I think what is clear from this conversation (even based on our limited sampling set) is that whether a therapist has contact, and of what nature that contact is, is not an easily settled question and will probably differ from therapist to therapist. Dr. Stein clearly stated in his article that he knew not everyone would handle it this way, nor did he claim to be “right” and everyone else wrong. He stated what he believed the right thing to do and then went on to explain his reasons for those decisions. I am sure that therapist’s who decide differently also can arrive at those different conclusions through a well-reasoned process. I am always suspicious of any solution that assumes that every human being should march in lockstep. I also do not need to have everyone agree, but I do think that for a therapist, these kinds of decisions should be made consciously and after some deliberation on the issues involved for all their clients.

    Josie, if I hear you correctly, and please tell me if I don’t, but the real basis of your disagreement is that Dr. Stein removed the decision from the client. It sounds like it feels very disrespectful and infantilizing to you, that a “false” power imbalance is being imposed by his acting unilaterally. It also sounds like you feel like it denies the reality of the relationship. I can understand why feeling that way would bother you and make this a method you do not agree with.

    On the other hand, I think that a lot of what is being expressed by other people is the sense that while yes, the relationship is real, part of its power is that it is contained within therapy. And that as painful as it is to contemplate a day when the person is no longer available (I am with you Louise on hoping BN never retires! I have visions of holding sessions in his nursing home. 😀 ), we would rather do that than risk injuring the work that was done.

    Which is why I am glad that there are therapists out there who work both ways. I suspect that people who feel the way you and Louise do find a therapist who works that way because it is suited to their needs. While someone like me, who in a sense feels a need to be protected from that personal relationship because really, on a fundamental level, I do NOT trust how demanding I might become on one hand, or how disillusioned on the other, finds a therapist like Dr. Stein or BN who has very clear, stricter boundaries. What feels restrictive to one person provides a sense of safety for another.

    Thank you to everyone again, I think this was such an important discussion and that so many people will benefit from reading it. BN once told me that one of the most important ways to learn about yourself in therapy is in paying attention to and understanding how you react to the boundaries. From that point of view, I think this is profitable topic for any client to think through. Personally, I think it has allowed me to see, once again, how good a therapeutic match BN is for me.

    AG

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  14. July 30, 2014 at 4:39 pm

    Hello AG, your summary re all the discussions that have taken place is very fair and honest. My apologies if I have hogged the show; this was not my intention.

    I think interactive discussion is very good.
    Thanks Josie

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    • July 30, 2014 at 4:47 pm

      Josie,
      Absolutely no apology necessary; you did not hog the show. It was a really good discussion and for a while you were the only one holding up a point of view. You did so with a great deal of grace. I also think that discussion is good, we can all learn from each other.

      Like

  15. July 31, 2014 at 12:25 am

    I think we all can tend to project our relationship details onto others. No two relationships are the same. There are probably many therapist/client relationships that should not continue outside of a therapy setting, while there are others that could continue quite nicely. Of course care and consideration should be taken by the therapist and the client if they want to pursue a friendship or even a casual acquaintance type of relationship after the therapist/client relationship ends.

    And these relationships don’t end just because the therapist quits or retires, it can also end when the client has sufficiently healed and no longer needs the therapist/client relationship and could handle a friendship with the therapist.

    If a retired therapist decides not to pursue relationships with former clients then that’s a valid choice as well. He might not be able to do it with a clear conscience. But if a former therapist was open to pursuing relationships with former clients then as long as they did so with care and caution then while it’s not risk free, I don’t see massive concerns with it.

    Like

    • July 31, 2014 at 10:49 am

      Judy,
      I very much agree with what your saying. I think one of the things that can become complicated when discussing our relationships with our therapists is that they carry a heavy symbolic weight in addition to the actual adult to adult relationship, but what those symbols are and the weight they carry is going to be unique to us and our experience. So in some sense we’re not talking apples to apples when we’re discussing this. I said before, I think it’s a fruitful subject for a client to explore and I really appreciate us all discussing it because we will see it different ways.

      There is one thing I meant to say earlier, and if I may, I’m going to use my reply to you to do so. 🙂 We keep talking about leaving the relationship behind. But I believe that is utterly impossible. In the time we have worked together, BN has become inextricably woven into you I am, and although I believe the effect on him is disproportionate to that on me, I have changed him also (he’s told me so). No matter where I go or how long since I have seen him, I carry him with me and he carries me with him. Not the same as actually seeing them, I know, but it’s not nothing. 🙂

      Liked by 1 person

  16. July 31, 2014 at 10:17 am

    Hello AG,
    Let me put my principles into practice. I have only recently contacted my ex T from a number of years ago. She has now retired and I want to have contact with her.

    My mother is very seriously ill in hospital and will not last much longer. She has already outlived the doctor’s expectation.

    I have alerted my ex T to my current situation and I am expecting to have contact with her.

    Obviously the proof of the pudding is in the eating and I may have to wait; as I suspect she is currently on holiday at present.

    I am not expecting her to respond like a T though; I just need to let her know how I am and doing; during this difficult period.

    This is where i would appreciate a cup of tea and chat.

    Both of us are on equal footing apart from the fact she has lots of background information re myself and this will not be discussed.

    I may be completely wrong and she may decline my offer and this I need to accept and respect.
    Thanks Josie

    Like

    • July 31, 2014 at 10:52 am

      Josie,
      This is even more impressive, you weren’t having a theoretical discussion about something in the future, you’re in the midst of it now! I am very sorry about your mother. I have no idea what your relationship with her is like, but losing a parent is a difficult passage no matter what. I can totally understand why you would reach out to her at a time like this. I sincerely wish and hope that you hear back from you and she is willing to meet with you. I am sure it would provide a lot of comfort and strength at a time like this. If you are wrong and she does decline your offer, maybe this discussion would provide some solace, that although you think she’s making the wrong decision, that she is sincerely motivated by care for you. But I hope it’s a yes. xx AG

      Like

  17. Louise
    July 31, 2014 at 10:33 am

    AG – I am so glad that I’m not the only one with a nursing home fantasy!

    I had the privilege of hearing the lead attorney on the Supreme Court case that overturned DOMA speak at my work. One of the anecdotes that she shared that stuck with me was that Edie Windsor’s wife was a therapist. She had 3 clients on her schedule the day she died. She was 77. So there is hope…

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    • July 31, 2014 at 10:57 am

      Louise,
      LOL definitely not alone. Love the 77! i have the feeling BN is planning on practicing as long as he stays sharp and can get to the office. I am 53, and he is 65 (although in great shape, he’s always been very active). Every once in a while I ask if he has any plans for retirement and he just gives me this lovely smile and says no. Maybe someday I will decide to leave (I tried that but it didn’t take. 🙂 ) but in the meantime, I’ll take what I can get. 🙂 ~ AG

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  18. Ann
    July 31, 2014 at 3:33 pm

    Josie, I am very sorry to learn of your mom’s critical condition. Of course most everyone needs good emotional support dealing with a loved one’s death. Unfortunately, when discussing issues online, we can’t know when someone’s point of view comes from an abstract opinion or when the person is dealing with a true life personal experience. Whether it comes from your former therapist, family or close friends, I hope you will receive the support and empathy you need during such a sad time. Best wishes, Ann

    Like

  19. July 31, 2014 at 3:52 pm

    Thanks Ann, your kind words are very much appreciated. I needed to express my views as the articles caught my attention. In some ways this was a distraction for me re the current situation with my mother.
    I needed to feel alive and AG did pick up re my anger. This was not intentional on my part. I also tried to retain some objectivity as this subject matter I have previously discussed with a current T.
    I have argued the case with her and I suppose she is not sure what approach she would take if she retired and an ex-client wanted contact. There are too many variables at stake according to her.
    She is aware that I have contacted my ex T and has no problem with this.

    She is very supportive where my mother is concerned and being honest I do not deserve someone like her.

    A lot of my anger is projected on to her and this she takes. I feel awful at times as to how I treat her.

    I think the waiting re my mother’s death is getting to me and I am also waiting for my ex T to contact.

    I have looked after my mother for the last 20 years and this is a big wrench for me. My current T knows this and is trying to support me; if I will allow it.

    Thanks Josie

    Like

    • July 31, 2014 at 4:49 pm

      Josie,
      I do want to be clear that my asking about your anger was out of a desire to understand how you were feeling. I was not upset about your anger nor do I feel like it was improperly expressed. You are facing a very difficult time, of course you are feeling a lot. I hope I am not overstepping, and if I am, please forgive me, but I wanted to make sure that you know I am in no way upset. I think Ann expressed it so much better than I was able to, but that is very much what I hope for you also. Peace, AG

      Like

  20. Ann
    July 31, 2014 at 6:50 pm

    Josie, As was thinking it through (and you made me think), I came to the conclusion that entering into therapy with the expectation of a later outside relationship would confuse me. However after the fact, with a few years passing, I don’t know how I would feel about visiting with my T after therapy. It is one of those things you don’t know what you would do until you face it. I haven’t been there, but you have! This is why I love AG’s site. She doesn’t shy away from disagreements as long as people are respectful. She sets a terrific example and is always gentle in her responses. I think she also is very straightforward towards those who refuse to show common curtesy and will call them out! This makes this site safe. I hope you feel comfortable coming back and letting us know how you are doing! If you do see your former T, I would love to know how it goes. Keeping you in my thoughts during this difficult time.
    AG, you have done a ton of writing in the last several days! You are on a roll. I think your BN will be proud to see how productive you have been! Now if I could get my lazy butt off my sofa! 🙂 xo Ann

    Like

  21. happylou
    August 3, 2014 at 10:05 pm

    Hi AG–thanks for sharing this article. I think this T was thoughtful in his response to this potentially challenging issue.

    I would completely expect my T to decline such an invitation from me. It pains me to say this because I cannot imagine my life without him–I desperately want to “keep him” in my life forever. I know he wouldn’t decline an invitation to be mean, but because he is so committed to being what he needs to be for me (my T), not what I want him to be (my BFF..lol).

    Although it saddens me that our relationship will never be more than what is shared within the walls of his office, I appreciate him looking out for my best interest (I can’t even believe I am writing this–perhaps I am inching closer to accepting our therapeutic relationship for what it really is?).

    As you have alluded to in the past, from an intellectual standpoint, I completely understand the boundaries and ethics, but my heart missed the memo. Does anyone in this community have tips on narrowing the gap between the head and the heart on the myriad of feelings you can have for your T?

    Like

    • August 4, 2014 at 1:19 pm

      Hi happylou,
      Good to hear from you! I think it’s good that you can recognize that the boundaries are necessary while also acknowledging that they evoke difficult feelings. I think it’s really important to hold both. And yes it does sound like you are inching closer to accepting the necessary limitations of the therapeutic relationship 🙂 a slow, difficult process in my experience. The best advice I could offer (but am very interested to hear what other people have to say) is to continue to go and talk about the feelings that come up with your T. Wanting to be able to keep him, how painful the thought of losing him is, sad that the relationship is only in his office, etc. Our heart misses the memo, I think, because its about more than just our relationship with our T. Understanding and processing the losses evoked slowly leeches the intensity of the feelings I think. I know while it can still happen that I can experience sharper pangs of pain here and there, overall, I think the pain happens much more infrequently and with less intensity these days. Really good question. ~ AG

      Like

  22. liz
    August 10, 2014 at 10:44 am

    I resuscitate this discussion after some time (I was on vacation) to send all my sympathy and my support to Josie in this difficult time.
    And to say that I (and a lot of other people who commented, I guess) was objecting to the original comment on a totally hypothetical and universal way, so I apologize if I sounded rude or anything.
    I obviously think that in such a particular and delicate situation it should be perfectly acceptable for somebody to contact their former therapist.
    I really hope everything will turn out fine (as far as possible, anyway, given the circumstances).

    Like

    • JOSIE DUFFY
      August 11, 2014 at 4:11 pm

      how can I post comments too quickly? Is there some sort of rationing? Thanks Josie

      Like

      • August 11, 2014 at 4:22 pm

        Josie,
        I do not have any limits set on how often or how much anyone can post comments. The only restriction is that replies will only nest four deep. The only other thing I can think of is that you are hitting some kind of spam filter WordPress has in place, but I honestly don’t know anything about it; I can assure that it’s not anything in my settings that I am aware of.

        Like

  23. August 10, 2014 at 3:05 pm

    Hello Liz, thanks for your support, my ex T has been on holiday and I am hoping some time this week she will respond. My mother is critically ill and she was not good today and I do not think she had much longer to live.
    There has always been some significance between my ex T and my mother and she is very much aware of this. Call it transference; but it is more than this. The time gap has been over 15 years; yet the connection is still there.
    If there is no response from her; I shall be very disappointed and hurt. This will seem like a further loss in my life.
    During this desperate time my ex T does come to mind quite frequently and I need some support from her in whatever way she can give.

    Thanks Josie

    Like

    • August 10, 2014 at 10:29 pm

      (((Josie))) I am sorry that you are facing the loss of your mother so soon. I hope that you hear back from your ex-T. If it helps, I hope you would feel comfortable coming here for support also. xx AG

      Like

  24. August 11, 2014 at 4:44 pm

    thanks for your support AG.

    Like

  25. August 11, 2014 at 4:46 pm

    The waiting is getting to me re my ex T. If there is no respose the person who will recieve the backlash is more than likey me and my currentT.
    Thanks Josie

    Like

    • August 11, 2014 at 8:46 pm

      Josie,
      I’m so sorry you haven’t heard back, you do not need this added stress. And I’m sorry, because I think you’re right that you and your current T will bear the backlash, which I am sure feels very unfair. It can be difficult to see how we can move through hard and painful times, but we are often more strong than we know. I hope that you find some comfort. I’m sorry, words feel extremely inadequate in consideration of what you are facing.

      Like

  26. Betty
    August 12, 2014 at 5:49 pm

    I have, as many have seriously struggled with this issue as my T for almost 25 years will be retiring in a few years! After much thinking & discussions with myself & my T it occurred to me that when we go to our physician, GYN, dentist, CPA, etc. are we looking for a personal relationship? For most, no we are not! Why is it we expect to have one with a therapist, when we decided to go to them to get help and than decide to fight so hard to get this dual relationship?

    I do believe it is because “emotions” are involved and because of what needs were not met as children!? My T explained a “relationship circle” to me which has 5 layers. We let our therapist’s into the most inner layer of that circle (letting them know everything about us) which is not a “normal” relationship with any other person, even including your own partners! We are seeking a truth to find ourselves & in order to do that we let out T’s in far further than anyone else in our lives so we can face & grieve our losses, work on our issues & become a “whole” person which is what most want when seeking therapy!!

    I do not believe it is a “power trip” for therapist’s (some it can be due to their own issues) & when we stop and really look at why we desire and long for these relationships with our therapists, it usually is due to something that was void in our childhood!

    The feelings are normal as we are all looking for the “perfect” relationships but when you step back and look at the therapist what are you looking for, and how does knowing everything about them going to help/resolve your own issues? If you got what you thought you wanted would all your issues be resolved? Absolutely not! If it was that easy, I believe we all would be “healed” very quickly!

    We forget due to our emotions being involved that therapists are “trained doctors”! We seek them out because something in our life isn’t working for us so we are trying to seek & face these issues just like we would for a “physical” ailment.

    Yes, since our emotions are involved it is much harder to remember they are truly “trained doctors” and that expecting them to be our friends really is not a realistic expectation as it would not be for any other doctor you see!

    This is difficult for me to write but it also is necessary as I have to face and grieve the losses, longings, fears, anger, etc. which is why “I sought out my “THERAPIST/DOCTOR” for help not a friendship!!

    Like

  27. August 30, 2014 at 2:00 pm

    Hello AG
    Just thought I would post an update re my situation.
    My mother did die about two weeks ago and my ex T has responded. Whilst I have not had that cup of tea or coffee; she has written on 2 occasions. Both letters have provided me with some comfort. My current T is well aware of my contact and my ex T is only glad that I have my current T.
    I do not believe that boundaries have been broken in any way by either T.
    The intention being that I am happy with my current T and I was never looking for my ex T to provide therapy. I shall more than likely have further communication with my ex and at the end of next month shall see her.
    This poses no problem for either T.
    Obviously I am very vulnerable at present and I need comfort.
    Thanks JD

    Like

    • August 31, 2014 at 5:55 pm

      Josie,
      Thank you for updating us, I have been wondering how you were doing. I am so sorry for the loss of your mother. You have my deepest condolences and will be in my thoughts and prayers. I am so very glad that you have heard from your ex T and it has provided comfort. You are facing a difficult loss and deserve any comfort available going through it. I never thought for a moment that any boundaries were being broken. I don’t think there’s a right or wrong in a situation like this, it’s up to the people involved to decide what is best. It sounds like you, your T and your ex-T are all on the same page and communicating about what is going on, I can’t imagine a healthier situation than that. I hope you continue to find comfort as you grieve. Peace, AG

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