A Nurturing Potential main theme report
Contents:
What do we mean by boundaries?
Some observations on boundaries
Boundaries in personal interaction
Boundaries in the group context
What do we mean by boundaries?
Every one of us is involved in boundaries in one form or another, whether this be in our personal or professional lives.
In recent years it has become a buzzword in its application to misconduct, particularly sexual misconduct, between professional therapists and their patients/clients. It represents the limit of what is appropriate behaviour in a professional relationship.
But it applies also to virtually all relationships and inter-relationships. Thus, what are appropriate boundaries between organisations or within organisations? What boundaries should be established between children and their parents? How should boundaries be established and observed between educators and their charges?
Furthermore, what is the most appropriate way to set personal boundaries and/or to reinforce them? How do we maintain boundaries? Whose is the responsibility for maintaining boundaries?
Here are a few observations on boundaries:
An
important condition of boundaries is that we can establish our own; no one can
force us to accept their boundaries if we do not choose to do so.
A
boundary need not be regarded as a barrier to keep people out, but a footpath designed to
keep them away from areas of danger.
Perilous
areas may be more effectively circumvented by a series of stepping stones with
restricted access rather than a bridge available to all and sundry.
To
understand a person's boundaries, it is necessary to understand the person.
To
value a person's boundaries is to value the person.
We
all have boundaries even when they appear to be non-existent.
The
prime function of a boundary is to maintain a neutral position so as to avoid
posing a threat to another person's concerns.
To
maintain one's own boundaries while respecting the boundaries of others is the
art of negotiation.
A
boundary may be physical or abstract. The one delineates a person's
physical space; the other marks the area of the ideas and beliefs that they
cherish.
Infringing
either physical or perceptual boundaries can profoundly affect relationships of
all kinds.
Ritual
greetings such as shaking hands, kissing on the cheek, or hugging are typical
examples of the wide range of physical activities that may be acceptable to some
people at certain times, yet abhorrent to others. At the limit of such
contact, for example, might be the level of intimacy permissible to the
therapist giving a body massage.
The abstract boundaries corresponding to these
physical boundaries could comprise such behaviour as rudeness, abrasiveness,
being judgemental, scorning the other's opinions, and asking inappropriate
questions.
We had wanted to reproduce an article written in 1990 by Sandra D. Shattuck of the University of Alabama[*]. Alas Dr Shattuck tells us that it is expected to be included in book to be published and cannot be reproduced herein. A pity. But here are the last few words which sit well within this section:
". . . as I flipped through the thesaurus, I was reminded of the double meaning of "bound." As a verb, the word means to demarcate, circumscribe, restrict and define. But as an adjective, "bound" means to be obligated, committed, engaged, responsible, accountable. This meaning resonates for me when I am given the gift of my students' courage and anger as they grapple with old maps and with the bewildering spaces of the unexplored. Together we are committed and accountable to the journey."
Boundaries in personal interaction:
It is convenient to divide boundaries into two types. One is the physical boundary, that is, the boundary that protects our personal space. The other is the emotional boundary, that is, the boundary that protects our sense of emotional security.
Of course there are other ways of describing boundaries. We might suggest, for example that the two types of boundary are those designed to protect ourselves and those intended to be protection for others. The first of these will help define for others the limits of behaviour that is acceptable to us. We need to define, honestly and openly, how others may behave towards us and what forms of behaviour are unacceptable to us. The latter definition is one that is particularly relevant in the area of psychotherapy and counselling.
We cannot set boundaries and establish acceptable limits of behaviour unless we are able to communicate our intentions and our needs to others in an honest and congruent manner. This presupposes that we are honest with ourselves. It also means that we have to admit our own feelings to avoid any risk of blaming, shaming, accusing, or offending others. Therefore it is advantageous to preface any statement describing boundaries with the personal pronoun “I”. For example: “I feel threatened when . . . “ “I feel angry when . . . “ “I feel discounted when . . . “ And “I would be happier if . . . “
Boundaries are intended to protect us, to safeguard our dignity, our self-respect, our self-esteem. They correspond to “not acceptable” messages. “It is not acceptable for you to hit me.” “It is not acceptable for you to call me names.” “It is not acceptable for you to lie to me.” Prefacing such statements with the “I feel . . . “ message will make them acceptable to the other person. Thus: “I feel unhappy when you call me names”; “I feel diminished when you lie to me.”
But it is not enough simply to set boundaries; it is important also to maintain them and, where they are breached, to enforce them. This can be a quite frightening experience requiring a great deal of mental courage, but if we truly respect ourselves, we will find it easier to convince others to respect the boundaries we have established. For example: “If you persist in this behaviour, I will end our relationship.”
Of utmost importance is to recognise that setting a boundary is not intended as a threat, or an attempt to control or manipulate, it is merely intended to establish the limits of what we consider to be acceptable in given circumstances. It is a mark of our desire for independence rather than co-dependence. It is - to borrow a concept from Transactional Analysis[1] - an acknowledgement that we intend to step outside the "drama triangle"; that we will not accept the role of victim, persecutor or rescuer.
So, in setting our boundaries, we are saying: "This is my territory; this is my space. I accept that you may be unable or unwilling to modify your own behaviour, but this is the limit of what I find acceptable and I reserve the right to choose what action I am prepared to take to withdraw from a relationship that does not respect my boundaries."
Setting boundaries with others is, therefore, communication. It is negotiation. It is formulating desired outcomes and then dovetailing them so that we each get what we want without infringing the autonomy of the other person.
Boundaries in the group context:
The dynamics of groups will inevitably have some effect on the nature of the boundaries that are imposed internally as well as those with which they interact with the outside world.
Internally boundaries will be addressed to such concerns as:
Physical space and time span
The area to be occupied as well as the permitted physical interaction between members has to be established. The time fixed for meetings as well as the total time frame for which the group has been formed must be agreed.
Task boundary and input boundary
The limits of what members are required to contribute has to be clearly defined.
Punctuality and commitment
The failure of any group members to arrive on time to group meetings or regularly to absent themselves from such meetings will constitute a threat to the feeling of safety of the rest of the group. Regular unpunctuality may be regarded as a sign that the "culprit" lacks commitment to the group.
Consideration for others
No infringement of the personal boundaries of individual group members should be permitted. Respect for individual boundaries will encourage respect for group boundaries.
Permissibility or prohibition of substances such as drugs, alcohol, tobacco,
food, etc.
It is common for all such substances to be banned within the physical space and time span of group sessions.
Relationships between group members
This can be a tricky obstacle to navigate in terms of overall group safety. Some groups will not permit any relationship between members outside group sessions, unless such a relationship pre-existed. Others will carefully monitor such relationships to ensure they do not impinge on the harmony of the group and the welfare of individual members.
Relationships between group members and group facilitator
Boundaries have to be clear and unambiguous from the start. There will often be a tendency for some group members to impose their wills on the facilitator. Procedures have to be established for dealing with such breaches.
External boundaries will be occupied with:
Meetings and discussions outside the group
As a general rule nothing that has been discussed within group sessions should be referred to outside the group meeting between group members and under no circumstances with other than group members. If any such discussion takes place, this is an infringement of a fundamental boundary, and - in such an event - it is important that the discussion or meeting be reported back to the group at the earliest opportunity.
Sanctity of the group identity
There is an obligation on the part of group members to respect group boundaries and group identity whenever the subject of the group crops up externally.
Additional admittance to the group; departures from the group
Any newcomer admitted to the group subsequent to the group's foundation, and any group member leaving the group, will have an effect on group identity. In some cases this can be traumatic for group members. No new members should be permitted unless this is discussed and approved by the entire group. Any group members leaving the group should respect group identity by providing an honest and sincere explanation for their departure.
These are not rules. they are boundaries established for the harmony, welfare, and mental security of group members. Groups, and particularly therapy groups, are safe spaces for their members, where the conventions of social engagement may be relaxed, so that members can let down their guards without losing the sense of safety that has developed over the period of the group's existence.
The boundaries have to be specific and firm, but permeable enough to allow for an adequate flow of communication. They have to clarify group expectations. They will create and maintain a balance between the independence of each group member and the commitment of each to the well-being of the whole.
It is important to instil the idea of boundaries into children from the earliest ages. They will inevitably get conflicting messages from authority figures, peers, and media, but they have to be introduced to a set of clear and respectful rules and limits that will enable them to acknowledge the rights of others while establishing rights of their own.
It is essential to recognise that young children do not intentionally violate standards and infringe boundaries. If they have been inadequately explained or grasped they must not be blamed. But every unintentional violation is an excellent opportunity to explain and reinforce lessons.
Boundaries need to be drawn in simple, direct and specific terms and must be enforced consistently to avoid confusion. Modelling behaviour is a more valuable way of teaching than simply telling them what to do or what not to do.
Boundaries that are established for the physical safety and security of children are non-negotiable and must be firmly maintained. Boundaries that are respectful of others, however, may be re-negotiated as children grow older and can appreciate the limits of flexibility.
Boundaries in therapy are specifically designed to prevent unethical behaviour between therapist and patient. This concern applies equally in the areas of psychotherapy, medicine, and social work. The boundaries are intended to remove any hindrance to the patient’s potential for healthful therapy and also to protect therapists from involvement that, at one level, will reduce their capacity to heal and, on another level, might bring them into breach of their ethical obligations or even the law.
An important pre-requisite to an initial contract between therapist and patient, therefore, should be a clear and unambiguous description of the rules to be followed in therapy sessions. These might include:
No violence to self or the other during a session
No physical violence to or with objects in the therapy room
No participation in a therapy session while under the influence of any
non-prescribed drug or alcohol
What fees are to be paid and when they are to be paid
How many sessions will be held initially
What scope will there be for further sessions
What provision will be made for evaluation at the end of a session
A major difficulty in imposing and maintaining boundaries is that much therapy largely depends on a degree of intimacy if it is to be effective. A distinction has to be made between boundary violations which may cause harm and boundary relaxations that may be helpful.
This has been put very clearly by Dr Glen O. Gabbard [2]:
"While it is ordinarily inappropriate for a therapist to hug a patient, for example, it may be entirely correct to do so when a sobbing patient who has just lost a child reaches out to the therapist. This example illustrates the distinction between a boundary violation and a boundary crossing. A violation is a serious breach that causes harm, while a crossing is a necessary breach that may actually be helpful".
The analogy with stepping stones given on the front cover of this issue would seem appropriate in this connection. Perhaps even more apposite would be that of tightrope walking.
Some examples of boundary violations would include:
Hugging or excessive physical contact.
Therapy sessions in intimate surroundings rather than in the therapist’s
office.
Failing to maintain strict time-keeping.
Failing to make an appropriate charge for the therapy being provided.
Failing to maintain confidentiality.
Digression from the treatment into areas that are more the concern of the
therapist than the patient.
Patients need to feel that their concerns are being properly and adequately addressed. Therapists need to feel that patients are not making inappropriate demands on them.
If, as a patient, you feel uncomfortable with some aspect of a therapist's treatment or behaviour, it is recommended that the situation be explored before it persists for too long. Ideally you would raise your concerns with the therapist, but this can be daunting to a patient. Describing your concerns to a third party, be it a family member, a friend, or another therapist, can be useful.
It is, however, perfectly normal under many circumstances to find work in therapy unsettling. It is also far from rare for a therapist 's behaviour to be deliberately aimed at disturbing the equilibrium of a patient. Issues frequently arise in therapeutic treatment and in counselling that produce anxiety, unhappiness, or even fear. Some of these feelings may even be directed at the therapist. It can be a useful part of the treatment to discuss these feelings openly with the therapist or counsellor. It should not be dismissed, therefore, as exceeding permitted boundaries. But a healthy, safe and supportive relationship between patient and therapist would invite a discussion about these feelings.
The intimate nature of the therapeutic relationship often creates a vulnerable situation for clients, one that could be open to abuse. The codes of ethics of the various professional bodies in the area of psychotherapy and counselling are designed to protect clients and incorporate many of the "rules" proposed above. Unfortunately a number of practising counsellors or therapists have no professional qualifications and sometimes very limited training.
REFERENCES:
[*] Teaching What We Don't Know: Plotting the Boundaries of Our Ignorance by Sandra D. Shattuck © 1990 - from http://userpages.umbc.edu/~shattuck/teaching.html
[1] Developing Transactional Analysis Counselling by Ian Stewart, Sage, 1996. Pages 38 ff.
[2] Article in The Menninger Letter, Vol. 3, No. 4 (April 1995), pp. 1-2. (The Menninger Clinic is located in Houston, Texas.)