Patient-therapist relationship

Dear Eli,

This is a tough question Eli. There are several possibilities and it hits on many issues that entire books have been written to address. To begin, the whole theory of Psychotherapy is that a therapist goes into the field because they care about other people and therefore want to help, they are interested in the mind and how it works, and often they go into the field to resolve early family issues of their own. But, it is also time consuming and therefore they can't do it for free and still make enough to eat. It also becomes their business. It is also tough and exhausting work at times and therefore a therapist needs a lot of alone time.

No matter how equal, caring, or authentic a therapist is to the client, they are in an unequal situation. The client shares and the therapist rarely does. The client gets help and the therapist does not. This is a positive thing and also a negative thing.

One of the reasons that therapy works is through transference. A client will often put undo expectations and attributes onto the therapist. They will take a dependent position and see the therapist as having the same attributes of their parents or having the attributes that they wished their parents had. Therefore, they see them as good Daddy or bad Daddy, good Mommy or bad Mommy. They often see them as a prospective mate. This is natural and allows for symbolic re-parenting and therefore growth.

The therapist however is also a person and often goes in to the field at least in part because they want to feel needed and liked. This could well lead to counter transference where the therapist sees the client the same way they viewed an important person in their life. If this is not recognized and dealt with effectively by the therapist this can destroy the therapeutic relationship and impair growth. The amount of skill a therapist has and their experience level varies greatly.

The diagnosis of Borderline Personality Disorder is simply put a problem with early parenting and bonding. One of the characteristics of people with this problem is that they are in some ways full adults and in other ways children who are still frustrated with not being able to be loved as much as they would have liked by mother or father. They often were not taught good boundaries or self-reliance and look at important people in their life in a very black and white manner. People are seen as either good mommy or bad mommy even if they aren't therapists. Therefore, the whole typical problem with transference is heightened with either an unskillful or inexperienced therapist or a client suffering from this disorder or both.

From this distance it is impossible for me to know where the mistakes are being made. Usually both people are a part of it, but not always. I would suggest speaking with her again and bringing up the issue of transference and boundaries and tell her how you feel and ask her what she thinks and feels about it. There should be a way for caring and professionalism to exist side by side and for good boundaries to be established and maintained for both of you.

Good luck.

Jef Gazley, M.S. www.asktheinternettherapist.com