A History Of Veiled Violence And Broken Boundaries In Psychotherapy. Case From Practice

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

The case that I want to describe demonstrates the situation of correspondence supervision. Therapist - Veronica, a 32-year-old woman who faced a situation of violation of her boundaries in the course of psychotherapy. The client is Robert, her age-old, successful, handsome, well-built man, single, has a high social status. It should be said that already at the beginning of supervision it became clear that the boundaries of the therapist and the client were "blurred" at the origins of the therapeutic process. Due to Robert's "extraordinary busyness and lack of time for unnecessary travel" Veronica agreed to hold sessions on "his territory" - in one of the offices occupied by Robert.

Despite the fact that she included billable travel time to and from Robert's office in her fee, Veronica felt extremely uncomfortable. The situation was aggravated by the fact that Robert was very attractive to her. He is attractive not only outwardly, but also with all his behavior and way of life. Veronica, a divorced woman raising a small child, really liked, as she put it, "mature, self-sufficient, socially successful men." Robert was interesting to Veronica not only as a client, but also as a man. From time to time she found herself sexually attracted to him. Believing that she could cope with the complex contexts already formed in the therapeutic relationship, Veronica agreed to therapy with Robert.

At the time of seeking supervision, therapy had already lasted for several weeks. From the very beginning, it turned out to be difficult for Veronica. First, she was touched by a story about Robert's life, very similar to her own story. He got married quite early. But the marriage was unsuccessful, and after a while he divorced. Since then, Robert not only did not intend to marry, but even in a sense was afraid of women. He was afraid of "their rejection or manipulation of all kinds." According to Veronica, for some reason she "felt a very strong desire to rehabilitate women in the eyes of Robert," returning him to faith in the possibility of a reliable relationship. Second, she had sexual fantasies about a client: "I sometimes think that we could be a good couple." Thirdly, and this was the most difficult for Veronica, from the very beginning of therapy, Robert behaved sexually provocatively, as if flirting with her and making ambiguous proposals. These proposals never contained an explicit appeal for sex, but did involve a violation of therapeutic boundaries. These included multiple invitations "to chat not in the office setting, but over a cup of coffee," "to meet somewhere in nature," "to go to a concert." All this, plus the tone with which Robert voiced these proposals, caused confusion in Veronica. She invariably refused them with an ambivalent feeling. In this regard, in her supervision, she said: “On the one hand, I was very flattered to hear this from Robert and would even like to go. On the other hand, I understood that therapy would simply stop there. The already senseless and sometimes completely "dead" process will collapse altogether."

It could not but cause amazement that, realizing the complexity of the therapeutic situation, Veronica retained complete psychological anesthesia for what was happening. Sometimes the impression was that nothing of the events of therapy touched her. Nevertheless, I knew Veronica as a rather sensitive person and a qualified specialist, which made me doubly worried. Needless to say, with this state of affairs in therapy, especially in terms of the sensitivity of both of its participants to the phenomena of boundaries and contact in general, therapy could not but be paralyzed. It is for this reason that acting out took the whole time of the therapeutic process.

However, this is not all. The reason for asking Veronica for supervision was not so much an awareness of therapeutic difficulties as an incident that somewhat discouraged him. Having come to one of the therapy sessions, Veronica did not find Robert in the office. The secretary asked her to wait a little while "the boss takes a shower." Veronica went into the office and sat down in a chair. After a short time, the door to the study from the bathroom opened, and Robert entered. And completely naked. Despite Veronica's amazed look, he slowly took a towel, dried himself off and, without leaving the office, just as slowly, dressed. Then he sat down in a chair to start the session. Nothing in the face and look of Robert, according to Veronica, did not betray the fact that he considered what was happening as something unusual. Veronica was confused for almost the entire session. Judging by her description of her condition, she was more paralyzed than confused. Of course, that neither earlier, nor, especially now, there could be no talk of any presence. As a matter of fact, this opportunity simply could not appear in the focus of Veronica's attention.

It was in this state that Veronica applied for supervision. It took a lot of work to restore her sensitivity to what was happening. Veronica quite clearly understood that something was wrong, but she was blocked in the awareness of her reactions. Of course, the experience in therapy was impossible. In addition, Veronica described herself as "absent, detached, reminding herself of some kind of mechanism rather than a living person." It is for this reason that in supervision we have focused on the process of experiencing what is happening in therapy. However, any attempts I have made to help Veronica regain her awareness have been futile for a while. I said, “How does it feel for you to face this kind of violence? For me, for example, your story evokes fear and sympathy for you, as well as a desire to protect you. " It seemed that my words surprised Veronica. “Violence ?!” she asked. It didn’t seem to have occurred to her that a situation like this could be classified that way. Suddenly Veronica burst into tears and said that she felt very anxious. We focused on Veronica's experience of her boundaries in her relationship with Robert. In this process, confusion and anxiety soon gave way to fear, intense shame and pain. Veronica, continuing to cry, said that she felt very vulnerable and scared. That she goes to every regular session with a vague sense of the threat that the meeting with Robert conceals for her. Veronica's recovering sensitivity to her boundaries in supervision seemed to unleash a tremendous amount of experience. However, the same process from "the stable and stable therapist, whom she had previously imagined,", "turned her into a confused and frightened girl."

The sensitivity that returned to Veronica had a downside - vulnerability. Veronica has become more lively, but not more free. Confusion remained, but its content changed. If earlier Veronica, not noticing the obvious, asked the same question: “What to do with Robert? How to return him the right to a happy life? ", But now another question is hanging in the air:" How to maintain contact with Robert without destroying yourself in this contact? " Sexual interest in this young man only exacerbated the situation. Veronica said, "I'm not sure I can continue to work with Robert." Her voice trembled at the same time, she looked confused. I asked Veronica: "Do you think Robert knows that with his behavior he can hurt others, in particular you?" She replied, "I don't think he even knows about it."I said that it seemed fair and important to me if Robert could learn about the reactions he evokes in those around him. Horror appeared on Veronica's face. She said, "But I won't be able to tell him about it, it will destroy me as a therapist." I asked, "Please tell me about the nature of the risk you would take if you started talking to Robert about your feelings." “Admitting my vulnerability to Robert, I would surrender to his power and lose myself,” said Veronica and burst into tears again. In response, I was surprised: "Is it possible that by informing Robert about your experiences, on the contrary, you will regain yourself, as well as the power in contact?" The next few minutes of supervision focused on the possibility of restoring the boundary-contact through the risk of worry. Talking about her feelings in contact with me, Veronica began to feel more and more stable and resilient, despite, and possibly due to, her vulnerability and felt vulnerability.

At the next supervision, Veronica excitedly talked about how the therapeutic process had changed as a result of a frank conversation with Robert. For the first time during therapy, according to Veronica, she "felt like a woman." The most interesting thing was that for the first time Robert noticed in front of him not only a "therapeutic apparatus" for serving his life, but also a vulnerable woman in need of his attentive and caring attitude. According to Veronica, “he seemed to wake up, became more alive and talked about being very vulnerable in relationships with women,” and also began to talk about his vulnerability in the perception of himself as a man. Needless to say, this process was very difficult for both the client and the therapist himself. But, nevertheless, the described session turned out to be in a sense a breakthrough as a therapeutic contact. It is in this way that the therapist's risk of being and being present in therapy, including the experience of his vulnerability, was rewarded by the field.