19th November 2018

Therapists are mortals, too

The ethics of boundaries and self disclosure

Privacy (c) KarinSieger.com
Privacy (c) KarinSieger.com

Some years ago I found a lump in my right breast. In the week between tests and diagnosis I prepared a contingency plan, not for me but for my clients. My intuition told me this was cancer and, if so, I would need to stop working with immediate effect.

The day after the diagnosis I agreed with my then employer a hand-over plan, and what I would tell clients. Therapists are encouraged not to disclose information about themselves to clients. Personal boundaries are essential to avoid anything that might distort and take away from the story of the other, who is seeking support.

Over the next days I met all my clients informing them this would be our last session, and what was in place for the continuation of the counselling. I started each session with the same statement:

“I have had some news, which means I will no longer be able to continue seeing you or any of my clients.”

There was a common assumption that I had found something better, another job, been promoted; and disappointment that I did not honour my duty of care and finish the work we had started.

Yes, I had found something else and, yes, I would not stay on. I felt the hurt I had caused and we talked about it, how it might repeat past experiences and expectations of rejection, but I chose not to disclose more. I did not want to cause concern about me. But instead it appeared I had torn into existing wounds.

I left the two GP practices where I had been working without telling the practice staff why. I thought I was protecting my clients and did not want them to find out the real reason from a third party.

I felt like a thief at night with an unsavoury secret.

A key support in my life was my own therapist. Three months into my cancer treatment I received an email telling me that due to health reasons, there would be no more sessions until further notice. Would I like to be put in touch with someone else? No, that would not do.

I was shocked and worried for my therapist.

My cancer treatment continued and was increasingly debilitating – physically, mentally, emotionally. Doubts started to set in about everything in my life, including my therapist. Perhaps dealing with my cancer had been too much. Perhaps I was too much. Part of me knew it was not really like this. I had trusted this person with my life story for years; but the nagging remained.

Some months later, at the start of a new year, between my chemotherapy and radiotherapy, an email arrived with my therapist’s name in the subject heading. The email had been sent to all current and former clients. My therapist was dead. No more explanations. We were invited to get in touch with a named contact if we needed support with what had happened.

I was distraught and angry. I wanted to know what had happened. Initially, the request for further information was turned down. Eventually, I got the news I had expected: cancer.

I don’t know what it would have been like had I known the diagnosis while I was going through my own cancer treatment.

Perhaps my therapist had been trying to protect me. Perhaps they had been too ill to do anything different.

I would not have been in a fit enough state to converse with clients while I was undergoing my treatment.

But, on balance, I wish I had been told. The not knowing and fear of abandonment was tormenting. Telling me would have taken away that uncertainty and stress. The truth would have frightened me, for sure. But if I had been told calmly, that may have also calmed and steadied me at a time of my own crisis and uncertainty over life and death.

These are all complex situations and assumptions, and I do not doubt for a second that my therapist did their best and acted responsibly, just as I did with my clients.

Life’s experiences shape us. Knowing what I know now, if I have to do it again I would like to do it differently. I hope I will have the time and strength to be open. With the increasing incidence of cancer, most of us in the UK will be affected by it one way or another.

I believe that there are moments in therapy when not shying away from our own truth and our very human story can be of real value.

It is therapeutic for all of us not to lose sight of our humanity, vulnerability and mortality, therapist or no therapist.

If you like this post, then you might also like my articles about when I got angry with my therapist and why CBT alone does not help in a crisis.

Have you read Living in Peace: Why and How?

(Published by The Guardian newspaper.)

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