Boundary issues in Therapy

Boundary issues in Therapy

Defining boundaries is to contract for safety and agreed ground rules in therapeutic work.

The behavioral therapist must ensure not taking advantage, especially sexual relationship with the client. On touching, even if innocuously benign, one way to determine this is to check if the touch (placing an arm over the client) or intervention is for the sake of client (client needs it), or for the sake of the therapist, that is gratification for himself: gratification of one’s own ego. The use of touch is with fair risk (even if it has only positive meanings for the therapist), and must be with the highest sensitivity, lest it be confused with sexual connotations. If a request is made to act in a particular way which is violating boundary, it would be useful to ‘talk through it’ and how ‘you feel about it’ rather than acting on the request. More so, a therapist needs a senior colleague, as a supervisor to discuss his work with from time to time, as also to be aware of ‘red flags’, an unusual behavior that patterns itself outside the norm.

Is the discussion an exploration of the goal: which is the primacy of the task. Even more, one needs to discern if the emotion is legitimate: a ‘need’ or a ‘demand’. In therapy, issues of transference, and counter transference keeps coming up in the process, and this needs to be understood.  A warm, empathetic understanding is enough. And mutual needs and respect needs to be protected, both for the therapist and the client.

Apart from space boundary, and confidentiality and trust, time boundary is also critical to negotiate: an important to clarify that this a professional relationship and that use of time is important, as time is finite.

Choosing the physical setting is also important to confirming the professional relationship. Having a designated office, rather than a lounge or eating house. Yes, the therapist does provide a service for a fee, but it is only with the adherence to these boundaries that the work can be done. While I notice a lot of pro bono work being done, I would recommend that in all cases a small minimal amount be charged to ensure value is perceived.

The relationship should always be singular: the relationship that arises from therapy. Other relationship like friendship, employer, etc intertwined must be avoided.

Also, introducing jargon, or expletives, or personal sharing of one’s own problems/ issues must be avoided. Power struggle needs to be avoided, as this would be manipulative.

Building contract and rapport is critical. ICF has clear guidelines defined on ethical behavior in the realm of Coaching. Mostly, common sense applies.

Using Psychodrama in Process Work

On Psychodrama

Over the many years, since 1992, I have been involved with Process Work that has used psychodrama in helping Personal Growth in labs. Have also used it, and adapted it to Executive Coaching.

We are all natural role players who do well when guided by their spontaneity and not by learned mannerisms. Psychodramas represent absentee significant others, with whom our relationships need to be resolved.  This is done in a theater, a canvas that allows for openness. The facilitator (the director) himself is the ‘tool’: his own style determines the intervention. If the tools are well set up, the method work: if held with authenticity.  

The process is about building awareness to the ‘here and now’. The initiation could be done by a ritual, a song, or by use of music. This warm up is essential to anchor the protagonist. It’s critical that the process is perceived to be safe. When facilitated well, it can be an invitation to explore, if done ineffectively, it could be seen as an intrusion, worse still a violation. All resistance can be explored through psychodrama: allows for it to move from an abstraction to a reality. The sensing mind ( limbic) connects to the conscious mind (the cortex), allows for reconnecting that which has been split.

In role reversal, the protagonist (primary ego) begins by taking the role of the significant other: and demonstrates it as experienced. This is a helpful diagnostic tool, which allows for data to emerge. Allows for examining old meanings and its reinterpretation. Enabling newer choices, newer directions, and newer actions. The whole idea is to look beyond the perception of the protagonist, because what we have is only a perception. And we know that the map is not the territory. In short, it allows for a refreshed relationship. Critical to ensure that it is not left just at the level of catharsis: insight must follow for integration. 

The auxiliary ego (assisting actor), can be introduced as a go between to the protagonists and the group. It borrows the authority of the significant others and acts from that: not as an imitation, but that which emerges from within, as held in the psyche. Or the intervention of being a ‘fly on the wall’.

Using doubling, as in shadowing, allows for the alter ego to get amplified. For the double, it is also insightful: awareness that comes from one’s own use of body, non-verbal, rhythm of breathing, etc.

Again, the work can be extended to collectivity (the group present). Here the macro ego looms large and brings awareness to the overall gestalt that is playing itself out. The other reality begins to emerge.

Work by Albert Ellis, Fritz Pearls, Moreno can be read further to understand more about what is described above.

Let me conclude by saying that work such as this creates learning and awareness once the work begins and ends when the work concludes. No prefix allows an easy introduction. No Suffix permits and easy summary.

As a process worker, the understanding and competency is acquired through practice, and not by theory. Explained from one to another: and not by literature.

Read also:
http://stevecorrea7.blogspot.in/2015/02/perceptual-canvas.html
http://coachcampus.com/coach-portfolios/power-tools/steve-correa/

Right talent for the right phase

Organizations evolve like human beings: the essence of us remains the same, yet on the outside we change continuously. Even after many decades of time we are still familiar and recognizable to those from our past, as is evidenced when I returned to an alumni meet after 30 years. We have changed, yet we have not changed.

In today’s VUCA, a world of rapid change, we are constantly engaged at work doing one of the three things: Thinking, deploying strategy or implementing and embedding.

Perhaps this calls for a new way of looking at talent: those that are involved with the thinking unit (TU), some who are involved with the building unit(BU), while others in the operating unit(OU).

Let me offer an analogy to explain this. If suppose, we want to build a world class Hospital on 30 acres of land, you would first want a team of specialists who would be involved with the thinking unit: those who would be responsible for developing the blueprint, the actual plans. They would be tasked with the Design and Architecture. This would be the most critical stage to the whole piece and would require deep Subject matter expertise.

The next phase would be the building stage: clearing the land, digging, building the foundation, the columns and the floors. This stage is the conversion of the design to that which is physical and would require its own brand of expertise, but quite different to the earlier set above.

Finally, once the hospital is built, one would require talent that can operate the unit well: doctors, nurses, administrators, cashiers, lab technicians, etc. This stage requires the design of the operating model that would allow for integrated operations to come seamlessly together.

As we resource Projects, we need to be very clear, what phase we are on: TU, BU or OU. This would determine the right talent that would be effective at this phase. Usually, one tends and brings in consultants at the TU Stage, Service Partners and external vendors to help in the BU stage. Its only at the OU stage that regular role profile are appropriate.

I argue that Business Leaders need to keep this perspective in mind when selecting the right resourcing. Projects fail, often because the specific competencies required for each phase is not available.

Today’s leaders need to clearly recognize that they work in an environment in which all of the three stages are in play. Being able to pick the right talent is critical to succes

VUCA - Competencies for new times!

VUCA

It’s become a trendy managerial acronym now: VUCA, short for volatility, uncertainty, complexity, and ambiguity, and a catchall for “Hey, it’s crazy out there! So what are the competencies that allow for employees to be effective in such crazy times.

The law of entropy (the degradation of the matter and energy in the universe to an ultimate state of inert uniformity), a universal phenomena plays itself out as simple moves to complex, single correlates to multiple, and order to seemingly disorder. The only constant they say is Change.

In such times, I would like to share from my own reflections what are the issues employees need to manage in such VUCA times.

For one, Need for Speed. Almost everything is required to be done in ambitious deadlines. During such times, one cannot cross the chasm in two leaps, and one needs to simultaneously work on both the urgent and the important. Change agents need to work hard, and smart, anticipate issues that would come up, while consolidating gains already made.

Secondly, need to manage ambiguity and uncertainty. Change by definition, means the design elements are changing. I have realized that people are open to change, provided they can be helped through moving out of their comfort zones, feel ‘safe’ in the change process, and if asked to participate. The key is to ensure regular communication at all times: milestones and clear path to destination. In addition, fair set of consistent and fair and sensitive principles, on how people would be managed in such times.

Thirdly, the change champion needs to manage Personal Frustration. During each day, there would be countless throughs and peaks: trials and tribulations. She requires to be balanced and moderate her emotions through this period. Emotional intelligence is the act of using one’s emotion for self and the other. Frustration is the result of ‘what I love is threatened’ and hence the reactivity that follows. Ensuring that thought, emotions and actions are balanced and in harmony is key during such stressful times. Hope and curiosity are two positive emotions that exist in troubled times. Crucial to see the ‘glass half full’.

Finally, during explosive change the change agent needs to manage personal obsolescence.  Managing change requires new skills: often drawing from past experience, often crafting new solutions. The ability to reflect and learn and be willing to recognize one’s own limitations and lack of knowledge is crucial. Wise is he, who knows that he knows not.

I would like to end with the analogy of white water rafting. The competencies required for such a sport lends itself to today’s Corporate turmoil: Energy, Thinker-Doer, Intellectual honesty, team player, managing and anticipating, clear objective of goal, willing to adapt to win.

Attention and Inattention

The nature of our self reality, is a function of the choices we make, actions we undertake, meanings we give, and values that we live our lives by.  Our values are shaped from a multitude of belief systems, some rejected, others dropped over time, some modified: what remains is the values we uphold.

Our behaviour is not causal as is demonstrated by most laws of physics. Instead, it is a function of our Identity as held in our self notion as well as the 'location' which is the context under which we act. How we then generate behaviour is a complex interrelationship, both consciously and unconsciously, which leads to an action. The action is a fused outcome of both thought and emotion.

I argue that over time we give attention to a select few thoughts, and encouraged by the accompanying emotion, we act. That shapes our decisions and how we further take action. The cycle of inference plays itself out, and we are rewarded with expected consequences for our acts. Regrettably an act, with intended consequences does not come about at all times. This unintended consequence and how we respond to it, sets up another vortex of a chain of reactions.

The pleasure seeking principle and with it the will to survive act simultaneously: we are attracted to a few things, while we are repulsed with others. The repulsion is not handled often quite subtly. We have choices to be extremely vigilant to these negative thoughts. Yet, in many cases we collude by becoming inattentive. This inattention to the emerging gestalt can occur both consciously and unconsciously.

In our social systems we inhabit, at home or at work, we pay inattention to many acts of discrimination, violence, or suffering. This collusion is not to lie, but not to square up to face facts, which would then cause us to act. Speaking the 'Satya' or truth is not acceptable: it remains uncalled out. The lie remains and perpetuates. Whistle blowers know this painfully well, as also family members, who keep family Skeletons locked in cupboards for years.

Guilt and shame remain within, and with time to cope with this it is given inattention and obliterated from memory, or given rationale that is another lie.  We experience learned helplessness, and worse still Stockholm syndrome where we are in direct collusion with the perpetrators of the violence itself.  This desensitisation of the self is not gradual: it is learned and painfully. For if we are not outraged we are not paying attention. 

Ancient rituals in tribalistic societies understand this: Joseph Campbell explains the dance of the mask. In this ritual, the frightening masks confront the adolescent and petrifies. It represents all the illusionary masks of society and to which the child must combat.  In the final ritual a fight ensures. The masked man allows the adolescent to win. The ritual ends with the masked man taking off his mask and putting it on the face of the youth. He becomes now the carrier, one more member of the tradition of the community.

That we live in slumber is established: half truths and lies, that push truth away.  Explanations that are palpable are offered rather than the journey to experience the truth. Life is lived: borrowed but never one's own. Truth stays elusive.

Pay attention to what you are inattentive to.