Therapist Boundaries From a Dynamic Perspective

As a 2023 SimplePractice survey found, therapists are burning out.

In a private practice environment, it can be easy to allow ourselves to creep toward unhealthy practices that heighten burnout.  For example, no one checks in about when I last took a vacation, or whether I’m sticking to my fees or late cancellation policy, or whether I’m doing too much emotional lifting for my clients.

It seems that today, more than ever, therapists need to examine their boundaries.

“Boundaries” has become a phrase present in most recent conversations on self-care. People looking for mental health advice, relationship advice, or self-care advice all seem to be asking about how to manage or establish boundaries.

We clearly need to think about boundaries. But as a belaboring process-oriented therapist, I believe the real issue lies in how we think about boundaries.

In this article, we’re going to look at boundaries from a dynamic intrapsychic perspective. I’ll show how the conventional concept we use to create and maintain boundaries (interpersonal wall), in practice, sets us up for more burnout and exhaustion, and how an intrapsychic concept of boundaries (self-awareness) can help you avoid burnout.

My hope is we can help you experiment with how you create sustainable care with your time and energy.

Imagining boundaries 

The term boundary is a rule we use to govern the use of our time or energy.

With boundaries we can efficiently say no to things that don’t align with our priorities or needs. We can resist the pressure to work an extra hour.

It strikes me that the term boundary carries a strong visual.

Boundaries, like walls, borders, or fences, are used to protect. When you put up a fence in your backyard, it’s to protect your property from those who would make use of your space without your consent, and possibly take advantage of it.

When conjuring up imagery of a boundary, the idea is inherently related to thwarting or protecting yourself from a threatening, objectifying, or predatory entity..

The conventional boundary imagery is a fortress with a surrounding wall. We can call this kind of boundary an “interpersonal wall.”

A boundary is a structure that stands between a threat and ourselves. Baked into our imagery of a boundary is the assumption that others are potentially exploitative. Our response is to protect ourselves and clearly state our rule.

You may wonder, What does it mean that we view boundaries this way, as “interpersonal walls”? 

Two important implications come to mind:

Projected needs

First, the interpersonal wall may project our needs onto our clients. Projection is a psychological defense against our own pain. It’s a way of unconsciously “placing” parts of ourselves—like emotions or identifiers—onto another person.

For example, when we consider whether to “cave in” and see a client at a time we’re usually unavailable, we may be making an assumption about  our client’s needs.

This can sometimes be a projection of our own neediness for our clients.

Are you worried about finances? Or worried about being abandoned by clients?

This worry can explain the compulsion we feel to accommodate our schedule. In this case, the wall imagery helps us defend ourselves, not from our client’s needs, but from developing self-awareness of our own fears and needs.

Internally we come to believe our clients, not us, are the ones in need, and a boundary is needed to keep them from taking too much.

Overestimating capacity

Second, the interpersonal wall may overestimate our capacity to care or help.

While on one side of the wall, a boundary may project our needs onto our clients, on the other side of the wall, we assume we have a wealth of resources to give.

Much like a castle or a fortress may be laden with treasures and supplies, holding boundaries with our clients may carry with it the assumption that we have much to give.

This image involves a double-edged sword. The first edge is the need to protect our resources (time, energy, finances) against intruders (clients) who may want to take it. The second edge is the guilt we feel at withholding resources from our clients.

This is the defense of moralization. The degree to which we feel we ought to hold a boundary may be the degree to which we feel guilty about doing so. Thus, in our guilt, we find ways to sneak goods over the wall in the form of sliding our fees, not holding to cancellation policies, or extending sessions.

Yet the sober truth is we are far from being storehouses of emotional or financial goods.

In short, when we see boundaries as an interpersonal wall, we create a cycle of guilt.

The boundary “wall” makes it:

• Easy to neglect our own anxieties
• Easy to feel guilty for withholding from clients
• Easy to break our own rules
• Easy to exhaust ourselves

This begs the question: Is there any other way to look at boundaries?

Setting functional therapist boundaries

There’s a different functional way to look at boundaries—self-awareness. Beyond simply changing our perspective, I believe this construct helps us to actually behave differently with our clients and ourselves. It removes the cycle of guilt that can come from enforcing an interpersonal wall.

In the psychoanalytic world, boundaries can refer to two different ideas, which are related—the therapeutic frame and self-other boundaries.

The first is the therapeutic frame. This boundary has to do with the scope of the relationship and the agreement between therapist and client as to how the relationship functions.

The second, self-other boundaries, is an internal capacity. A person who is “boundaried” can distinguish their own internal state from external reality.

As psychoanalyst Nancy McWilliams, PhD, points out, we all set boundaries along a spectrum.. In her book, Psychoanalytic Psychotherapy: A Practitioner’s Guide, she writes, “some aspects of therapy are essential, and some are widely varied, reflecting the needs of the therapist and client dyad.”

In fact, at any point of the day, our self-other boundary may be more or less blurred. For example, when we feel frightened or insecure, we may confuse our own internal state for someone else’s thoughts: They must be thinking I’m selfish. The fuzzy boundary makes us react and accommodate to get rid of the feeling, such as to disconfirm the selfish judgment.

To the degree that we feel unsafe or disconnected from others, our self-other boundary tends to wax and wane.

A clear self-other boundary helps us be curious about the landscape of our own thoughts. The spotlight of our own internal attention is freed from scanning other’s intentions, and can shed light on our internal world: our fears, needs, hopes, and memories.

It also allows us to consider others’ experiences in the same posture. A self-other boundary is the cooling of the reactive impulse to avoid abandonment and pain.

In short, if we hold off on the idea of boundaries being a wall between ourselves and others, we can think of boundaries as the security to be mindful of our full selves, even when there’s a conflict. It’s the ability to be self-aware.

When we are self-aware, we open ourselves up to different behaviors.

Let’s consider a common situation: a client in moderate (but not life-threatening) distress wants to reschedule their session for a time when you’re planning to have dinner.

If we consider the interpersonal wall view of boundaries, here’s what we’d expect:

1. You’re wary of their neediness: You might feel bad for their situation, and you also know your policy. You’re worried that if you give in, you’ll set a precedent.
2. You enforce the boundary: You say no, possibly aware of what you should do to practice self-care.
3. You compensate: Without being aware of your guilty feelings for pushing the client away, maybe you find yourself trying to bend in other ways to soften the blow. You extend the next session, or over function by taking more responsibility in solving the client’s problems, or flex boundaries in other ways.
4. You’re exhausted: You can’t seem to hold to your rate and feel like you’re giving too much of yourself, without being properly compensated. You chide yourself for not being strict enough with boundaries, and resolve to be more firm next week with your clients.

Let’s now consider self-awareness in the same situation.

Alternatively, when the focus isn’t so much on enforcing rules, but on listening to our own signals, the effects of setting boundaries are very different.

Let’s consider what setting boundaries based on self-awareness look like:

1. 1. You’re aware of your needs: When the client asks for a time when you don’t usually meet, you are aware of the pressure you feel. When you pay attention to the feeling, you think about how much you’re afraid to lose the client if you don’t help them. You feel insecure, needy, and low. You’re afraid of being judged as a bad therapist and you worry about losing money.
   2. You soothe yourself: You remind yourself that you’re worthy, and that you have plenty of support. You’re cared for. You feel a release from the need to please or accommodate your client.
   3. You’re conscious of the cost of accommodating: If you gave up dinner to accommodate your client’s schedule, you know you’d resent it, and feel it would contribute to your exhaustion.
   4. You empathize with your client’s needs: You recognize their distress. You can place yourself in their shoes, without having to fix it—understanding what it’s like to ask for extra help when distressed. You’ve been there too.
   5. You communicate your boundary: You tell the client you can’t meet at that time, but you express empathy about what they are experiencing.
   6. You look for appropriate alternate ways to respond to the distress together:If you’re anything like me, you can already feel the small and big ways feelings like insecurity and fear impact the way we hold boundaries with clients. So, you can share coping mechanisms or offer alternative times to meet that work for both your schedules.

Boundary self-care

Seeing boundaries as self-awareness broadens the way we maintain boundaries as therapists. Instead of trying to be more rigid or strict, we might invest in habits and relationships that help us feel safe.

The safety we experience with others allows us to reclaim self-other boundaries. It allows us to feel soothed when a conflict arises, and to negotiate with clients in ways that don’t lead to our own exhaustion.

Below are some good habits to help you nurture clear self-other boundaries.

How are you doing with each of these?

1. Consult with other therapists regularly
2. Call a parent figure regularly
3. Enjoy playful activities regularly

In conclusion, therapists need to examine their boundaries from a dynamic perspective to prevent burnout, practice self-care, and ensure their own well-being. This necessitates broadening the conversation from enforcing rules to include the ability to distinguish one’s internal state from external reality.

The self-aware approach promotes empathy and clear communication, while reducing the risk of exhaustion, resentment, and burnout. By nurturing clear self-other boundaries, therapists can better provide the best possible care to their clients, while caring for their most important clinical instrument: themselves.

Sources

McWilliams, N. (2004.) Psychoanalytic Psychotherapy: A Practitioner’s Guide.

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