The 5 limits that should not be broken in psychotherapy

It is frequent that many people who go to psychological therapy for the first time do not know certain limits that should not be transgressed during and around it.

It is necessary that these red lines are known and respected from the first moment in which psychotherapy begins, both by the patient and his therapist.

And is that always there are limits whose transgression is much more serious and detrimental to the therapeutic process and the psychic and emotional improvement of the patient than others. Therefore, below we will see what they are.

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Why is it necessary to clarify the limits in psychotherapy?

It is not an easy task to define what the limits are in psychotherapy, since there are cases in which a fortuitous encounter could occur outside of therapy (p. eg, meeting in a restaurant or supermarket, meeting at a party, etc).

However, there are other types of encounters and relationships that are avoidable; For this reason, it is necessary to establish clear limits in the psychotherapeutic relationship, since it is a very different from any other, as it occurs in a space where the patient tends to open up emotionally with his therapist and, for that reason,

another type of relationship outside of therapy could affect the course of the same.

It is essential that the limits of psychotherapy are marked and clarified by the psychotherapist from the beginning, since in this way the therapeutic process can be facilitated it is done in an environment that transmits security to the patient and, with this, feels the confidence necessary so that the sessions can be fluid and benefit from the therapy psychological.

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Boundary differences between different therapeutic approaches in Psychology

There are various approaches to psychological therapy and, although there are common limits in most, there are also some limits that are given in some but not in others, as we will see in some examples that will be discussed at continuation.

It is true that some modalities of psychological therapy, such as behavioral orientation, may use exposure techniques outside of the usual consultation where the sessions are held, since to work with certain phobias, the most efficient method is by exposing the feared stimulus in a real context.

Something similar occurs with physical contact, an act that, if justified, may occur during therapy sessions from a Gestalt approach, whereas in other psychological therapy approaches, such as psychodynamic, physical contact is not recommended.

Another example of the difference in limits that exist in the various models of psychotherapy are lthe self-disclosures that the psychologist makes during therapy sessions about some aspect of his personal life that is related to the subject of the patient that is being addressed at a given moment, this being allowed in therapy that follows a person-centered approach; On the other hand, in other models of therapy it is forbidden for the therapist to share information with the patient about her private life.

These examples make it clear that there are limits in psychotherapy that can sometimes be somewhat diffuse and that depend, to a large extent, on the therapeutic approach that is being carried out. However, there is no doubt that from the first moment the process begins therapeutic limits should be clear, so that both the therapist and the patient respect.

With all this, for the therapy to be beneficial, the psychologist must actively listen to his patient in order to understand, from a perspective wide and impartial, what happens to him and also, it is necessary that he use therapeutic techniques in an appropriate way and use the most accurate clinical judgment that is necessary for him possible, maintaining professional secrecy at all times through confidentiality with your patient.

On the part of the patient, it is necessary to attend all the scheduled sessions that he has agreed with his psychologist, respecting schedules and punctuality, and strive to follow the guidelines that he has received in session to perform on his day to day. It is also important that you open up emotionally during psychotherapy sessions so that your therapist can help you find her strengths.

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The dual relationship in psychotherapy

A dual relationship in psychological therapy is one that It occurs when the psychologist or psychiatrist and their patient maintain, in addition to the therapeutic relationship, another type of relationship. This other relationship that they maintain could be social (either friendship or even more intimate), professional or business, with both types of relationships being able to occur simultaneously. It could also be the case that the extra-therapeutic relationship could be forged after the therapeutic process has been completed.

There is no doubt that the maintenance of intimate relationships would be, of all the variants of dual relationships, the most inappropriate. The fact of transgressing the limits of therapy, reaching this type of relationship outside of therapy, It would encourage the patient, in addition to not benefiting from psychological therapy, to have a misconception of the context of psychotherapy.

Even when the psychological treatment has concluded, there is consensus among experts in the field that it is still inappropriate for the therapist and his former patient to maintain any other type of relationship since the image that patients have of their therapist and, by extension, of mental health professionals in general; Furthermore, this could affect a possible psychological therapy process that he may need in the future, even if he was treated by another professional.

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The main limits in psychotherapy

Research on the subject of the limits that should not be broken in psychotherapy has found a series of dimensions that could put the development of the therapeutic process at risk, promoting the transgression of limits: the place where it is carried out, the fees and gifts that the patient could offer to his therapist, among others.

1. Clarify from the first moment what is the place of therapy

It is convenient that all the sessions that take place throughout the therapeutic process take place in the same place, which is usually the therapist's consultation.

There are exceptions with respect to this point, as is the case of the live exposure techniques, already mentioned. above, where the patient needs to be in the real context of the phobia to be treated so that the treatment is more effective.

Another exception would be if the therapist found it beneficial accompany individual therapy sessions with group sessions, in which he must go to another room; in which case, as long as the patient has accepted it, it is possible to change the place of therapy during these sessions and also other therapists may intervene.

Except for cases like these, the therapist and the patient should not have any contact outside of therapy sessions and all sessions should take place in the same place.

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2. Referral to the private practice of the therapist

It could be the case that the patient is receiving psychological assistance from the system public health, where the frequency of the sessions is usually lower, given the high demand, than in the Private sanity; For this reason, the patient could request the therapist to attend his private consultation in order to receive psychological care more frequently and with longer sessions.

In such cases, so that the therapeutic setting is not affected, it is advisable for the therapist to advise the patient to continue with their sessions in the public system, always respecting the patient's right to decide to go to a private consultation in the event that the The frequency with which you receive psychological treatment is insufficient and the delay between sessions is long.

In these cases, the patient has the right to decide to change from public to private healthcare, but not It is lawful if the therapist recommends that you change, in order for you to come to your consultation private.

3. Gifts

The therapist must reject the gifts that the patient could offer him as a form of gratitudeExcept if these were small gifts with a nominal price, in which case he could accept them.

However, the therapist must also assess whether the fact of accepting this gift, even though it has a negligible economic value, is going to affect the therapeutic relationship.

In the event that the therapist feels, in some way, the obligation to reciprocate his patient by speeding up the delay between sessions or similar favors, it would be more It would be advisable for him to reject the gift with kindness and correctly explain to the patient that these types of gifts could impair the process of his therapy psychological. In this way, the therapist would take off the pressure of having to be grateful and this would not have a negative impact on the therapeutic process.

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4. Fee

In the case of private consultations, patients must respect the fees stipulated for each therapy session and try to pay them within the deadlines agreed with the therapist, without haggling or trying to negotiate.

A gift should never be made in order to pay the price of the therapy, thus replacing the payment with money of the fee corresponding to the sessions.

5. Physical contact and personal disclosures from the therapist

There is no doubt that in an environment in which very personal aspects of the patient are dealt with, where he opens up emotionally and feels trust towards his therapist, as is the context of psychotherapy, it can sometimes happen that the patient, without ill intention, breaks certain limits (p. (eg, asking the therapist personal questions about whether he has children or is married, about his hobbies, etc.); also being able, in some cases, to give the therapist a hug, as a way of thanking him at the end of the session.

Faced with this type of event, even if well-intentioned by the patient, the therapist must solve them by positioning himself in the role that corresponds to him, as a mental health professional, and thus stop giving rise to misunderstandings, in which the patient may feel so confident that he thinks he can treat the therapist as a friend or family. These situations can be solved by reminding the therapist to the patient that revealing aspects of his private life are not convenient in therapy.

However, there are therapeutic models, such as some found within the humanist current, where the self-revelations of the therapist can be used as a therapeutic resource at certain times in order to facilitate the therapeutic alliance with the patient.

Too, sometimes, they are necessary as a therapeutic resource with children and adolescents who show reluctance towards the therapist in order to make them feel more confident and this facilitates the therapeutic process

With regard to hugs, it will not negatively affect the fact that, at a specific time when you need it (p. g., when grieving), the patient gives a genuine hug to the therapist; however, the therapist should make it clear to the patient that this should not become a habit in sessions, nor should it become a way of saying goodbye after each session.

The most convenient way to say goodbye and say hello at the beginning of each session is through words, accompanied by gestures that show openness and serenity, on the part of both; too it's okay to shake hands.

Making the limits clear in cases such as those mentioned recently is not comfortable for the therapist, but it is necessary due to that if it is not done from the first moment, the limits could be broken more times, being increasingly difficult slow them down. Therefore, it should always be clear to both of you that your relationship should be exclusively therapeutic.