Posted by DAisym on October 8, 2007, at 15:18:09
In reply to Re: another bad termination » pegasus, posted by pegasus on October 8, 2007, at 10:39:07
Hi Peg,
I'm late to this thread and haven't read all the responses but I wondered how much potential the client has for a psychotic break? As a mother, this would frighten me, particularly if I was aware how easily information can be found on the internet. We can't hear whether the client is wishing that there were no barriers or if there is an implied threat. And I don't know the therapist's history with threatening situations, so this might be too big of a button to be pushed for her.
I'd even go so far as to think about what termination might trigger in an unstable client and think through how honest about it you'd want to be. Again - I don't know the client. I think about myself and how I have thoughts about my therapist's wife - but they aren't in the "I want to harm you" category. But sometimes they are "I wish you didn't exist" category. But I don't think I'm scary, so termination around this wish wouldn't be necessary. But we've had clients at my agency that are too intense and need someone who can tolerate their affect. And what if the therapist was feeling an inappropriate response to a client's feelings - such as a reciprocal attraction? I know - the gold standard is "no tears and no erections" - to quote "In Session" but how realistic is that? A good therapist includes those that know when to transfer.
And more than most people think, many therapist believe that strong sexual transference is a reason to transfer, mostly to protect the therapist from a variety of potential scenarios, including getting sued. It is a reality of the world we live in.
The ultimate question becomes whether the therapist feels they can continue to work effectively with this client and if the answer is no, a sensitive transfer, with the therapist owning their "stuff" is really the most ethical thing to do. And I'm not completely suggesting that the therapist own their stuff out loud with the client. Honesty versus damage to the client must be wrestled with.
We might all wish that therapists can handle anything we throw at them. But since they are human, the next best thing is that they know what they can't handle and what to do about it.
I feel for both the therapist and the client here.
poster:DAisym
thread:787720
URL: http://www.dr-bob.org/babble/psycho/20070929/msgs/787900.html