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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 13 to 37 of 37. Go back in thread:
Posted by DAisym on May 27, 2007, at 0:44:55
In reply to Re: 4 years today, posted by spalding on May 26, 2007, at 23:26:14
I guess I think the most professional and ethical thing for any therapist to do is to know how to provide the most effective therapy for each individual client. For example, I personally think taking phone calls while in session, except in rare emergencies, constitutes bad boundaries. It is like allowing another client to intrude on my space. But other people seem to accept it. So what works for me, and what matters to me, might not work for you.
As far as the matter of gifts, there are therapeutic reasons to accept small "appropriate" gifts. Clients who struggle to feel accepted, clients who have been more or less continuously rejected by important people in their lives and clients who are afraid of the intimate relationship therapy offers may benefit from having a gift accepted and valued by a therapist. Often there are opportunities to talk about the meaning of the gift and of the giving. But more often there is an equal opportunity to let the client feel a sense of pride in the giving and a sense of having this expression of their feelings understood and accepted.
I would hope that any therapist who has decided on an absolute "no gifts" boundary (which I completely respect as their choice)would somehow let a new client know in advance. I can think of nothing more mortifying and rejecting than having a gift you've probably suffered over picking out, refused at the time of giving.
Posted by sunnydays on May 27, 2007, at 9:40:18
In reply to Re: 4 years today, posted by spalding on May 26, 2007, at 22:04:31
I think my T has amazing boundaries. He would never give me a hug, but I do believe he would accept a gift as long as it was small and not overly extravagant. I would only give it as a way to commemorate our relationship, not as some sort of reward or anything. And there are a lot of different people that come to this site. I personally try not to make assumptions about them or their Ts. My T is one of the most genuine people on the planet, and has told me he has loving feelings for me, even though that would be a boundary crosser for many Ts. He thought a lot before doing it and explained how it wasn't sexual or anything. I saw it as totally appropriate and it didn't raise any expectations in me that we'd have some relationship other than the one we have now.
Please be considerate of other people's feelings.
sunnydays
Posted by sunnydays on May 27, 2007, at 9:47:59
In reply to Re: 4 years today » spalding, posted by DAisym on May 27, 2007, at 0:44:55
Well said Daisy. I think your T is absolutely wonderful - right up on the same level as mine. :) I agree that it really depends on the client how the T responds and should respond. Some clients probably need really tight boundaries, while others like you and me would probably have a hard time trusting if the boundaries weren't a little more flexible. I know my T uses lots of examples from his life and his interactions with his kids to show me that my parents weren't great, and that my reactions are the same as how other people would react.
You write so clearly, Daisy.
sunnydays
Posted by Racer on May 27, 2007, at 12:35:18
In reply to Re: 4 years today, posted by spalding on May 26, 2007, at 22:04:31
> That your T. accepted a gift from you for "your anniversary" -- and I have seen both my T. and my pdoc for four years, ironically -- I find shocking.
>
> And muffled, are you serious, saying things like, "He strong. He gonna take care of you OK" ? Do you like coming off as ignorant?Please don't post anything which could lead others to feel accused or put down, or jump to conclusions about others.
If you have any questions about the civility guidelines on this site, please read the FAQ, located at http://www.dr-bob.org/babble/faq.html#civil Any follow ups about this subject should be directed to the Administration board, and should themselves be civil.
Dr Bob has final authority over this site, and may choose to modify or reverse any deputy actions.
Racer, acting as deputy to Dr Bob
Posted by spalding on May 27, 2007, at 13:07:04
In reply to Re: 4 years today » DAisym, posted by sunnydays on May 27, 2007, at 9:47:59
An interesting article I came across, authored by a training psychologist. I won't post the URL because of possible cross-linking traffic for the site owner.
**************************
"Just a Little Something I Made for You: Gifts in Psychotherapy"
Thanks to my supervision group for exploring this issue so openly and frankly in discussing their responses and thoughts on gifts as part of our supervision session. This has led me to summarise some of these thoughts and add a few of my own that I thought might be useful for other students and supervisors to think about.
Gifts in psychological treatment are complicated. They inevitably arouse conflicts and emotions within the therapist including:
*
Pleasure, feeding of self-esteem, specialness, feelings of approval
*Conflict and anxiety to accept or not to accept
*Guilt about accepting gift: I want to but I am not allowed but maybe just this once
*Guilt about rejecting the gift: I will hurt the client, they will disapprove, become angry, punish me, I may not be able to cope with their rejection
*Anger how dare they intrude on my boundaries, how dare they put me in this conflict.
Why do clients give gifts?
Clients may have a genuine appreciation of the therapist. At times of significant change clients may what to genuinely acknowledge the contribution the therapist has made to their lives.
Clients may want to test the boundaries of the relationship with the therapist. Clients may attempt to bind the therapist to them. I have given you a gift now you owe me. Clients may want to see how far they can personalise the relationship with the therapist. Gifts may be given at times in attempt to make the therapist “be nice” to avoid confronting certain issues or themes i.e. to buy the therapist off. They can be a defense or an attempt to ward off perceived therapist anger or criticism A need to feel special may underly some gift giving.
A gift may be an attempt to become more special in the eyes of the therapist. Gifts made by the client may reflect “look at what a clever boy/girl I am”. Gifts may be an attempt to personalise the relationship with the therapist and balance the power in the relationship.
Gift giving may have a masochistic or serve the purpose of confirming an underlying negative schema. Clients may give gifts knowing they will be rejected.
Gifts can be an expression of unexpressed feelings about therapy. A client of mine gave me a book of crossword puzzles to do over my holidays. Cross words = angry words. How dare I go and leave him for 4 weeks.
Some ideas on handling gifts
Gifts must be acknowledged.
-You have brought me a gift/present
Gifts in general should not be accepted although see the debate below
-I know it is important to you that I accept your gift. We have a policy at the clinic of not accepting gifts
The positive intent behind the gift should be acknowledged first.
-You feel coming to see me as really important in your life and you felt a need to acknowledge this with a gift.
The trick is to acknowledge and accept the meanings behind the gift but not the gift itself.
-I wonder if the your gift doesn’t also have some other meanings?
Some general musings on gifts
If you do decide that accepting a gift is ok what types of gifts will you accept and not accept
* Are gifts under 10.00 OK under 20 under 50 under 100?
* What kinds of gifts are OK? Are flowers, wine and food acceptable?
* Is a carving acceptable? What if the carving is erotic or violent?
* Is it OK to accept gifts at the start of treatment, part way through or at the end?
* Are cards OK even at the end of therapy. Even these can be problematic. One client gave me a card of a half dressed woman standing over a man in stylised modern art. Did I think that termination was successful; no I did not.
My own thoughts: Gifts even at the end of therapy usually indicate some lack of resolution on the part of client with termination. A message to the therapist to "never forget them" to make them still special in the therapist’s eyes. On another level they may reflect also genuine appreciation for what has happened in the therapeutic process. Their complexity is that they are multidetermined. Gifts part way through therapy are always likely to be problematic either accepting or refusing will raise issues that need to discussed and processed.
Clearly the nature of many gifts is symbolic: Carved totems, pictures clearly representing the therapy journey or intrapsychic conflicts or resolutions. Food and drink. (nurturance) Growing plants (growth) and surprisingly often blankets with personal embroidery are not uncommon gits.
Interestingly some state level code of ethics in the USA ban the acceptance of gifts. However both the American Psychological Association (APA) and the Australian Psychological Society (APS) appear to have no comment on how to manage this issue.
July 04, 2006
Posted by frida on May 27, 2007, at 13:16:24
In reply to Re: 4 years today, posted by spalding on May 27, 2007, at 0:39:06
that's okay, I understand...
I just think that it is impossible to judge other therapists and people's treatment without knowing the full situation and the therapist.
In my case, it is the connection to my T what I find healing and what has helped.
She also tells me some things about herself sometimes to show me how to share and how to trust, because it took me a long time to be able to say a word...and she has told me her own feelings too, and it has truly helped in my treatment.
Everything she has shared, has made me trust her more and see her as a human being. If she hadn't, I would probably still be silent all the time because I really have trouble internalizing caring, feeling accepted and trusting others.
She's told me very deep things about her own childhood, to reach the little, terrified girl in me...I know how old she is, her birthday, I know how many kids she's got and her grandsons. I've seen pictures of them too.
And about gifts, in my case, it has helped me to be more spontaneous, not so afraid of being rejected, and we always discuss why I've chosen a certain gift and it has helped to have very meaningful sessions. I usually give her hand-made things, like drawings and the like.I guess I'm telling you this because sometimes other kinds of boundaries do work for other people and it doesn't mean therapy is not effective or the therapist isn't good. They are just different.
I understand that this approach is more effective to you..
I guess we all need different things and that's perfectly ok. :-)
Frida
Posted by frida on May 27, 2007, at 13:24:39
In reply to Re: 4 years today, posted by spalding on May 27, 2007, at 13:07:04
Different therapists have different views on this, and different training..
I think another thing to take into consideration is that there are cultural differences, I am from South America, for example, and my therapist is from Europe and moved here. She has 30 years experience or more. She views gift-giving totally different. I've given her pictures, drawings, books, tea boxes, etc..I know she values and appreciates the thought and love I've put into them and it's a way for me to express my feelings, she receives them that way.
Each T has a different approach or view..I respect that, I'm happy I've found my T and an approach that works for me and my needs.
just some thoughts..
Frida
Posted by muffled on May 27, 2007, at 19:12:58
In reply to Re: 4 years today, posted by spalding on May 26, 2007, at 22:04:31
And muffled, are you serious, saying things like, "He strong. He gonna take care of you OK" ? Do you like coming off as ignorant?
>and you know it all dont ya????
You don't know sh*t bout Daisys realtionship and the whys and hows of it.
I would NEVER EVER have talked to my T if she hadn't have been as open as she was. I'd proly be f*cking dead now.
We should ALL listen to you cuz we all doing it WRONG.
Right. NOT.
Ya know what spalding, I can take some sh*t, but not today
SO F*CK YOU, ya got that?
Ya, I not a fine lady thats for damn sure, but I don't pull sh*t on people, and I don't think I above others. And I KNOW I am a sh*thead supreme, but hell you not exactly impressing me either at this point....
So unless yopu can get your sh*t together to not put others down, then I have NO interest in corresponding to you beyond this point.
Just felt the need to defend myselfs.
M
Posted by gazo on May 27, 2007, at 23:10:18
In reply to Re: 4 years today, posted by spalding on May 27, 2007, at 0:39:06
read "the gift of psychotherapy" by Yalom
Posted by annierose on May 27, 2007, at 23:10:30
In reply to Hey spalding...., posted by muffled on May 27, 2007, at 19:12:58
(((muffled)))) don't let the bad guys get the best of you. sorry spaulding hurt you and daisy. but he/she doesn't know you. it's just some random person out in cyberspace stirring up trouble in our safe place.
i guess i shouldn't mention the gift i purchased for my t last christmas ... wonder what the symbolic meaning is behind "work out" clothes???? that i think seeing me is like working out ... or that she'll need to work out after seeing me ... or ... who cares. i love picking out a present for my t and i am thankful she accepts the gift graciously.
Posted by gazo on May 28, 2007, at 9:47:00
In reply to Re: 4 years today, posted by spalding on May 27, 2007, at 13:07:04
articles don't talk about human beings as individuals. That is why the process of therapy grows and changes, not just because of research and a lot of theorizing, but because of the experience of therapists and their clients in the real therapy rooms. Therapy is not a theory or a school of thought. Purist therapists would have limited success in many cases. I am not a percentage point, nor do i fit neatly into a theory somewhere.
A good case in point is the development of the sort of therapy i am in now... schema. The very reason it exists is because certain clients did not fit into the nice little rules. It didn't work.
Perhaps the discussion of ethical vs nonethical views of therapy practices should be moved to it's own thread? Daisy should receive support. In fact, i'll start such a thread...
If i don't think gift giving is appropriate then i just don't give one. Seems like an adequate solution does it not?
My cultural background would strongly drive me to giving gifts in many circumstances..but i don't see that in the theories or research. It is a deep part of who i am because of my culture. Much research doesn't account for those variables.
There are articles out there which will support just about any view on any argument you can think of. i am in the middle of doing quite a lot of reading about psychology and psychotherapy and one thing i am learning quickly is that there are so very many points which are debated between the various schools, and even between associations.
i see a number of things in posts which raise my eyebrows now and then, but who am i to criticize? i have no place from my distant observational point to try to squeeze my ideas into someone else's working relationship with their therapist. It would be amusing for others to watch should I attempt to do so I would think.
Posted by Dinah on May 28, 2007, at 9:54:42
In reply to Hey spalding...., posted by muffled on May 27, 2007, at 19:12:58
> Ya know what spalding, I can take some sh*t, but not today
> SO F*CK YOU, ya got that?Muffled, I know you were upset, but please be sensitive to the feelings of others even if yours are hurt. Please don't post anything that could lead others to feel accused or put down.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above posts, should of course themselves be civil.
Dr. Bob is always free to override deputy decisions. His email is on the bottom of each page. Please feel free to email him if you believe this decision was made in error.
Dinah, acting as deputy to Dr. Bob
Posted by Dinah on May 28, 2007, at 9:56:35
In reply to Re: Hey spalding.... » muffled, posted by annierose on May 27, 2007, at 23:10:30
> it's just some random person out in cyberspace stirring up trouble in our safe place.
Annierose, I know you were trying to be supportive of Muffled and Daisy, but please don't post anything that could lead others to feel accused or put down.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above posts, should of course themselves be civil.
Dr. Bob is always free to override deputy decisions. His email is on the bottom of each page. Please feel free to email him if you believe this decision was made in error.
Dinah, acting as deputy to Dr. Bob
Posted by Dinah on May 28, 2007, at 10:18:57
In reply to Re: 4 years today, posted by spalding on May 27, 2007, at 13:07:04
When I first asked my therapist what his gift receiving policy was (long before I ever gave him a gift), he talked to me about most if not all of the potential problems you brought up, then with careful thought elaborated his own policy both in general and in specifics.
As it happens, he does accept small gifts given occasionally. I've since given him a small statue whose symbolism I made sure he understood and an accompanying homemade card on an anniversary, and a bunch of daisies on our last anniversary.
I appreciate that my therapist has given significant thought to gifts, and has a policy in place regarding them. I'm also glad that he personalizes the policy to the needs of the therapeutic relationship.
As it happens, my therapist also allows hugging, under his hugging policy, and he's given similar thought to that policy and it's also individually tailored to the therapeutic relationship. His conclusion is that yes, hugs can give overtones to a relationship that are not therapeutically beneficial, but that the withholding of hugs can also be somewhat seductive. In that making something forbidden also makes it more attractive. He assesses each relationship to determine what's best in that relationship.
I must confess that he doesn't think that carefully about all boundary issues and that after all our time together he gets a bit sloppy from time to time on things like personal disclosure.
But I do appreciate that in areas he considers volatile, he gives a great deal of thought to the issues and is flexible enough to think of the relationship and client needs first.
I didn't really disagree with the article, since it placed in prominence the perfectly normal natural and healthy reasons a client might wish to give gifts. My therapist merely came to a different conclusion after considering the same things.
The only thing I'd be annoyed with in a therapist is assuming that a crosswords puzzle meant "cross words". I'd far prefer a therapist discuss such things with me and take into account such explanations as "I always like to bring crossword puzzles on a plane trip and I was trying to be thoughtful. I regularly give crossword puzzle books as bon voyage presents, and in my group of friends, giving small bon voyage presents is customary. Yes, I might be angry with you for leaving (or no, I'm not particularly angry with you) but sometimes a crossword puzzle is just a crossword puzzle."
Reasonable people can and do disagree about these things, which is probably why many states and both national organizations take no universal position.
I'm glad you've found a therapist with whom you are comfortable.
Posted by Dinah on May 28, 2007, at 10:24:53
In reply to 4 years today, posted by DAisym on May 24, 2007, at 23:54:25
You know how special I think your therapist is. :)
When is he holding that seminar? I'd happily fly my therapist there.
I think that was a very thoughtful gift. I always am impressed with the meaningful gifts you manage to find.
And he's lucky to have you for a client too, Daisy. You're so fearlessly open and so very good at articulating what's inside.
Congratulations on four years of hard work, and especially for accepting that your attachment is what it needs to be right now.
I've recently reattached to my therapist, on one level at least, and I appreciate that attachment and its benefits very much even if I also am conflicted on some level.
Posted by muffled on May 28, 2007, at 10:37:53
In reply to Please be civil » muffled, posted by Dinah on May 28, 2007, at 9:54:42
OK Sorry Babbleland for my incivility.
I was uncivil.
I have my moments.
I feel like a part of me was attacked so felt the need to protect it or something, but that was wrong to fall down to that level.
I will strive to improve my demeanor in future.
Muffled
Posted by Dinah on May 28, 2007, at 10:43:45
In reply to Re: Please be civil, posted by muffled on May 28, 2007, at 10:37:53
Posted by DAisym on May 28, 2007, at 15:25:10
In reply to 4 years today, posted by DAisym on May 24, 2007, at 23:54:25
It occurs to me that I've only responded to the challenges of this thread and not to the lovely sentiments expressed by so many. Thank you for your support (not just here but always) and for the kind words.
I often wonder what my therapy experience would be like if I hadn't found Babble. I read about what others have been able to say and the honesty they reach for and I'm then able to push myself to do the same. (well, I try anyway.) At the exact same time, I read about what people don't say or feel or do and I then question myself--am I even doing this "right" - if there is such a thing. But even those moments propel me to go back in there and ask questions, questions I probably wouldn't have asked if not for the discussions here.
I've said it before, but when my therapist and I talk about Babble, he calls it my "group" -- and he has enormous respect for the support and the intelligence of our posters here. I think we make him think too -- which is a good thing!
So Thank You. I wish I could give you all a gift too! :)
Posted by gazo on May 28, 2007, at 19:24:34
In reply to Thanks All, posted by DAisym on May 28, 2007, at 15:25:10
Daisy, i have to say that the word that i feel best describes you is "gracious." i have thought so for a while. You said you talk to your T about babble... do you tell him the name of the site? if yes, does he read here? It has always made me curious as to whether any T's read the site. i wonder if random T's or pdoc's read mental health forums... i would imagine it would be unlikely, but it makes me curious anyway... and a little paranoid. i think my T would learn a lot about me if he did.
Posted by annierose on May 28, 2007, at 19:49:00
In reply to Please be civil » annierose, posted by Dinah on May 28, 2007, at 9:56:35
virginity ... blush.
I was patient ... it took 3 years in this relationship but in the heat of the moment, I tossed caution to the wind and you know the sad story that followed.
No regrets. But I'll try to remember to use better protection next time.
Posted by annierose on May 28, 2007, at 19:51:56
In reply to Thanks All, posted by DAisym on May 28, 2007, at 15:25:10
Well said. I feel the same way. I too often wonder what my therapy would be like without the support of babble. I think I would be frustrated more often. Here I can read other therapy stories and realize how difficult and wonderful the therapeutic relationship can be.
And I made some new friends along the way.
Posted by TherapyGirl on May 28, 2007, at 20:21:40
In reply to Thanks All, posted by DAisym on May 28, 2007, at 15:25:10
I totally agree with you about how special the support here is, Daisy. I feel like I have learned so much from everyone here and when I'm having an issue with my T (like I am right now), I know there are hundreds of people on here who will immediately get it. That kind of support is priceless.
So thanks for what you bring to the table, too, Daisy and HAPPY ANNIVERSARY!
Posted by DAisym on May 28, 2007, at 22:42:11
In reply to Re: Thanks All » DAisym, posted by gazo on May 28, 2007, at 19:24:34
What a nice thing to say, Gazo. Thank you.
Nope - don't/haven't said the name of the site. He might know it from other things that have happened. And yes, I've thought about asking or saying "please don't read there" but I haven't. I doubt he reads here, in the first place, but if he does, and if he read something that bothered him, I'm sure he'd bring it up.
Funny thing, I've bopped around a few other mental health sites and there always seems to be a poster named "Daisy" -- not me -- so if he did find a site with that posting name, he could be reading a whole different person! Wouldn't that be wild?!
We had a whole thread on here a while back about whether discussing your therapy here was harmful or helpful to the therapy. There were lots of different opinions. I asked him and his first response was that he had no interest in controlling any (non harmful) activities I was engaged in. We did talk about diluting the emotions and the intensity of my reactions but so far that hasn't been a problem, most likely due to the frequency of my therapy. Sometimes things that happen here to other posters open up things for me that are worth talking about. Once in a while I get upset or stirred up and he expresses concern over what I am reading.
Occasionally I worry about what he might think if he reads a bunch of my posts. But truthfully, they really aren't all that different from what I straight out tell him. I sort of misplaced my pride around 3 years ago...But still. I don't refer to Babble by name, we call it "the Board" or "your group." And that suits me fine for now.
Posted by Dinah on May 30, 2007, at 9:54:28
In reply to Re: I lost my PBC ...., posted by annierose on May 28, 2007, at 19:49:00
Posted by Dinah on May 30, 2007, at 9:58:23
In reply to Re: Thanks All » gazo, posted by DAisym on May 28, 2007, at 22:42:11
Mine knows the name, and I've had him promise he won't read. Usually he is rather dismissive, since he doesn't use the internet much himself, but he promises. Last time it came up he answered that he had no desire to intrude on a place where I found support. And that even though he knows I vent here, he figures everyone needs to vent sometimes.
A lot of times he really appreciates the ideas expressed here, and think they're better than what his one head could come up with.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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