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Ask the Mental Health Expert Archives 2001-2004

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Emotional Boundaries

Q. Could you please suggest information for distribution to psychiatric patients on the subject of emotional boundries?

A. I don't believe there is a single cookie cutter approach to informing psychiatric patients about emotional boundaries. Much depends on what we mean by that term; the particular pathology of the patient; and what sort of professional follow-up can be provided after the information is distributed. For example, we often speak of loose boundaries when we discuss patients with schizophrenia or borderline personality disorder.

On the other hand, we also refer to co-dependent people (e.g., the children or spouses of alcoholics) as having boundary problems. Individuals who have suffered childhood sexual or physical abuse may also have problems with intimacy (as well as post-traumatic symptoms) that might loosely fall under the rubric of emotional boundary issues. The educational and psychotherapeutic approach would likely differ among all these patients.

Then, of course, there is the difficult issue of boundaries as it applies to the psychotherapeutic setting; e.g., when do therapists inappropriately cross certain professional boundaries? You might want to take a look at the book, Boundaries and Relationships: Knowing, Protecting, and Enjoying the Self, by Dr. Charles L. Whitfield and John Amodeo (1993). This might help you get oriented to the specific boundary problems you want to address with your patients.

There is also the book Keeping Boundaries: Maintaining Safety and Integrity in the Psychotherapeutic Process, by Richard Epstein MD (1994). In my book, A Consumer's Guide to Choosing the Right Psychotherapist, I also discuss some of these therapeutic boundary issues, sexual exploitation, etc. I hope this gets you started.

February, 2001

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