So how much can you care? Boundaries are a difficult thing to explain. It’s simple to define them as where I end and you begin, or a fence to keep me in and you out. I don’t know if that’s enough. Freudian analysts kept a clear distance and always worried about transference and counter-transference. Some west coast therapists in the 70s thought that there were no boundaries and sex was a great way to help patients. Some psychiatrists now act like family practice MDs with only 15-minute medication visits. They see so many patients that they have trouble remembering their names. Some family practice docs act like psychiatrists and that is both good and bad. They can offer real warmth and interest, but often times they can RX the wrong med or advice.
There have been countless books on boundaries and co-dependence and there will probably be countless more. Therapy presents some unique issues with boundaries. Whenever someone comes for “help”, they are automatically in a vulnerable position- but so is the therapist. I got to the point that I didn’t think I could work with someone if I couldn’t find something to like. Usually I could find something. Virginia Satir was great at this. She once told the wife of an ax murderer that he was only trying to make contact with her when he tried to kill her and this showed how much he really cared. Now I couldn’t do that. I did refer out a particularly nasty man with narcissistic personality disorder. I just got tired of the way he talked about the women he was abusing. He was also trying to build a case against his ex employer and filing for psychiatric disability. I just got to the point that I couldn’t stand to listen to him.
Now I know that this isn’t the way it is supposed to be. It’s hard enough to make a decision to go for help, and now what happens if your therapist doesn’t want to work with you ? Carl Whitaker ,one of the founders of family therapy, once said “I care very easily, but you have to make me care”. It didn’t take much. I think all I asked was for a person to make a reasonable effort to take some responsibility to change . As long as I could see that , or see where someone was trying to even get to that point, I would be fine. This does get back to the question of how much to care. The problem is always if you care more than they do. Sometimes you can care too much. I think that is the danger of being swallowed up in someone else’s life. It is a very fine line to walk. Robert Frost wrote about his neighbor saying “Good Fences Make Good Neighbors”, but he wonders about that. Before he would build a wall he wants to know what he is walling in and what he is walling out. If you build stone walls you have to be careful because they can crack. If you have no walls you are at the mercy of everyone’s emotions and crises. What price do you pay for this?
“Burn Out”, “ “Compassion Fatigue”, “Vicarious Traumatization” or whatever words are now being used for being overwhelmed with work. I have had lots of people ask how I could hear other people’s problems all day long. Did it ever affect me? Of course it did. Most days I would be able to leave ,get in my car, start blasting the Rolling Stones,and let it all go. However some days I wouldn’t be able to. I think as I got older and more experienced those days got fewer, but my family might disagree. I know that by the end of the week I was tired. Usually I would have Friday off. My wife would go to work and I might sit in a chair and read. The windows would be closed with the curtains drawn. It wasn’t that I liked the dark , it was just that I wanted privacy with no other distractions. I would rationalize this as my own recovery time. Exercise helped this too. If I ran or did some other strenuous exercise, I could focus on that and not on work. By the time my wife got home I was usually better. The rest of the weekend would fly by and before I knew it, I was back at work. I think the clinic was a good place where wonderful work was done. I also think that because of the work, I would get so caught up in the process and the very number of patients, that I didn’t realize what was happening to me. I think the importance of focusing on self care is often neglected. The less I took care of myself, the worse my own boundaries were. I could always tell when I was getting to the edge when I would argue with a patient or get in a “power struggle” because they weren’t listening to me. The reality was I wasn’t listening to them.
Retirement is still strange. It’s like I put my instrument in the closet and haven’t taken it out for two years. I can try it on my wife and family, but I don’t think they want to hear that kind of music from me. One of the changes now is that the curtains are always open in our house. Sometimes I still want the dark, but I am getting used to the light and still working on new music- and new walls. I need to work on gates and maybe learn about picket fences that you can see thru and lean on and sometimes reach across. I think I am at least getting more ready to try.