A little while ago a friend told me she had just learned that her therapist, whom she was no longer seeing, was being disciplined by her state board for inappropriate conduct with a patient. Needless to say my friend was upset as she knew this misconduct occurred around the time she herself had terminated. She asked if I would write a bit about this. And here it is.
Therapists are human and we make mistakes. And the best of us learn from them, even from the serious mistakes and go on to do better work. Doing therapy is dangerous work. My friend's therapist had just completed her residency when she started seeing her. This is very vulnerable time for new therapists because they may believe that now that the state says they are ready to be in practice, they actually are. But that is only the very beginning and it is once one is in private practice that supervision is truly critical because there is no one looking over your shoulder then. I always say it takes 10 years to make a therapist and I mean 10 years in practice, not including training.
The boundaries that therapists should all hold are not natural and it is hard to learn them and get how truly important they are. Like I can't participate in Facebook as I might were I not a therapist. I am quieter about my political inclinations too ... Because I need to be opaque enough to be a projection screen for my patients. I can't become friends with them because the therapy relationship is sacrosanct and even when the therapy is done, I hold the door open for the patient to return which means the relationship has to be held as therapeutic. This means we have to make certain sacrifices in order to hold boundaries and maintain the temenos of therapy.
In addition the work we do is intimate. A common problem among therapists is to neglect our own intimacy needs and neglect to direct them into our personal lives where they belong. We may fall prey to mistaking the intimacy of therapy as the place for us to meet our own needs and desires, always an error no matter how strong they are. It is an important thing in this work that I have friends I can confide in and people I am close to as well as other professionals I can consult with, all to help me maintain good boundaries.
That is what I mean when I say it is dangerous work. And sadly the exigencies of today's mental health system and directives of health insurers do not support or encourage the view of it as sacred work requiring sacrifice and long training and supervision. If I ran the world, all therapists would be required to be in their own therapy for at least 3 - 5 years and clinical supervision as well. But I don't and we are all human and some of us make serious mistakes.