Boundary Transgressions in the Psychotherapeutic Framework: Who is the Injured Party?

Abstract

The authors emphasize the therapeutic value of establishing and maintaining boundaries between clinician and patient. No universal definition of a therapeutic boundary exists, and this ambiguous term spans a diverse spectrum from benign crossings to harmful violations. Understanding of the traumatic nature of faulty boundaries in psychotherapy has derived largely from the study of severe sexual transgressions by therapists. In contrast, this paper highlights the importance of recognizing a wider and more subtle variety of boundary crossings, especially those by patients, which can compromise the integrity of treatment and traumatize the vulnerable therapist. This is exemplified here in the case study of an incest survivor and a novice clinician.