Torrey Orton
Oct. 4, 2013
Work in
progress…the contributions of social media
I’m going to a workshop entitled
“Boundaries, borders and multiplicities: ethics and professionalism for
psychologists with emphasis on social media” on October 16th, ‘13.
So I thought I’d think about it a bit first since I know some of my practice is
a bit borderline – or, maybe unbounded? - for some. In fact, I think I work the
borders with persistence and urgency – the borders of feelings, of spaces, of
intentions, of understandings, of behaviours, of roles…all the places where
patients arrive in therapy unproductively self-constrained!! The social media
provide new opportunities for boundary stretching and/or unintended crossings!
My point here is not to argue the role of social media but first assay the
field of boundaries, among which it is a relatively new one.
So, let’s start with a definition of boundaries
and borders (with frontiers on the sidelines). I think they are still fitting
for a virtual world. That is, social media can be partly described and engaged
using these three concepts – boundary, border and frontier – with the emphasis
on the last of the three.
Boundary,
border, frontier share the sense of that which divides one entity or political
unit from another.
Boundary
in
reference to a country, city, state, territory, or the like, most often
designates a line on a map: boundaries are shown in red….
Border
is
more often used than boundary in direct reference to a
political dividing line; it may also refer to the region (of, for instance, a
country) adjoining the actual line of demarcation: crossing the Mexican border;
border towns along the Rio Grande.
Frontier
may
refer to a political dividing line: crossed the Spanish frontier on
Tuesday. It may also denote or describe the portion of a country
adjoining its border with another country ( towns in the Polish frontier )
or ….the most remote settled or occupied parts of a country: the
frontier towns of the Great Plains. Frontier especially
in the plural, also refers to the most advanced or newest activities in an area
of knowledge or practice: the frontiers of nuclear medicine
My professional organisation (the APS)
proposes the following cautions about boundaries. Interestingly, the concept of
frontier is not included, maybe because it is implied in the concept of
“boundary crossings”. And with that observation it immediately becomes apparent
that the relationship between boundaries/borders and frontiers is systemically
conflicting.
Here’s what the APS ethics rules say -
1.3. A distinction is frequently made between
boundary crossings and boundary violations. Crossings are
departures from commonly accepted practice that some
psychologists may see as appropriate, for example
attending a client’s special event. It is
acknowledged that both cultural background and theoretical orientation
will influence how psychologists and their clients
construe certain behaviours. Nevertheless, given that such
blurring of boundaries is often a precursor to later
major transgressions, it is important for the psychologist
to examine the implications of such actions, no
matter how innocuous they seem at the time. Boundary
violations will be referred to in Section 3.
1.4. In practice, major boundary violations are
frequently preceded by lack of attention to minor boundary
crossings. The process of boundaries gradually
eroding is sometimes referred to as the ‘slippery slope’
phenomenon, (Barnett, Lazarus, Vasquez,
Moorehead-Slaughter, & Johnson 2007; Gabbard, 1996; Gutheil,
1989). For example, in circumstances where
psychologists significantly alter their standard practice to
accommodate the ‘needs’ of their clients,
psychologists consider the following questions to help clarify
whether there are potential boundary crossings
emerging.
• Am I operating within my limits
of competence?
• Am I avoiding any topics?
• Am I showing any
uncharacteristic behaviours?
• Do I have discomfort with
boundaries?
• Am I self-disclosing more than
usual?
• Am I taking into account any
current personal difficulties?
• Is there a possibility of a conflict of interest
developing?
Professional
boundaries and multiple relationships
© The Australian Psychological Society
Limited 2008
Event
boundaries of therapy are the
field of my practice – I work in two shared offices (with financial and other
patient management services provided) and a home office (I provide all patient
management services). In addition under those rubrics for patient management purposes,
I have used non-typical locations: in a car, in a cafe, in a park, walking the
street together. These occur when, e.g., a shared office is closed unexpectedly
by alarm system failures, locked doors or patient preference for variety.
Social media are woven into my practice –
but NOT Facebook and Twitter - e.g. email (did supervision and therapy by email),
SMS (set and change appointments, take homework reports) phone (same management
matters and some therapy), and Skype (therapy and catch-ups overseas) in order
from least to most intimate. I wave goodbye to Skype partners at closing of
sessions!!! …and sometimes hello, too!
The standard therapeutic hour has at
least these three major segments with barely visible boundaries between them.
They come into view when a patient has trouble negotiating them. Entry and exit
seem most perilous perhaps because they require explicit agency from patients,
which is often what they are in the room for in the first place.
a.
Entry to office
and to room
b.
Working and the
setting in room – distance between chairs, size of total space, lighting,
heating, contents, etc.
c.
Exit from
room/office
Physical
boundaries – the edges of our
bodies and places and furnishings / designs.
For
instance, a patient who came and stayed for 6 months twice a week at his own
expense, noted after the first or second session that he had been strongly
discouraged from making ANY physical contact with patients (he’s a psych in
training) prompted by the fact I always shook his hand on the way in and on the
way out of every session. It clearly did not trouble him, but he had been given
the impression that it was a handhold too far for my academic colleagues. None
of my many practice colleagues who I have worked with for the last five years
has ever expressed a worry, nor has a patient. Nor is it mentioned for
forbidding in the above Professional boundaries
and multiple relationships, though it may be implied
in discussion of other hands-on therapeutic techniques elsewhere in the APS
ethics.
Intellectual
boundaries
I leak from therapy competences into
other life competences. For instance, when I bring therapeutic perspectives and
processes into many work settings as an executive coach. And I leak in the
reverse direction as a result of having a grip on organisation and group theory
and practice (as worker, manager and principal of professional practices),
which allows extension of individual therapeutic work into the spheres of
public and private action which range from family to team to organisation in a
range of industries.
Social
boundaries
Managing social boundaries like gender,
age, class, education, culture (and the respective cultural variants of each of
these factors) I do fairly well across at least European and Confucian cultures,
with some capacity in East African and Middle Eastern ones. I have lived as an
adult in the US, France, China and Australia.
Emotional
boundaries – displaying / expressing any of the core emotions – joy,
sadness, anger, shame, fear, surprise,
interest, disgust – which occupies a large part of my focus in session,
both as mine affect patients and as theirs affect them and me. I attend to how
they are expressed, which I point out to patients often and early to anchor
their level of self-awareness and control in our relationship.
Lifecycle
/ developmental boundaries
enforced by aging to some extent socio-economic factors – mentioning these is often a useful frame to
patients stuck in a swirl of factors leaving them pitching in a sea of emotions
without a shore in sight.
Institutional
boundaries – family, school,
club, work, church, state, nation….often interacting with the lifecycle/developmental
ones since the institutions often sit astride the entries and exits of
developmental stages. They are rites and rights of passage.
And, there are roles and hence role boundaries like therapist, teacher,
instructor, parent, - I understand myself to be shifting around these roles,
with therapist as the dominant one even if at times not at all the prominent
role of the moment. I consciously mark my transitions between them most of the
time, showing that I have the dependence / independence / interdependence triad
largely in hand in session.
Finally, the thing about boundaries is
they never (?) come in ones. Like people, they come in multiples, which is
maybe what the workshop title is hinting at. e.g. – restorative justice and trauma
therapy are conducted by processes somewhat similar in steps and goals, but
emerging from opposite ends of the practice spectra. Restorative justice is a
socio-legal prescription for a personal, socially imposed, hurt. Therapy
provides the setting for embracing the right to that justice.
The world of therapy is always complex
in many ways, and social media is just another way, not THE one that techonauts
blindly promote. In the therapy place, wherever and whichever it is, all is in
play face-to-face with mutually examinable settings for each player as needed.
The ‘mutually desirable’ bit is what therapy models and provides the
opportunity and experience to achieve in the everyday world.
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