One of the most difficult issues to deal with in therapy is dependency – a state of mind where we are supposed to rely on someone for aid and support – our therapist. Our deepest wounds, though, were inflicted upon us when we were the most vulnerable: when we were loving, trusting, and emotionally available children. As adults, we tell ourselves at some level that that will never happen again.

That is only natural. But, to protect ourselves, we learned to shut down our feelings, to distant ourselves emotionally from others, and to constantly be on guard against threats (real or imagined) coming from those around us. This, unfortunately, gives us a false sense of security because to feel is to be alive. To not feel keeps us prisoners of our past.

At some point in our lives, circumstances dictate that we seek out therapeutic help. We may be experiencing difficult circumstances like a divorce, job loss, a death in the family, or even the birth of a child and become unable to keep up the old façade of not letting anything upset our internal state of mind.

The therapeutic setting is supposed to be a “safe place” to voice concerns and receive professional treatment. But that involves sharing our feelings – our most protected treasure. I remember an old movie starring Arnold Schwarzenegger when a child was describing his father’s occupation. The child said, “My father is a psychologist. He helps people find their feelings.”

The leap of faith a patient takes in trusting a therapist and becoming vulnerable is something that is to be taken as sacred. We are bearing our souls – becoming vulnerable again. Most therapists understand this. Some do not and that can cause untold damage.

For example, a young, new therapist may want to show the patient she can be depended upon to be available day or night, no questions asked. The therapist has good intentions, has empathy for the patient, and wants to develop a strong bond with him/her. The problem is it is a poor example of boundary control because as the young therapist will learn later, s/he can’t always be available and may even begin to resent the patient acting upon the invitation the therapist has set up.

When the patient relies on the therapist’s willingness to be at his/her beck and call, day or night, and the therapist then starts giving excuses for not being available, the survivor feels tricked, just like s/he was tricked by his/her perpetrator(s) when growing up. Unless the patient and therapist can openly discuss this together and resolve the survivor’s pain and anger, it can cause problems in the relationship.

Therapists want to be there for their patients. They want them to get well. But they need to model for their patients appropriate self-care, and setting up healthy boundaries is one way of doing that. It is important to establish boundaries from the very beginning, but to do so in a caring manner. One therapist told a survivor, “I’m not going to buy into your old patterns of behavior. You need to understand upfront that I’m only available during these specific hours.” You can imagine what the survivor was thinking. “You can cram your hours you know where.” It would have been more helpful for the therapist to describe the need for boundaries, that this was one of the new skills the survivor would be working on, and to reassure the survivor that the therapist did care about him/her. This is an example of one of the issues they were going to work on together.

It is a very tricky but vital part of therapy to learn about dependency issues. Hopefully, this blog will help survivors better understand the need to talk about dependency and to be open to gaining perspective from both sides – the therapist and his/her patient.