At the beginning of this post, I find myself feeling much the same way I did when I wrote a piece about blog awards a few months ago – that is, rather full of trepidation and somewhat scared of offending anyone. Although, given that it may not be of interest to anyone apart from the very small handful of therapists (is there a collective noun for therapists?) who read my blog, and perhaps not even to them, that may be a wasted worry.
Why I am writing a blog post about blogging therapists? Because I read something recently that made me think about the subject more seriously than I have done before; because at the very least, I would like to give pause for thought. At best I hope to hear from one or two therapists with their views, either via comment, or (and I would be honoured if this were the case) by a reply post either on their own site or on here.
It struck me recently that there are some very different issues that today’s therapists have to grapple with, than existed several decades ago. With Facebook, Twitter, and all the myriad of other social networking sites, our lives are so much more ‘public’ than they used to be and there are so many more ways to connect with people. However, if you are in a profession where maintaining boundaries and keeping your non-professional life private, are key, how do you decide how much of yourself ‘to put out there’, and in what way?
Facebook recently asked me, out of the blue, whether I wanted to become friends with Person X, who was someone I saw once when I was ‘interviewing’ potential therapists around eighteen months ago. We had each other’s mobile numbers and email addresses, and that was enough for Facebook to connect the dots. I was alarmed at the suggestion and wondered how many other current or potential clients Facebook might be trying to connect her with, and so I looked at her page, more out of concern than curiosity. Once there, I could identify her family members, where they worked, and I could glean something of her political views from her public posts.
It may be that Person X was happy for her clients to have access to this sort of information about her – or she may simply not have realised how careful one has to be about privacy settings on social media sites. Either way, it does make me wonder: as a therapist, how do you decide how much of an internet presence you are going to have? How much thought do you give to this, in the context of your profession? How do you weight up the personal advantages (for example, keeping in touch with distant friends or family) against the possible professional implications? All therapists will know that many of their clients will look them up online and some will try and find out as much as they can. What impact will it have on those clients, to find out personal details about a therapist’s life, and whose concern, ethically, is that impact? Who bears responsibility?
A ‘personal’ presence on a site like Facebook seems almost compulsory these days –there can be a real sense of ‘missing out’ if one chooses (often for one’s sanity!) not to participate. But the decision to start a blog is quite a different one, and although blogging certainly connects you, it connects you to people outside your day to day life. From a therapist’s perspective, it also connects you to people who might either be potential clients, or are another therapist’s clients. I have come across a number of therapists whose blogging is strictly professional rather than personal in nature. That is, their posts may describe different types of therapy, address typical therapeutic situations or answer common client questions, and their interaction with readers is often limited. But there are also therapists and ex-therapists whose blogging is more personal – who share with us a little of themselves, as well as a great deal about their craft, and who are happy to engage in conversation.
And so I’m intrigued: if you’re a therapist or ex-therapist who blogs – why do you do it? What drives you and how deeply have you explored your motivations? As a therapist, you know that clients are often desperate to find out more about the process of therapy and to find out what makes therapists tick. In fact, frustrated by their inability to see into the hearts and minds of their own therapists, clients may seek out therapist bloggers in the hope that finding out what is in their hearts and minds, will give them a better sense of who their own therapist is. What impact, if any, does this knowledge have upon what you choose to say or share? Is there any sense in which your blogging is part of what drove you to become a therapist in the first place, or is it much more about what it does for you, than what it does for those who read your work? Are you ‘therapising’ (if there were such a word, which there isn’t), at a distance? Or are you always extremely conscious of not falling into acting in that capacity for people who are not your clients and whose own therapeutic alliance needs to be upheld?
An ex-therapist blogger who I am extremely grateful to for his very helpful and insightful comments on my posts, once made the point that he was assuming that my therapist was correct in the way she was working with me, and that we knew our own relationship best. It was a very affirming and supportive comment, and it did make me wonder: is that the hallmark of ‘ethical’ blogging by therapists? That it should be ultimately be affirming of the process, and of people’s experiences of it? Or does it not make sense to talk about ‘ethical’ blogging (and if does, why should clients, or anyone else, be excluded)? Is it simply anyone’s prerogative to tell the truth, as they see it?
The reason for all of my wondering, you see, is this. A few weeks ago I read a blog post by a practising therapist, which really unsettled me. Fear over ‘driving my therapist away’ was very much on my mind. I was testing her in small ways, and wondering what it would take for her to eventually want to stop working with me. The post, which talked about the potential fragility of the therapeutic relationship and went into detail about the therapist’s own feelings about the matter, fed those fears and sent me into an even greater state of anxiety. Originally, I was going to reblog the post with a short introductory paragraph. That paragraph turned into its own 1,000 word post. However, having discussed the post and the effect it had had on me, with my own therapist, I decided neither to reblog it nor to publish my own thoughts. Although the post was helpful in a number of ways (for example, by reminding me that my therapist is human, despite the fact I often idolise her) – I couldn’t in good conscience share something which overall, for me, was more disturbing than helpful.
I do not wish in any way to offend the therapist who wrote that post, and I know for a fact that a number of readers found it helpful. And I am grateful to her for raising all sorts of questions in my mind – questions that I think it’s important for me to ponder as they apply just as much to ‘in session’ as they do to ‘out of session’. We make so much of ‘telling the truth’ and being straightforward and honest in our communication – at least, I do. As clients, I feel we are encouraged to tell all and to leave nothing out, and often I feel as though I want at least a little reciprocation from my therapist. But how much responsibility does a therapist bear for telling the truth, and for holding it back? How do you, as a blogging therapist, judge what should be said, and what, for the sake of the client, it would be best for them not to know (even if they wish, desperately, to know it)? And not just your own clients, or ex-clients, but any vulnerable individual who may be reading your posts?
Parents want to be honest with their children; but they are also anxious not to burden them with emotions or with facts that would cause more harm than good, at their particular stage of development. For example, a parent may talk to their child about grief, and may even share aspects of their own; but there is a fine line between sharing in order to teach, and burdening a child with something that they are not equipped to take on. In as much as clients bring themselves, at all ages, into therapy, I think similar factors apply to the therapeutic relationship. As an adult, I may find the idea of my therapist ‘protecting me’ and ‘not burdening me’, difficult to accept. But I am often not an adult during session, or indeed between sessions, and my therapist would be remiss if she didn’t bear in mind the fact that sometimes she is dealing with the child, and she is more ‘parent’ than ‘partner’. So that brings me back to my earlier question – if you are a therapist who blogs, how do you decide how much of your own thoughts and feelings to share? Is there an ethical dimension to that decision? Is there any sense in which you feel you have a responsibility towards other therapists’ clients, as well as to your own?
Finally, if the therapeutic relationship is at the core of therapy, how do you view your relationship with your readers, and those whose blogs you also read? Are you attune to the dynamic of the interaction in the way that you might be during session? And does that influence the way in which you respond, or even if you do respond?
A few weeks ago I realised that the way I felt about the interactions I was having with an ex-therapist blogger, reminded of me past relational patterns, particularly with other ‘authority’ figures. I became aware of the familiar feelings of wanting to ‘be special’ (which I have in relation to my own therapist as well), and of wanting his attention and his compliments. More than that, I became conscious that I was seeking from him, what I felt I wasn’t getting from my own therapist – validation, reassurance, praise. I talked to my therapist about this, and she said that it was rather like going to dad when mum was not forthcoming. She was right – but to me, it also felt like having an affair. I asked her whether my interactions with this blogger bothered her, and she said no. And yet I had wanted her to say yes – I wanted her to feel ‘jealous’. To be protective of our therapeutic relationship and to feel put out at the thought of me ‘looking elsewhere’ for what I thought I needed.
As often happens, bringing something ‘secret’ out into the light and talking about it, robbed it of its power. I still great enjoy and value my interactions with that blogger, but I no longer feel as though my mind is caught up in some bizarre kind of therapy attention-triangle. My relationship with my therapist is stronger than it’s ever been, and I’m learning to recognise the ways in which she gives me what I need, even if it’s not always in the ways that I want. But I ask myself – do therapist bloggers wonder if there are similar dynamics in play with those they interact with? Do they wonder if they are becoming part of those individuals’ therapy? If that blogger had been aware of what our interactions meant to me at the time, would it have made any difference to how he responded? I hope not – and I hope that knowing it now, doesn’t cause him to pull back in future. That is my greatest fear in writing this post – losing the connections I so value, and driving away therapists (including those who are not my own!).
I feel that that is more than enough questions for now – and I have gone on at far greater length than I intended. If you have made it this afar, and are still awake, let alone interested, congratulations! And if you’re a therapist, a blogger, still awake, still interested and are minded to reply – I’d be very excited and honoured to hear from you. As indeed I would be to hear from anyone who has thoughts on this subject….
April 4, 2015 at 9:29 pm
This is extremely thoughtful. As you know, I am a retired clinical psychologist. Were I to answer each question, my response would be far longer than what you have written. That said, I believe your questions are important and should be addressed, at least in part. I’ve approached these questions, at times, on my own blog site, so an interested reader might try to plow through them to find relevant posts. However, at some point I will try to post something more, either here or on my site, and be responsive without being attentive to all the worthwhile points you raise. In the meantime, don’t think I have been in any way offended by the questions.
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April 5, 2015 at 6:32 pm
Okay, so I must firstly admit that I’ve never thought of looking my Therapist up online before, so I couldn’t resist, but came up with zilch. I could’ve searched further but thought, ‘what am I doing’? Would I really wish to know anything about him? No, I wouldn’t. I may be closer to my T, but I still want/need to work with a blank canvas and cannot see that changing anytime soon, if at all.
Thinking of when I worked in Drug Rehab and counselling for a number of years, I would never have had a social media account that clients could connect to. I joined Facebook a couple of years ago, really just to connect with my sister and relatives in SA. Within a month, I had two people asking if I was the same Cat who used to work for this rehab. There is something still in me that would hate to burst their perception or illusion of who they knew all those years ago, so I took that FB page down.
I imagine most Therapist would go to lengths to keep their private life and personal views out of reach, but maybe I’m wrong.
April 6, 2015 at 2:37 am
I hope you will get some answers 🙂
April 6, 2015 at 1:42 pm
Dr Stein sent a lovely reply, and investigating his archives, and through a future post he is hoping to write, I think I will learn a great deal 🙂
April 6, 2015 at 1:03 pm
Just wanted to follow up. If or any reason I’ve misunderstood you or you’d rather not post my comment, no problem. I’m good no matter what.
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April 6, 2015 at 1:23 pm
Not at all and I’m really sorry for the delay. I was travelling back from holiday yesterday, packing the night before that and I’m really struggling to cope today. My mood is very low – I’m hiding in the bathroom as we speak!..it can sometimes take me a while to approve comments but only because i like to reply to each and every one and things are so hectic with work, kids, therapy etc that it can sometimes take me upwards of a week. I hate that and I know I should just take the pressure off myself and approve and like comments and come back to them at a later stage for a reply. I really value this aspect of blogging and building up relationships and I regret I don’t have anywhere near enough time for it. I really really appreciated your comment and am honoured you might reply in a post at some stage. I am also very glad you were not offended by anything I said, though I was going to ask if you were also as unphased by the fact that the blogger I was referring to at the end of my post, was you (as you may have suspected ). I value the conversations we have but also worried it was unfair to burden you with any ‘complications’ even if they are solely in my head. I better stop there but thank you again so much for your comment and for following up – both of which mean a very great deal…
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April 6, 2015 at 1:39 pm
Ps as soon as I get a chance I will look back at your archives and try and find some of those posts you mentioned, that give some answers to my questions. At the moment I’m really struggling with the therapy easter break, and in particular with the knowledge I will never be a part of my therapist’s life. It’s that sense of feeling excluded – I intend to write about it at some point, when it’s less raw – but wondered if you’d written about this? I fell to pieces at the start of a session recently, triggered simply by seeing her walk to the postbox. Being brought face to face with her life outside our sessions, which doesn’t include me, is painful….sorry have gone completely off tangent now!
April 6, 2015 at 2:12 pm
I haven’t dealt specifically with the issue of feeling excluded from a therapist’s life, but here is one on therapist vacations: https://drgeraldstein.wordpress.com/2014/09/29/managing-the-dread-of-a-therapists-vacation/ The idea of exclusion is a provocative one. Perhaps I’ll write about it at some point.
April 6, 2015 at 10:53 pm
Thank you so much for directing me to the link, which was very helpful. As usual, it’s good to hear your perspective as a therapist and to have it reinforced again (even though I know it, so well, logically, though it’s difficult to cope with emotionally) that therapists need holidays too. And the point about managing the process within your own limitations was very useful too. My therapist is happy for me to email her during breaks, but I find it very hard to take her word for it and so I try not contact her. And then of course, when I end up doing so, I feel bad about it and as though I’ve imposed on her time, until I hear from her. She has asked me on a few occasions whether I find it confusing – I don’t, and despite the panicky moments when I revert to child-mode and worry I’ve burdened her, overall the contact is incredibly helpful, provides continuity and is tangible evidence of her caring (so important to me). Also, it tends to throw up aspects, questions and emotions that then provide very fruitful material for sessions when we look at why I reacted in the ways that I did (and this goes for email contact between sessions as well as in breaks). But I need to trust that she knows her limitations, and take her at her word, while at the same time maintaining a sensible restraint. I know I have an urge to protect her from myself – I need to let go of that a little, I think, while at the same time trying to manage, where I can, on my own, and bearing her needs for rest, in mind too. As for exclusion – provocative is an interesting word, and if you write about it, I’m already intrigued to read it!
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April 6, 2015 at 10:58 pm
I’m glad this helped. And thank you for making me think about “exclusion.” I have a first draft and will probably post it at week’s end.
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April 6, 2015 at 11:19 pm
Looking forward to it 🙂
April 6, 2015 at 2:05 pm
Since I have now been “outed,” let me respond directly to what you referred to at your post’s end. Specifically, this: “As often happens, bringing something ‘secret’ out into the light and talking about it, robbed it of its power. I still great enjoy and value my interactions with that blogger, but I no longer feel as though my mind is caught up in some bizarre kind of therapy attention-triangle. My relationship with my therapist is stronger than it’s ever been, and I’m learning to recognise the ways in which she gives me what I need, even if it’s not always in the ways that I want. But I ask myself – do therapist bloggers wonder if there are similar dynamics in play with those they interact with? Do they wonder if they are becoming part of those individuals’ therapy? If that blogger had been aware of what our interactions meant to me at the time, would it have made any difference to how he responded?”
I try not to interfere with anyone’s treatment. But, I do make a few comments, mostly to be supportive or ask questions — sometimes to help someone get a new perspective. I don’t think it is more than a friend might do for you. It is not more than I have done for some of my friends who have problems with which they are struggling, whether they are in or out of therapy. I also recognize my profession might cause my words to carry a bit more weight than a non-professional friend.
In the end, language and relationships are complicated. Any comment by a friend or acquaintance has a potential impact. I have yet to be told that my words on the internet have caused anyone lasting trouble. I realize an absence of data doesn’t rule out the possibility, however. My position, to some extent, is this: 1. No one is forced to read my words and 2. No one should weigh them more heavily than someone they know personally, especially a professional with whom they have a relationship. As I state whenever I’m asked for a detailed clinical opinion on the internet, I don’t (really) know you and can’t provide what you ask. Mostly, I am hoping people will think for themselves. Sometimes I might be able to prod that a bit, if the reader is willing.
I’d also say that if I occasionally cause a person to be momentarily unsettled, that might not be the worst thing in the world. I’m sure I’ve unsettled my friends at times, by comments on email or in person. We can grow from being unsettled, at least I have, much more than never being awakened from my own moral or intellectual slumber.
One other thing: I avoid social media except for tweeting the publication of new posts.
If you or any of your readers would care to suggest what I’m missing or where I’m going wrong, I’d welcome it. The internet is a place of ideas — some great, some terrible, some not worth the time to read. I am not God. Teach me, if you will, and I will try to learn. My role is a small one and my ego is neither large nor fragile.
Thanks, again, for your post. You got me to think.
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April 6, 2015 at 2:49 pm
Thank you so much for the detailed and helpful reply. And I hope it was okay that I ‘outed’ you, although if not, please do let me know! I’m afraid in my current state of mind, my need for reassurance got the better of me. My therapist knows that phenomenon well…..! Your comments have always been supportive – as noted in an earlier part of my post, where you might also have recognised yourself. And they have been thought provoking. I agree that unease can be a good thing and I often tell my therapist that I like to be challenged. It can be profoundly difficult but ultimately helpful. So if you feel minded to prod a bit, I am definitely up for being challenged and thinking things through. As for your comments , so for your posts. I have found them honest, thought provoking, motivating, interesting. And as for the right kind of unease and challenge, your post on Trust, as you know, was really significant for me. It made difficult reading but was written in such a way as to be careful, balanced and hopeful. There was certainly a big difference between that and the unsettling post I wrote about – though it can be difficult to precisely describe the differences. From my perspective, when it comes to your posts, there is nothing missing. I couldn’t say you were doing anything wrong, though if I saw something to feed back on, what does come through your posts is a modesty and humility that makes me sure you would indeed receive that feedback openly. Thank you again for your comments and I’m glad my post was thought provoking. 🙂
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May 11, 2015 at 6:45 pm
Wonder what it feels like to be an ex-patient of a retired blogging therapist, who ethically has minimum contact with his former clients but can respond with therapeutic advice (even if a disclaimer is attached), encouragement, friendship, and genuine concern to all his non-ex-client “followers” in the blogosphere. To former patients, the “ethical guidelines” must seem like some torturous, giant sheer wall of unbreakable glass, through which they can see all this loving and admiring interaction between their retired counselor and patients of other therapists, while they are, “for their own good,” either totally cut off or at best severely limited in their access to the person who once was one of the most important people in their lives. To say that “No one is forced to read my words”, is rather unrealistic in such a case, because it’s like saying, “A moth is not forced to fly into the light that zaps it.” Ex-patients can no more stop themselves from reading than the moth can stop from flying to its death. Does this aspect of your blogging/commenting ever cause you worry or concern? Does it ever give you pause that your generosity, support and kindness in sharing your insights and wisdom with other counselor’s patients may be causing pain to your ex-patients to whom you can no longer ethically offer the same type of attention and support?
May 11, 2015 at 11:28 pm
I’m sorry the writer has had this experience — felt this way. I can only speak for myself as such a retired therapist and blogger. I have offered all my ex-patients my availability to refer them. I am open to suggesting particular forms of therapy for them, should they wish a referral, based on my knowledge of them (and yes, with a disclaimer that my knowledge of them isn’t current). I have offered them encouragement and expressed concern. I have not offered my friendship to either ex-patients or anyone who I know only through the internet/blogging activities. I do not consider anyone I treated a “moth,” incapable of resisting whatever draw my life has as it is represented on the internet. I blogged a couple of years before retirement and many (most) of my patients didn’t (and don’t) follow my writing. Everyone has a choice, especially if reading my essays cause pain. It saddens me if that happens, however. At bottom, however, I cannot prevent anyone (at present or when I was in practice) from making decisions freely. Some will be good, some won’t. I wish them all the best.
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April 8, 2015 at 8:58 am
I really like reading this therapist blogger at “what a shrink thinks”. 🙂 I am curious about therapist bloggers too, as I’m very curious on what it’s like on the other side. 🙂
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May 18, 2017 at 1:19 am
Hi there! I know this is old but this topic came up recently in a Twitter feed that seemed to take on a life of it’s own so I went looking. I think whether or not a therapist has an online presence is usually down to their modality. I had a psychodynamic therapist who had her BACP profile and Linkedin but nothing else. I could not get over the sense of longing for something I was not allowed. It was painful and her black and white boundaries made it impossible for me to even discuss it.
I’m luckier now. My current therapist is Integrative so uses Humanistic and Psychodynamic principles in a balanced manner. She is also a relational developmental therapist, meaning she encourages (within professional boundaries) the dynamics which play out in my ‘real’ relationships to play out with her. So, as far as is reasonable, she is very responsive, very compassionate, doesn’t with-hold, tells me what she’s thinking etc. She is incredibly open, in a way which is taking me a while to get used to. She DOES have an online presence… OK a professional one but she’s on Twitter and I can follow her if I like and she does have blogs etc. I haven’t followed her at the moment, simply because I feel that because my personal account is anonymised, she would wonder who this person following her was, click into it, IMMEDIATELY recognise me as a client and then feel like I tricked her into blurring the boundary.
With both therapists, it was written into their contracts about social media. The first was a strict ‘NO’ in all aspects (including contact outside session) whereas current therapist’s contract states ‘You can follow my business profile, but I will not follow you as I feel this blurs the professional boundaries and I prefer to hear about your life from you’.
I think it’s lovely that whenever I need to see her smile, I can just go onto her website. I am lucky. In fact because I can, actually I don’t very often. Giving me what I need reduces the need sometimes (not always).
HOWEVER (and this is a big however) what I do not appreciate is when therapists insist on giving their opinions on particular groups of clients (BPD for example) and then do not regulate comments nor educate those commenting. I have seen therapists say very negative things about BPD and a whole bunch of uneducated comments will flood in, making the issue worse. Meanwhile, what does the therapist running the blog do? Nothing. I cannot help but wonder whether a) are these therapists still working with clients with BPD and if so… do they think their clients are blind? What therapeutic value is there in exposing them to that? b) if they are not practising with BPD clients but have in the past, there still should be some awareness of their comments attracting stigma and perpetuating the stigma, surely? c) If they have never worked with BPD clients… what experience do they have which makes them think their opinions amount to a hill of beans on the topic?
I think retired therapists are different, their mindfulness maybe only needs to extend to ‘doing no harm’ because as Dr Gerald says, people aren’t under any obligation to read what he writes (they never are really, but a client is more likely to). However, I think practising therapists should take it a step further by mindfully writing as if their most vulnerable client were going to read it. I am a wedding photographer, it is more than my job’s worth to share my opinions or stories about the worst clients I’ve encountered on my business blog. If I wrote how much I hated Indian weddings (not true, I love them, they are my favourites) not only might I lose any Indian clients, but also potential Indian clients and anyone who hates racism! It’s totally counter-productive and in a therapist’s blog can do a lot more damage.
I also want to be clear, I’m not against therapists blogging, I find it helpful. I just would expect the same thoughtful judgement, compassion and empathy for the therapist’s audience to be identical to that which they would give their clients. Sorry for the long ramble, it’s just something that gets my back up sometimes.
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