I feel that the frame referred to in the podcast is the more strict psychoanalytical frame of working with a client. In my case, my T does not adhere to that frame and for me it works very well. While we do have the same day/same time appointment (unless vacations or holidays come up) and I feel that my T has good boundaries, he does blur them when he feels it's appropriate.

For example, he does use some self-disclosure when it fit into what we are discussing and it is always about me and not him. He self-discloses to make a point about what we are discussing if he feels it will help me. It always does. He also accepts small gifts from me. We have discussed both the particular gifts and why I have chosen them and also the practice of gift giving in general. Most of my gifts are small and relate to what we have been discussing or working on in sessions. Sort of private therapy jokes or serious symbols of my progress. For a trauma patient, self-disclosure helps us to better learn to trust our T and I personally believe it is very difficult to feel safe with someone who you know absolutely nothing about. And in working with trauma safety is priority number one. If you don't feel safe enough with your T you won't tell him/her anything important or traumatic.

He also uses safe touch. He will shake my hand (although it was a year before we got to that point), pat my shoulder or even hug if I ask for one. For me this has taught me that touch can be safe and asks nothing back from me. In fact, this has been quite healing for me as we discuss abuse issues.

I have also seen my T in places other than the therapy room, such as at seminars, or the camp that my son attends. We have used different rooms in his building (when his office was being rennovated) and none of this really had any impact on our therapeutic relationship. It has only grown stronger over the years and I have been able to go deeper and deeper into the issues with him because I know that he is safe.

In the end I think it depends on the judgement and discretion of the T involved. For some patients with an abuse history touch may be very threatening or harmful. For some patients knowing too much personal info could be difficult. Some patients need more boundaries than others due to the nature of the issues involved. I don't think it's appropriate to ever VIOLATE boundaries, but crossing them or blurring them with good reason can be appropriate and helpful in certain situations.

TN