Grief, Loss and Professional Boundaries, Part II


About six months ago I wrote about the therapist-client relationship, specifically the delicate balance of maintaining professional boundaries while dealing with personal challenges that impact the therapeutic relationship.

Recently I have had to revisit this complex ethical issue due to a series of family losses and medical crises that warranted my leaving town several times within a relatively short time frame. This meant canceling and rescheduling client appointments, as well as responding to a handful of questions and concerns about "how I was doing."

Nothing in my academic clinical training adequately prepared me for this. On the one hand, aging, illness and loss are unavoidable, universal experiences. On the other hand, I would not want my clients to feel encroached upon or burdened. How would I stay grounded without seeming steely or cold? Would I be able to express my sadness or grief and hold it together?

I have been deeply moved by the kindness and compassion clients have expressed with me. In several cases, they have also said how meaningful it was to know what was happening (the death of my grandmother, for example), rather than simply being told something vague and dismissive.

Like our clients, therapists age, get sick, become injured, and have other visible life changes that impact the therapist-client relationship. Some of my pregnant colleagues have written about this topic; when the therapist is pregnant, her real life and humanity (not to mention her physical body) have inarguably entered into the therapy relationship in an unprecedented manner.

It would be unethical to foster any needless burden or feeling of responsibility for clients to take care of a therapist. However, these issues also offer opportunities for both parties to experience healthy, respectful, mutual compassion. Perhaps this is a new perspective on the healing power of mirroring, to be broken-hearted without being broken, to extend and receive mutual kindness. I have been blessed by this kind of transformation, a genuine experience of reciprocity that can nourish and inspire both people.


It really boils down to this: that all of life is interrelated. We are caught in an inescapable network of mutuality, tied in a single garment of destiny.

–Rev. Dr. Martin Luther King Jr.