Do you think it's inappropriate for a professional to openly discuss their personal experiences with their service users? For example if someone made a professional they were working with aware that they had gone through something traumatic like rape & were struggling with it, and then the professional talked about their own past experience of rape/sexual assualt, do you think that is okay? Do you think it's okay to for a professional to make repeated comments about their lives/their own experiences/their other patients (everything but names)?
Last edited by when.will.it.end : 11-04-2012 at 08:08 PM.
It's hard to say: yes and no. To an extent yes but it depends on each individual scenario. It is appropriate if it is deemed that it will be of benefit to the client/service user but not just for the sake of airing it.
I think it's all down to individual circumstances. If the professional is discussing it to help uou in some way and doesn't make it about them as such then in some situations it might be appropriate.
However I think in most circumstances it creates some dodgy ground!
My therapist has never discussed any part of her life with me except that she has a dog and I think that's the way it should be. She uses her experience without using experiences if that makes sense.
She does sometimes use reference to other patients or colleagues but only in a vague way.
My social worker has taken to talking about herself and her other patients in great detail and I'm unsure what to do about it. I attempted to point out to her last week that I was uncomfortable with some aspects of her approach but we happened to be in the middle of a very heated discussion and she reacted very badly by telling me I was Borderline and therefore would not discuss any aspect of our relationship with me, now or ever.
At the start of our appointment the first thing she said was "I'm turning 50 soon. I think that's an achievement as most people die before they get to that age." Previously, when I was talking about dissociation she also told me that the only time she could relate was when she was sexually assaulted and she got dissociated and "went psychotic but I knew what was happening so I was able to control it". She also asked me to meet a couple of her other patients, apparently to I could warn them off ED behaviour. I know nothing about these other patients and she seems to think that because we have both self harmed that this means we would be able to relate.
I'm pretty cut up and freaked out about the whole thing. If she is insisting I am Borderline and therefore incapable of saying anything valuable about relationships then what the hell am I meant to do? It makes me uncomfortable as I don't feel able to respond to her emotional needs when I am so vulnerable and needing help myself. I have no idea what I am meant to do when she starts telling me these things. And I really don't want to be meeting random patients of hers when I know nothing about them and would have to, again, take a caring role.
In answer to your original question, I think it depends upon the individuals involved. I had a psychologist who used to refer to other patients of hers (no names) occasionally and I told her it made me feel very uncomfortable, so she stopped. With therapists I work with, they're very boundaried (as it should be) and say very little about themselves. With my support workers, the relationship is more casual and they say (within reason) things about themselves when relating to me. But nothing unmanageable.
Your social worker should not be telling you these things. She is disrespecting your boundaries rather than the other way round. Using the 'Borderline' label pejoratively like that is out of order. I personally think some treatment for BPD relies fundamentally on being able to discuss the relationships between people. Not sure if that's the case with a social worker, but in any case, she should be listening to you saying it makes you uncomfortable to hear these things.
It sounds to me like you've got a lot more awareness of the situation than she has, and she sounds unprofessional to me. Is there any way you could get a new social worker and write to the CMHT manager about your current one?
I think it depends on the circumstances. My counselor mentions her own life and some of her other patients on a regular basis, but she does so very professionally. She'll use stories to illustrate how she wants me to change my thinking, or how to handle a situation. But it's just an illustration. It takes very little of our session time, and they are stories that would be appropriate to share in most settings. When she talks about her patients, I doubt they would recognize themselves if they were in the room with her.
But what you've described seems really inappropriate.
From what I'm aware, generally, professionals should not tell you about their own life experiences. They can say that they relate to what you're going through, or have gone through something similar, but that's where it should end. They should not be going into anymore detail than that. As for talking about other clients, that it completely unethical and not professional at all.
I would say that if you're feeling uncomfortable with this situation, maybe report her to someone higher up and see what could be done about it.
I think the ocassional short antedote is ok when relevant. For example my pysch told me a tale about when he was a junior doctor, exhausted and on a night shift and couldn't remember how to spell paracetamol to prescribe some for a patient. Which made me feel better about being so ditsy at the time as I was exhausted and not sleeping very well.
Another antedote he told me related to when his young son was ill and they kept checking on him through the night even though there was nothing they could do it helped them feel like they were doing something until they had faith that he was going to be ok and they didn't have to keep checking on him. This helped me understand why my parents at the time were being very smothering with me and that I just needed to give them time.
I think any tales that are to humanise and to rationalise things you are experiencing are ok provided they are light on details and quite generalised stories. Most other things are inappropriate.
I think the degree of what she has said is quiute innappropriate. Some comments here and there are fine but I once had a therapist who turned the session around to her, and how I was helping her ra ra ra and about herself and her struggle to the point where I sat there thinking, "bloody hell, who's in therapy? Her or me?" and so I discharged myself.
From speaking before that's probably not really an option, how about speaking to another member of the team or filing a complaint to PALS? or the head of the CMHT?
or your GP might do it for you if they agree - mine is.
I just have the whole 'you're a crazy Borderline so you know nothing about relationships' working against me.
My plan of action tomorrow is to tell her I don't feel comfortable discussing anything in my detail, like my family or past abuse, and that I would like to stick to touching base and talking about any practical issues, and see what happens. If I have to I will say I'm not comfortable knowing things about other patients for confidentiality issues and I don't feel comfortable with her talking about herself. But I'll try and say the other stuff first and see how she reacts. I'm going to ask that we reduce appointments to fortnightly.
Clearly we are on different planets with our views about what is appropriate, and our views on PD's, SH and my own behaviour and I don't want to waste my breathe trying to change her mind or defend myself.
On the plus I had a great appointment with the advisor at uni who basically completely agreed with me and said she would consider private funding options & referrals.
Personally, I would get really uncomfortable if a professional spoke to me about something that personal. My dbt therapist sometimes refers to her own life but it very general.
I'm sorry they are using a personality disorder as a weapon against you, sadly it does happen but it doesn't make it right!
Let us go then you and I, when the evening is spread out against the sky, like a patient etherized upon a table
- T.S. Elliot
I tried to make myself clear and put boundaries in place but she was talking about things in a very personal way, talking about philosophical things and the meaning of life, my degree, sociological and political issues and other random stuff I have no energy or mental space to talk about. We came to the topic of power within the mental health system and roles within the system, I said that I didn't want to discuss that because I thought we would disagree (i.e. idea about PD's, SH and how **** the mental health system can be), she pushed me and I kept saying I wasn't discussing it, then she started 'warning' me again that I 'make assumptions about things that aren't correct and I need to be careful'.
It was so strange. I stated at the beginning that I just wanted to touchbase with her and talk about practical issues, so why the hell she was asking me the meaning of life I have no idea. I'm wrecked. I suppose it could have been worse.
Hi Katie,
I cannot accurately judge your social worker and I am not familiar with Borderline, however, there is such a thing as therapeutic use of self in counselling. A health professional may choose to disclose something outside of the professional relationship- relating to their own life or other clients but for a specific purpose. Confidentiality is always an issue and the one and only time I was in a group for therapy, my counsellor made it clear that she would not tolerate any breach of confidentiality in this group- but that I had to realise that other members/ patients were not bound by the same law that prohibits her to disclose my sessions. Therefore I should never feel pressured to disclose anything I didn't want to.
I immediately thought "burnout" when you were writing about your social worker. I had a keyworker/ CPN that was so inappropriate in my sessions. She always asked my if I still wanted to do my therapy course at the start of each session- which infuriated me and once brought in a student nurse, and I felt like a case study, because we had no therapeutic relationship so I didn't feel safe enough to tell her I really didn't want this new person here. She was never supportive and I felt apprehensive before every session and focused on being as put together as possible. Eventually, I spoke to a mental health advocacy, wrote a complaints letter to the team, had a meeting with an advocate supporting me and got a new CPN. In my opinion, my keyworker was very burned out, because she was also off sick a lot.
The first step may be getting someone to intervene on your behalf. Do you have clear goals with your sessions? Why do you see this social worker/ particular team? What are the goals of the team and is it appropriate for your needs? Keep a notebook of dates of sessions and things that are said and why it makes you feel uncomfortable.
One thing I know that when I had issues with my psychologist more recently, I was panicking and thinking the worst. Similarly with my psychiatrist in the past. But relationships do take work and if you have otherwise had a good relationship with this social worker, it may be worth picking specific issues to deal with at each session. E.g. not wanting to be in a group.
Just calmly repeat your concerns, decisions and jot down any challenging statements the social worker makes. When you get home maybe may a list of evidence for and against what they say. If you have someone like your school advisor who you can use as a sounding board re: the concerns you are having, or your GP/ psychiatrist. Remember that even though you have a mental health diagnosis does not mean that you do not have the right to feel comfortable in your sessions.
Very proud of you for trying to voice your concerns. Hang in there.
Last edited by bitomato : 08-02-2012 at 07:16 PM.
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I also think yes and no, if its done 'right' like my cpn told me about another service user as they had a very similar problem ( to do with funding for a physical problem) but that was it.. infact i think since i saw her she only mentioned other clients... twice. I think what your social worker said had over stepped the mark. With the borderline comment and how she had only had an experience like that when she went through trauma is too far. My old cpn has spoke about what she likes , eg we spent about 4 mins talking about Only Fools and Horses once session. As i am nosey i asked her if she had children because of what we was talking about and i felt if i told my own mum how would she feel so i was getting to the point of well how would she feel etc. Though she did refuse to talk about it and did the ' were here to talk about you not me lauren' speech
I do need to think about exactly what I want to happen in our appointments in terms of goals and such but I'm not sure where she fits into my recovery given how she is being. I tried to make it clear that I wasn't comfortable talking about certain things but then she just got bitchy *sigh*
I think overall I feel like I can access good support elsewhere and I don't feel dependent on her role as much as I did in the past. I need a care co-ordinator so I still have access to CMHT but I don't really feel like I need her at all.
One thing I picked up is that she is very scatty and things don't seem to register unless they are said a lot. She was meant to be supporting me with the court case with my family and I hadn't told her the latest of what had happened, because it's too traumatic and upsetting, and I said to her that things were going on with it but I think because I didn't actually tell her what was happening it went over her head. I think I'm just going to keep our appointments very short, get in, get what I need and get out.
Hi Katie.
That is highly inappropriate and unprofessional of her. It's not even a matter of personaly understanding of ethics, it is part of the professional code that social workers/therapists etc do not talk about personal things with their clients.
Of course I don't know all the circumstances, but in that position, I would seriously consider bringing her behaviour to the attention of her superiors.
I think it depends on the circumstances. My counselor mentions her own life and some of her other patients on a regular basis, but she does so very professionally. She'll use stories to illustrate how she wants me to change my thinking, or how to handle a situation. But it's just an illustration. It takes very little of our session time, and they are stories that would be appropriate to share in most settings. When she talks about her patients, I doubt they would recognize themselves if they were in the room with her.
But what you've described seems really inappropriate.
My psychologist does the same - if he mentions them, it's very brief (without names) to give me insight into something :)
I think I probably agree with you all but I'm very worried that she would come down extremely hard on me if I did that and would manipulate things saying that I'm BPD so I know nothing etc.
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