Psychotherapeutic Boundaries

One of my lifelong priorities has been to demystify the language of psychotherapy. Academic terms and jargon more often make the therapist sound impressive rather than help the patient get better. “Make it simple and down-to-earth for me,” is something I say a lot – to fellow therapists and to my patients, as well. Vague confusion doesn’t do anyone any good.

So today I want to demystify two terms in the psychotherapy profession. These thoughts come straight out of my thesis of 38 years ago. The terms I’m talking about are the external boundary and the internal boundary.

Part of a psychotherapist’s job is to set and control the external boundary for their patients. This means – as simply as I can put it – that it’s my responsibility to create and maintain a safe and beneficial space for my patients. This setting will give them the best chance to understand and resolve their challenging personal issues. Part of the space is my office. Patients must be able to feel physically safe. This includes the promise to complete privacy and confidentiality.

The other “space” that’s part of the external boundary is the structure of the therapy I provide. Working within their budgets as best I can, I determine how many sessions, lasting how long, and happening how often, are needed to give my patients their best chance for success. I also set up scheduling and payment methods to help my patients be more accountable for their progress and success.

The internal boundary of psychotherapy, however, is less directly under my control. It is more like a delicate partnership with my patient. Patients cross the internal boundary to reveal to me their pain, wounds, struggles, and fears. They reveal their traumas from the past and the present and their hopes for the future. These revelations allow me to get to work – helping them address issues, resolve pain, and create a better life and relationships.

But crossing the internal boundary can be complicated by many, many things. Patients can feel shame and have trouble being honest. Patients can want to blame others or events and deny responsibility for themselves. Patients can be in denial, or disconnected, or just plain don’t know how they feel or why they keep making a mess of their lives.

Over my years in practice, I’ve developed ways to help people cross the internal boundary, discovering and revealing their most deeply held pain and secrets so that they can heal. I believe this is where psychotherapy goes beyond having a toolkit. Yes, tools are necessary, but there is an art to using them. In this area, I can always improve.

“Ten Things I’ve Learned About Trauma” – by Catherine Woodiwiss

List articles are popular on the internet, some more helpful than others. Catherine Woodiwiss’ “A New Normal: Ten Things I’ve Learned About Trauma” from the Sojouners website is better than most I’ve found on the subject. Catherine has done a good job of translating her experiences with trauma into wisdom and insights worth taking in. Below, you’ll find her first point, “Trauma permanently changes us.” Follow the link at the end of this post to read her entire article.

1. Trauma permanently changes us.

This is the big, scary truth about trauma: there is no such thing as “getting over it.” The five stages of grief model marks universal stages in learning to accept loss, but the reality is in fact much bigger: a major life disruption leaves a new normal in its wake. There is no “back to the old me.” You are different now, full stop.

This is not a wholly negative thing. Healing from trauma can also mean finding new strength and joy. The goal of healing is not a papering-over of changes in an effort to preserve or present things as normal. It is to acknowledge and wear your new life—warts, wisdom, and all—with courage.

Read the full article here.

Inaugural Issue of the Trauma Newsletter

Trauma_Newsletter_Nov13-1I’m excited to announce the arrival of the first issue of our newest publication, the Bernstein Institute Trauma Newsletter.  Each issue of the newsletter will contain helpful, practical articles on the subject of trauma, along with a personal note from me on a vital issue catching my attention.  My aim is to consistently provide accurate information and positive inspiration for everyone who has been touched by what I’m calling the “hidden epidemic” of our time.

This first issue includes two articles: “Financial Crisis, Trauma, and Reinvention”, covering the continuing, painful repercussions from our Great Recession; and “Military Suicides: Part One”, the first in a series exploring the facts and trauma-related issues underlying the dismaying spike in suicides by military personnel.  Also, in “From Peter”, my personal answer to the question, “What is emotional trauma?”

Soon, we’ll have a way for readers to subscribe to the newsletter through our website.  For now, please follow the link to download your copy today.

Honored by the Argus

PetalumaArgusCourier6-20-13_1I feel deeply honored to be the subject of a feature article in the June 20th issue of my award-winning hometown paper, the Petaluma Argus-Courier.  Here’s how it all came about.

A little over two weeks ago, John Burns, the Argus publisher, contacted Steve Rustad, my marketing consultant.  Would I be willing to give them an interview, John asked, to discuss my new book, Trauma: Healing the Hidden Epidemic?  I was more than happy to oblige.

Next, I received a message from an Argus reporter named Rose Teplitz.  She sounded young and energetic on the phone and I agreed to meet with her later that morning.  As Rose walked through the door of my institute and introduced herself, I discovered how truly young and energetic she was.  Rose is a Casa Grande High School student in their well-regarded journalism program and is serving as an intern at the Argus for the summer.

During the next hour, Rose conducted a thoroughly professional interview and was a joy to talk with.  I spoke with her at length about my book and my work and gave her some materials to use in preparing her article.  Last Thursday, “Finding a Path Toward Inner Healing” appeared on the front page of the Petaluma Community section of the Argus-Courier.

Rose is an excellent writer, doing both the Casa journalism program and the Argus proud.  She accurately and thoughtfully communicated my message that emotional trauma can be healed.  Her words conveyed my passion for helping military personnel and their families, and people who have suffered during our financial downturn to recover from their “hidden wounds” and move forward in life.

Thank you, Rose.  Thank you, John.  I appreciate this greater opportunity to give hope to hurting people.