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Setting Healthy Boundaries for Therapists


Healers often want to help everyone. Unfortunately some people are needy and will take advantage of an over-generous nature. The healer may become disillusioned, bitter, drained, or burnt out as a result. To avoid this happening it is best to set clear and healthy boundaries.

The model I use to help my therapy students avoid unhealthy dynamics in a healing scenario is called the Karpman Drama Triangle after Stephen Karpman who first described the pattern. There are three possible roles identified on the Triangle, all of which are unhealthy. The role unwittingly played out by many healers and therapists is the Rescuer. This is distinct from paramedics and others whose emergency rescue work is part and parcel of their job description. The other two roles in the Drama Triangle are the Victim and the Persecutor.

When people start out as a healer or therapist they understandably can feel very enthusiastic about their newfound ability to relieve suffering and want to help everybody. There can be a phase where the ‘zeal to heal’ is almost missionary. Temper your enthusiasm. Don’t send healing where you haven’t got permission to do so and don’t foist yourself upon people. If you don’t respect other people’s boundaries why would they respect yours?

Rescuers become too involved in the other person’s life, too drawn into the drama, or too personally invested in whether the other person recovers or not. If you are a therapist your job is to do your best for the person during the time they have booked with you. Keep your relationship on a professional footing. Once your clients have gone home they need to implement any positive changes for themselves, it is not normally part of your job description to keep checking on them.

Someone who is stuck in Victim mode may feel like the world has given the raw deal. Most of us have been in Victim mentality at some time in our lives, but hopefully we don’t stay there. Victims feel that they have been persecuted in some way. Of course some terrible things may have happened to them, so this could be true, however to stay in fear and self-pity does not lead to recovery. Victimhood is a disempowered state. You do not empower someone by taking their decisions away from them, or taking away their responsibilities. As a healer or therapist people will often turn to you for advice and whilst you may help them explore the possibilities you must remember their decisions are ultimately their own to make. If you insist, or badger someone into taking the action you deem as correct you may be perceived as the Persecutor.

When a victim invests their hopes in you to ‘rescue them’ from their predicament you’ll need to correct the dynamic. As a professional therapist I am firm in setting boundaries. Clients must book proper appointments with me, they are not permitted to call me at random times. I learned this lesson the hard way in my early days as a therapist when people would phone and want my attention at awkward times, such as when I was cooking dinner for my family. I recognise that this was my own fault for not making my boundaries clear enough.

Now I rarely have any issues because people know where they stand and tend not to try to take advantage. I use a caller display phone so that anyone who has the temptation to call outside of my working hours gets their call screened and has to leave a message. I do not offer emergency services and I am not available at all hours. Imagining you are the only person who can help your client is usually an ego trip! There are organisations that provide 24 hour support and your clients can be given their contact details. In the UK we have the Samaritans.

I have been drawn into the Drama Triangle a couple of times in my life, enough to recognise the dynamic at the very earliest stage and not to let it happen again. For example a particularly needy woman used to phone me regularly, to give me details of her latest drama with her boyfriend, asking my advice about what to say or do next. Reflecting on this I can see I was playing Rescuer and she was being the Victim. In the early stages I can see that some part of me was flattered by the way she depended on my advice, however her calls quickly became a time-consuming nuisance and when I asked her to ‘tune into her higher self for guidance instead’ she was furious with me and left me a very unpleasant message. Suddenly she was playing the Persecutor and I felt like the Victim! Fortunately I did not respond, refused to play the game any more and I stepped out right of the Drama Triangle.

This interchangeability of roles is typical in the Karpman Drama Triangle. If you fail to keep up your role of Rescuer the Victim tends to get angry and lash out, persecuting you so that you feel victimised. If your patience gets worn too thin then you may lash out in frustration and become seen as the Persecutor. Not healthy at all!

To avoid the Karpman Drama Triangle in therapy situations:
1. Resist the temptation to evangelise about your therapy and pounce on unsuspecting people whom you have decided would benefit from your skills. This is your ego in operation! Give them your card if you really feel you could help, but then let the person decide if they want to book a session with you.

2. Make proper appointment times and stick to them. Do not allow clients to just turn up unannounced, or linger after their session is over. I have no issue with standing up at the end of the session and showing my client to the door.

3. Make your ‘office hours’ clear to your client. If you don’t want calls late at night that is fine, remember you are not the emergency services! Give a needy client the details of an organisation like the Samaritans if they need to talk to someone between sessions.

4. Keep any unscheduled calls short and business-like, asking the client to book a proper appointment.

5. Avoid mixing your therapies with your social life. If you provide therapy for friends they are much less likely to respect your professional boundaries.

6. As you say goodbye to your clients at the end of a session imagine all energetic connections between you being severed. You might go and wash your hands, or tidy away your client notes as personal routine signalling that the session is finished, or you could visualise a giant pair of golden scissors snipping through any energetic cords that have formed between you.

You will be more effective as a therapist if you set healthy boundaries with all your clients from the start.

The Healer's Manual: A Beginner's Guide to Energy Therapies (Llewellyn's Health & Healing)
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Content copyright © 2014 by Lauren D´Silva. All rights reserved.
This content was written by Lauren D´Silva. If you wish to use this content in any manner, you need written permission. Contact Lauren D´Silva for details.

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