Oh, Hello, Therapist
March 20, 2014 1:28 AM   Subscribe

I just need a quick reality check: it would be totally unprofessional for my therapist to leave a comment on my unrelated-to-therapy blog, right?

I'm thinking about looking for a talk therapist again but I still have lingering unpleasant feelings about my last one. I left because I didn't feel like she was doing me much good; I felt like she thought I did interesting things and wanted to hear about them, but didn't actually give me much feedback in areas I needed it.

But specifically: I do music stuff and have a blog where I talk about it and she left a comment there. It was pretty innocuous and not stalker-y or anything, but I still felt like there was a crossing of borders or collision of worlds there that I did not want to deal with.

So: Is this a thing that I need to be specific with a potential new therapist about -- that I don't want them leaving comments for me on social media? Or was my previous therapist way over the line, and this isn't something I should generally worry about?
posted by K and S to Health & Fitness (14 answers total)
I understand and would be uncomfortable as well. I don't think it is unethical, necessarily, but most therapists I've worked with or those with whom friends have worked have been very clear to say something along the lines of, "If I see you at the grocery store I will pretend not to know you unless you greet me first." I thought that was standard.

I think you should listen to your instinct that she is perhaps more interested in hearing about the things you do or accomplish than she is in treating your presenting issue(s). I had a therapist like that once. I never suspected that she was crushing on me or anything, but I felt she was idealizing me somehow. When I experimented with something new, lifestyle-wise, she could not handle it, reacted very poorly, and it was very difficult for me to lose her "approval." (I was not doing anything remotely illegal or hurting anyone).

It's hard to find a good therapist, and you are right to ask a new one anything like this upfront. Good luck!
posted by Punctual at 1:42 AM on March 20, 2014 [3 favorites]

It never hurts to be explicit about boundaries, and if the therapist reacts badly, it's a useful sign that it's a bad match.
posted by gingerest at 1:57 AM on March 20, 2014 [2 favorites]

Yeah, it is crossing professional lines and I wouldn't like it either. Ick.

There is some debate over whether it's ethical to google patients, and that is something the patient doesn't even have to know about! So leaving a blog comment is pretty obviously questionable.

In my opinion, you shouldn't have to ask for something like this - the professional should know better. But of course, you should feel free to bring it up as something you don't like, because telling them stuff is also what therapists are for.
posted by tel3path at 3:50 AM on March 20, 2014 [2 favorites]

This is really off and lacking in proper boundaries, and you shouldn't have to stipulate it. It wouldn't hurt to mention it to your new therapist but it's likely they'll say they would in no way be relating to you on a public social media forum. Sometimes clients will send a friend request to their therapist and the answer is categorically "no".
posted by billiebee at 4:21 AM on March 20, 2014 [2 favorites]

At the very least, your previous therapist showed poor judgment.

I think you should tell a new therapist about this, not because a repeat is likely, but because it will help the new therapist understand what your boundaries are like, and help the therapist understand you as a patient generally.
posted by grouse at 4:57 AM on March 20, 2014 [1 favorite]

Just curious how you knew it was your therapist that commented?
posted by amodelcitizen at 5:42 AM on March 20, 2014 [2 favorites]

I felt like she thought I did interesting things and wanted to hear about them, but didn't actually give me much feedback in areas I needed it.

I have several therapists in the family and they all bemoan the fact that they can't ask some of their interesting clients about the interesting things they do/people they know/etc. but instead need to focus on why the client is there and PAYING THEM, that is, to get important therapeutic work done.

For what it is worth, my therapist family (mixed bag of PhDs and MFTs) would be very uncomfortable with someone ever doing what you're describing. They wish they could ask the "I'm curious" questions, but they never would.

Similarly, the only way they'd reach out to a client in the public sphere is if the client initiated the contact. This is true of the grocery store/restaurant contact (I pretend I don't know you unless you speak to me first, and then I follow your script) but also online, etc. My family has clients that want to connect with their professional linkedin accounts, etc. They are fine with this but would never initiate the contact themselves.

What you're looking for is a good, professional therapist. Doesn't sound like your previous one was doing her job OR had good boundaries.
posted by arnicae at 5:49 AM on March 20, 2014 [2 favorites]

3rdng the 'unprofessional to even acknowledge you're alive in public unless spoken to' This is for several reasons, not least patient protection and CYA 'dear god, don't violate HIPPA' (I think psych info is covered under HIPPA. If not, well, all my psychs treated it like it was)
posted by Jacen at 6:08 AM on March 20, 2014 [1 favorite]

Way out of line, but many therapists operate a little more casually and are a little lax on interpreting the rules. Generally clients don't mind. But there are rules and guidelines for a reason. You should have every expectation of a strictly professional relationship unless you make it very clear that you don't care, and even then, a rule-followy therapist will insist.
posted by brenton at 7:25 AM on March 20, 2014 [1 favorite]

It's a breach -- more of a warning sign than a problem in itself. Why is she reading your blog? If it's because she wants insight with which to help you... maybe it's okay, but only if you feel comfortable about it. Why did she comment -- because she was interested and wanted to participate? That's about what she wants, not what you need. You need to know, and it's okay to ask -- and to say it's not okay with you (if this sort of thing happens again.)

That feeling you got that she found your stories interesting -- that would make me wonder if she's putting her wants and needs in the forefront. Everything in your relationship with a therapist should be about helping you. Many, many therapists have blind spots and weaknesses now and then. For myself, I feel that if I can bring it up and it's met with a fruitful discussion, ending up in a positive change, it's okay. But I'm talking about rare incidents when it seems the therapist has momentarily lost focus on me and my therapeutic needs. You're not supposed to have to consider your therapist's feelings and other needs.

My current therapist has never mentioned his family or the life that he has outside our sessions -- unless it's aimed at making things better for me. Sometimes he finds my stories especially interesting or funny, but it doesn't get in the way. He's the only one of my total of 3 therapists in my lifetime. Such purity is hard to come by -- but even if a therapist has weaknesses, your talking about them can be therapeutic in itself if the relationship almost entirely constructive.
posted by wryly at 10:05 AM on March 20, 2014 [1 favorite]

Ah - no I think that was a one-off and a total boundary crossing. Not cool. I would be SO weirded out if my current therapist did that!

I've been with her for 2 years and I can't even imagine her doing this though, but she's a pretty good therapist. If this happened to me I'd run for the hills for sure.

If you do get a new therapist (I highly recommend it!) then on your first visit (intake) you could definitely tell them about this issue you had in the past, and they will probably reassure you that it won't ever happen with them.
posted by christiehawk at 1:00 PM on March 20, 2014 [1 favorite]

Agree that it was very off of your previous therapist. Not as awful as, say, attending one of your gigs, but definitely uncomfortable. I wouldn't bother asking any new therapists not to.
posted by radioamy at 2:26 PM on March 20, 2014 [1 favorite]

Thanks, everyone. This shakes out about as I expected. I don't have much experience with this sort of thing and I needed some perspective.

Just curious how you knew it was your therapist that commented?

I've since deleted the blog and I can't go back and check, but it was really obvious -- and obvious in such a way that it was clearly above-ground, and not intended to be sneaky or anonymous. I think she just used her name or something. (She did not start the comment by saying "HI IT'S ME, YOUR THERAPIST.")
posted by K and S at 12:56 AM on March 21, 2014

Just wanted to belatedly chime in that this is So. Not. Ok.

I'm reading a book about social media in the health sector*, which basically says it's a breach of privacy for a therapist to even Google their clients without permission and disclosure - and it also opens up a can of worms if you discover something surprising about your client that you then can't reveal. So unless you actually told her about the blog and how to find it, that's a bit of a no-no already. And it seems to me that commenting on the blog could be a violation of your privacy (certainly if the post reveals that she is your therapist, and possibly even if the comment reveals that she knows you and it's discoverable in other ways that she's a therapist). Even if not, her commenting on your blog goes outside the normal bounds of your therapeutic relationship - crossing into "friend" or "fan" relationships, and this complicates things in your professional relationship in a way that is not recommended by professional ethics.

I would hate to think that you'd have to spell this out to your next therapist, but if you're feeling burned by this experience it could be good to mention it - it would be an opportunity to negotiate the parameters of your relationship, and could help you build trust in that relationship. You could also mention that with the previous therapist you felt you spent a lot of time discussing your professional experiences, and that didn't seem to be a fruitful avenue. This would also be a good opportunity to map out together what kind of work would be most helpful to you.

*De Jong, S (2014) Blogs and Tweets, Texting and Friending - Social Media and Online Professionalism in Health Care. San Diego, CA: Academic Press (Elsevier).
posted by Cheese Monster at 7:34 PM on March 21, 2014 [1 favorite]

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