1. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 7: Sexual Boundaries: Protecting Our Clients

2. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Transference, Countertransference, and Sexual Boundaries Positive Transference: Crushes –Don’t take it personally Don’t be dismayed or flattered by a client’s innocent crush Don’t diminish your warmth & friendliness It is a sign that client trusts you –Don’t embarrass the client No need to talk about crush with client Crush will likely fade over time

3. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Transference, Countertransference, and Sexual Boundaries (cont’d) Positive Transference: Crushes –Protect yourself from inappropriate clients A crush is not “innocent” if client: Touches you inappropriately Makes a pass at you Asks you for a date Set firm limits with such clients & end session, if needed –Take care with boundaries Don’t encourage crush by socializing with client out of office

4. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Transference, Countertransference, and Sexual Boundaries (cont’d) Positive Countertransference: “Special” Clients –Warning signs Feeling a client is exceptional & different from other clients Wanting to rush into dating client Thinking others wouldn’t understand “special” feelings shared Sense that intensity of attraction justifies breaking rules –Treating a client differently from others & violating professional boundaries can be traumatizing for both parties –If tempted to take relationship further, consult a mental health professional

5. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Transference, Countertransference, and Sexual Boundaries (cont’d) Dating an Ex-Client –Factors to consider: Intensity of transference Emotional stability of client & practitioner Amount of time elapsed since therapeutic work –Check licensing laws in your state & ethical guidelines of your professional organization –If employed, adhere to employer’s policy

6. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Transference, Countertransference, and Sexual Boundaries (cont’d) Dual Relationships –Can cause confusion with sexual boundaries, as boundaries are already blurred –Trades can make it difficult to maintain clear & clean boundaries –Practitioners doing emotionally oriented work or deep structural work should probably avoid trades for bodywork –Be cautious of working with people who belong to some “family” type group you are in (i.e., religious or spiritual community)

7. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Transference, Countertransference, and Sexual Boundaries (cont’d) Secrets –Desire for keeping secret something you are doing with a client is a sign you are headed for trouble –Get such secrets out in the open –Share secrets with teacher or consultant –It may be that there is nothing to worry about, but then again, you may need help with client before situation gets worse

8. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clients Who Have Been Sexually Abused Sexual abuse, especially by a family member, leads child to feel betrayed by & to mistrust an authority figure May transfer feeling to practitioner & lack trust May be hyper-alert to signs of danger or seduction More likely to misread a careless word or gesture Will likely have distorted sense of boundaries Especially confusing when practitioner has also been sexually abused

9. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clients Who Have Been Sexually Abused (cont’d) Working With Clients Who Have Been Sexually Abused –With sexual abuse so common, you will likely work with someone who has experienced it –With client’s permission, consult with his or her psychotherapist –Suggest counseling for regular clients who seem depressed or self-destructive –Never attempt to delve into a client’s sexual abuse issues on your own –Educate yourself by reading relevant literature & attending workshops

10. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clients Who Have Been Sexually Abused (cont’d) Working With Clients Who Have Been Sexually Abused –Don’t push clients to remember past incidents of abuse –Stay sympathetic but objective Don’t share your opinion or experience Don’t criticize perpetrator –Make sure clients have a voice Ask them repeatedly to let you know when anything you are doing makes them uncomfortable Don’t dominate clients

11. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Cautions and Red Flags Professional Appearance –No short shorts, tank tops, & cleavage –Wear clean, neat, loose clothes that don’t draw attention to your body –Clients in some regions may find visible tattoos & unusual facial rings unprofessional Language –Avoid suggestive or flirtatious language –Choose words carefully when talking about client’s body –Avoid all comments about how you think the client’s body looks aesthetically

12. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Cautions and Red Flags (cont’d) Draping –Draping is always a good idea –In most massage licensing areas, it is the law –Underpants or briefs are a good idea for deep or emotional work Disrobing –Clients need to dress & undress in private –Tell them they don’t have to undress at all, if uncomfortable –They should undress to their level of comfort –If necessary, explain how clothing will limit your ability to work, but let them know the decision is theirs

13. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Cautions and Red Flags (cont’d) Locked Doors –Whether door was locked has been an issue in some court cases of a practitioner being sued for sexual harassment –Clients should be able to leave the room quickly & easily –Some practitioners like to lock the door to prevent unwanted intrusion of others during treatment –If you want to lock the door, explain why & request client’s permission

14. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Cautions and Red Flags (cont’d) Intrusive Work –Some manual therapies involve work near client’s genitals, coccyx, or breasts –Inform client of where you will be working & why –Use terms they can understand: breastbone, tailbone –Obtain client’s permission before beginning session Expressions of Affection –Don’t initiate hugs or kisses with clients –Respect clients’ personal space & let them be the ones to initiate

15. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Cautions and Red Flags (cont’d) Unintentional Touching –Take care not to inadvertently touch the client with your body other than with your hands –Avoid leaning on or propping yourself against clients –If a technique requires additional contact or leaning on client, explain reason for contact & ask for client’s permission –Avoid wearing dangling sleeves & jewelry