Something there is that doesn’t love a wall,
That sends the frozen-ground-swell under it,
And spills the upper boulders in the sun,
And makes gaps even two can walk abreast.
The work of hunters is another thing:
I have come after them and made repair
Where they have left not one stone on a stone,
But they would have the rabbit out of hiding
To please the yelping dogs.
The gaps I mean,
No one has seen the made or heard them made,
But at spring mending-time we find them there.
I let my neighbor know beyond the hill;
And on a day we meet and walk the line,
And set the wall between us once again.
We keep the wall between us as we go.
To each the boulders that have fallen to each.
And some are loaves and others so nearly balls.
We have to use a spell to make them balance:
‘Stay where you are until our backs are turned!’
We wear our fingers rough with handling them.
Oh, just another kind of outdoor game,
One on a side. It
comes to little more:
There where it is we do not need a wall:
He is all pine, I am apple orchard.
My apple trees will never get across
And eat the cones under his pines, I tell him.
He only says, ‘Good fences make good neighbors.’
Spring is the mischief in me and I wonder
If I could put a notion in his head.
‘Why do they make good neighbors? Isn’t it
Where there are cows?
Here there are no cows.
Before I built a wall, I’d ask to know
What I was walling in or walling out,
And to whom I was like to give offense.
Something there is that doesn’t love a wall,
That wants it down.’
I could say ‘Elves’ to him,
But it’s not elves exactly and I’d rather
He said it for himself.
I see him there,
Bringing a stone grasped firmly by the top
In each hand like an old-stone savage armed.
He moves in darkness as it seems to me,
Not of woods only and the shade of trees.
He will not go behind his father’s saying
And he likes having thought of it so well
He says again, ‘Good fences make good neighbors.’
“Daring to set boundaries is
about having the courage to love ourselves, even when we risk disappointing
others.”
Brene Brown
On the eve of American entry
into World War I, American poet Robert Frost penned "Mending Wall," this playful,
transgressive, and highly nuanced meditation on boundaries. In it, he questions everything about boundaries. Their necessity and utility, the
need for cooperation in their maintenance, their relationship to tradition and
identity, the fact that maintaining the boundary provides occasion for
community, and he recognizes that boundaries are both responses and prey to
aggression that menaces us from the dark place in others of which we are often
fearful. Despite his neighbor’s otherness,
Frost’s narrator cannot resist poking him about the wall, and when he does, he
finds psychological differences and defenses that have little to do with good
husbandry. In this he recapitulates our
ambivalence about diversity: that the
recognition of difference often requires tolerance.
Woodrow Wilson imagined he could keep a divided United States out of World War I. Once in, he violated many of our most cherished boundaries that protect freedom of dissent. |
Back in 1914, secure within the natural boundaries of two great oceans, the United States had a strongly pacifist President, and little reason to fear that the dark forces gathering in Europe would engulf us. Greater was our natural fear of our own fellow citizens, whose historical ethnicities and identifications would be deeply divided when the war broke out in Europe. About a third of Americans were of German origin, and sympathy for Germany was widespread. Another third, and many of our country’s cultural traditions, came from Great Britain, one of Germany's opponents And yet we would all have to pull together when the Atlantic proved not to be a boundary, but a battleground. German insistence on using unrestricted submarine warfare sank American ships and killed American sailors, thus dragging the US into the war. Uncomfortable with one another or not, Americans would fight together despite their differing ethnic identifications and identities over this 'boundary issue.'
In psychotherapy, boundaries
are often viewed as a valued necessity. In
my shorter quote, Brene Brown sees them as a concomitant of constructive
self-esteem. She is emphasizing that we
cannot uphold our values if we cannot say ‘no’ to pressures from others to
compromise them. Like Frost’s classic
poem, which was apt to his times, Brown’s quote is apt to ours, when public
servants decline to compromise across party lines for fear of betraying their
principles. Parlous times make for rough
boundaries. Some are even proposing a
wall…
The Great Wall of China. Our current President was hardly the first to consider a wall. This one was indeed, 'great', 'big' and 'beautiful', although far from entirely effective. |
Boundaries are an important
kind of psychological resource, and those who experience serious boundary
problems are vulnerable to many social ills.
But boundary problems are endemic to the human condition, careful
thought and reflection are needed when clients appear to handle them in a
dysfunctional manner. Community context,
subcultural values, client goals, and partner agreements must be thoroughly understood
to interpret the meanings associated with boundaries properly. Often, boundary problems are overdetermined,
influenced by many factors, and are not susceptible to simplistic solutions.
Boundaries are often described
as an individual psychological skill or attribute. People do vary considerably in their skills
at using them. However, this essay proceeds from a rather difference
conceptualization; boundaries are socially constructed, and require collective
participation to maintain or break.
Often, they are not a simple contract between two parties, nor is the
responsibility for their maintenance clear or constant. Anyone who examines successive maps of Europe
over the last millennia sees that boundaries are far from static, as they
ebb, flow, endure and evaporate over time.
Nor are they simple contracts between neighbors, as Frost observes. For a look at how much the map of Europe has changed over the last 1017 years, click on this link to YouTube (takes about 2 minutes.) Changing European Boundaries 1000AD to the Present
In the previous essay on this
blog, Darkness I closed with the suggestion that consent was an important ethic, but
only the starting point for an ethical framework for BDSM. Boundaries are an excellent example of how
consent cannot cover all the bases.
Boundaries are often not a simple matter of agreement between two roughly
equal parties. Not only are parties not
always nearly equal, but boundaries are defined, imposed and maintained by
stakeholders who may not be present nor have any input in consent agreements.
One of the things I have often
heard from therapists about kinksters is that they have “poor boundaries.” This is a very interesting comment, and it
does not do to immediately refute it.
This is particularly true because we all know clients, kinky or not, who
do in some manner have poor boundaries.
They are late for appointments, or they fail to pay their bills. They don’t do their therapeutic homework, or
interrupt us or their partners in session.
They show off at inappropriate times, or hog the spotlight. Sometimes they insist on being the identified
problem. Other times, they refuse our
suggestion that they have any problem at all.
Some, in a meeting of G-7 participants, barge in front of the assembled
heads of state. Oops, sorry, that is not
a kinky client, that’s the President of the United States! “Good fences may make good neighbors”, but
there is a lot of boundary violation going around these days. In the electronic realm, we often do not
even know where the boundaries are.
However, as I write this, we
see lots of analogies on the international stage that make boundary violations
inevitable, if not exactly acceptable, and the root causes for these are not
always clear. Fighting in Syria
deliberately destroys the boundaries of people’s neighborhoods, and they find
themselves struggling to smuggle themselves into Europe, thereby violating
international borders. Donald Trump
determines to build a 30-foot wall on the American/Mexican border at a point
when net migration from Mexico is zero.
And his conceptual boundaries decline to differentiate an American
citizen of Mexican descent from an undocumented migrant. These discussions of boundaries are
impregnated with issues of power.
Syrian Refugees coming ashore on the Greek Island of Lesbos in 2016. |
Boundaries are an important
part of social life, and transgressive values can be highly problematical with
these. Often, therapeutic boundary
discussions are saturated with power dynamics that conflict with constructive
therapeutic goals. We as therapists often
assume our role is to set boundaries in therapy and if we have difficulties
getting a client to accept our lead on how these boundaries are to be observed,
we make negative judgments about the client.
That may be appropriate sometimes.
In kink, as in other walks of life, transgressive behavior can denote
insensitivity, hostility, and a readiness to harm others. But like those unwanted migrants, these
behaviors originated someplace else before they wash up on the shores of our
consulting rooms. Often clients are
using the best boundaries they are able, and their handling of limits is a reflection
of their past experiences that seem far more compelling to them than our rules
do. In our own ways, all of us are like
those Syrian refugees, living as best we can within the boundaries around us
until we can’t, and then taking the risks that we will be sanctioned for
violating somebody else’s rules. It turns out, feeling like you can set your
own boundaries is often correlated with having high social privilege.
Of course, this discussion of
boundaries follows hard on the post about darkness because of the problems
‘boundary violations’ pose for the attempts of the kink communities to use
consent and contracting as boundary processes.
Consent violations degrade safety, and undermine the integrity of kink’s
PR claim that “Safe, Sane and Consensual” provides genuine security for participants
to make sound decisions about which erotic risks they wish to assume. Contrary to Frost’s implication that walls
aren’t needed if there are no longer any cows to stray, boundaries provide a
measure of security, whether we need it every moment, or only occasionally, and
even when there are no longer any cows.
As a cautionary, I point to
data from the 2014 Consent Violations Study, in which one sixth of those people
who had had at least one consent incident to report, described five or
more. Given the prevalence of kink
education efforts and the pervasive kink culture of consent, it is fair to
conclude that there are people who repeatedly risk re-traumatization through
BDSM experiences that are not conforming to safety norms in the kink
community. Although we found that
consensual non-consent and 24/7 submission experiences are riskier than some
other BDSM experiences, these multiple consent victimizations were not
associated with especially high-risk types of play. Rather, those complaining of these violations
seemed to take little benefit from the norms and structures that kink has set
up to make communities safer.
Therapeutic
Boundaries and Ethical Considerations:
The culture of psychotherapy
may share some fundamental values with the kink community, but the two cultures
diverge at many points. One of these key
differences is in how boundaries are understood. This essay on therapeutic boundaries for
altsex clients is the beginning of a discussion about the various goods that
are in conflict, but it is intended to legitimate the feelings often reported
by kinky clients and the therapists who treat them that crucial goods are in
conflict which are understood in fundamentally different ways by the two communities. In such circumstances, it is typical to feel
ambivalent and torn between competing values. This is often a consequence of social role
conflict, and competing values, not necessarily deep-rooted psychopathology.
Some of these differences
emerge from the histories of the helping professions and of kink, which will be
briefly reviewed here.
In previous essays, I have
reviewed the lives and some of the contributions to kink of crucial figures
like the Marquis de Sade and Leopold von Sacher-Masoch. These authors wrote and behaved in ways that
were very critical and defiant of the conventional social boundaries of their
times. The Divine Marquis never saw a
socio-sexual boundary he did not wish to break.
He eroticized murder and disparaged the use of the guillotine for
bureaucratically decreed dispassionate executions. Von Sacher-Masoch gave us the sadomasochistic
contract, but despite his erotic fantasies of submission, he leveraged his
social position to coerce his wife into behaviors to which she declined to
consent. Although these two writers did
not dictate the modern boundaries of BDSM, they did much to establish its
ethos. And it is an ethos of violating
contemporary sensibilities about how sexuality is conducted between partners in
which conventional boundaries are ignored.
When kink began to organize as
a subculture, however, it developed boundaries of is own. This initially involved respect for other
participants’ secrecy about ‘the Life’, and shared efforts to prevent those who
were not part of sadomasochistic communities from knowing about BDSM activities
until they were regarded as safe to tell.
In some of the early gay leathersex motorcycle cubs, new members had to
prove they were sincere by starting out in submissive roles, regardless of
their preferred sexual scenes. This
ensured that new members were fully indoctrinated in the group’s etiquette, as
well as discouraging anyone who was not serious or sincere. Early contact organizations carefully
protected sadomasochists’ identities through re-mail services, in which codes
were employed to ensure that participants’ identity and addresses were
protected until they were ready to reveal them to those who corresponded to
establish relationships or sex play.
Boundaries about doctor/patient confidentiality implemented by the United States Federal Government |
Doctors and psychotherapists
are also aware that many matters discussed with their clients are
stigmatized. Clients are afraid that
others will know if they have a disease, disability, or painful history. In an attempt to ensure that such matters are
fully shared in treatment, doctor-patient communications are confidential. Laws like the Health Insurance Parity and
Portability Act (HIPPA) ensure that many aspects of a patient record remain
confidential. It is a measure of the
social acceptability of these arrangements that such rules are characterized as
‘privacy’ when we discuss medical information, but ‘secrecy’ when discussing
customarily private sexual behavior! But
therapists and altsex clients are both familiar with the importance of
confidential communications even if some reasons are more widely viewed as
legitimate than others for maintaining these boundaries.
In another chapter I discussed
the development of the Safe Sane and Consensual (Slogans) ethos and its viral spread
among the early above ground kink communities in the 1980’s. This led to the
eventual development of an ethos of explicit sexual contracting, and
educational programs aimed at making play safer. Other attempts to create boundaries include
the institution of Dungeonmasters to monitor the safety of playspaces, and house rules of conduct in playspaces to prevent outsiders or novices from interfering in
scenes. While there are many kinksters who
criticize, disagree, or even reject some of these ideas and procedures for
enforcing boundaries, it is fair to say that experienced participants in kink
social organizations have extensive exposure to community boundaries, and many
who have never played face-to-face have read about them.
Figaro was a barber and a surgeon. Its all in the wrist, you know! |
Therapists, proceeding from
their status as allied health professionals, learned about professional
boundaries from the professional ideologies of physicians. Physicians in turn, learned their professional
boundaries from their long emergence from quasi professional status in the
medieval period to alpha professionals today.
Back in Galen’s time, “First do no harm” was their equivalent of “Safe,
Sane and Consensual”. Intended as a
professional ethic, it also functioned as a public relations statement. Back
when doctors had little knowledge of the boundaries of what they ‘knew”, it was
impossible to implement except by rote repetition of accepted practice. Remember that melodious buffoon in The Marriage of Figaro? He wasn’t just a barber, but a surgeon, and
as such he was the object of much jest, but also considerable fear. Although adept with a blade, surgeon/barbers
lost many patients due to the risks of therapeutic bloodletting and from
unintended sepsis due to unsanitary incisions stemming from the lack of
knowledge about the germ theory of disease.
With the emergence of medicine as a systematic science in the 19th
century, physicians and surgeons gained the social and commercial power to
dictate what good professional boundaries meant. Good patient management has gradually come to
mean not only that physicians, not patients, get to determine the time and place
of their meetings with clients, but that they no longer make house calls and
instead maintain offices with lots of diagnostic equipment and the tools to
maintain sterile conditions. The power balance
between physicians and clients has been decided by physicians, hospitals,
technological advances and medial insurers, with little input from their clients.
All of this was very far along
in practice in 1980 when I began training as a clinical psychologist. I was taught that I was responsible for
determining the time, place, length of appointments, and great training effort
was expended on what I could say about clients and to whom. I was instructed that therapeutic boundaries
were all important in establishing the boundaries for successful treatment, and
that it was my job to educate my clients to these rules. This did not mean rigidity was recommended
for its own sake, but my ethical boundaries as a therapist, while grounded in
Galen’s dictum, were not just between my client(s) and me. I was a representative of my entire
profession, not just my personal values or therapeutic orientation. I had responsibilities to my client and even
myself, but also to my profession, the state, and to the larger society that
needed to be considered in setting boundaries and in contracting with my
clients. This is equally true in
2018. As an AASECT Certified Sex
Therapist, I promise to adhere to The AASECT Code of Ethical Conduct. This set of guidelines was adopted with three
goals co-equally in mind: protection of
the public, protection of the profession, and protection of the individual practitioner. Never mind that those lofty goods occasionally
conflict, and their interpretation was dependent upon time, place and changing
social context.
Boundary maintenance has a
central role in the in how we as therapists think about professional
ethics. We set appointment times not
only to regularize and regulate our own schedules, but to communicate our
stability, predictability and reliability to clients. We keep the focus on their thoughts feelings
experiences and narratives as demonstration and fulfillment of our promise to
put their welfare first. We moderate our
feelings about their stories because personal stories are highly emotional, and
over-responding to their experience risks substituting our narrative for their
own. When Sigmund Freud discovered that
severe behavioral symptoms might moderate from discussion alone, but that in
such intimate discussion, patients often fell in love with their doctors, often
in ways that went far beyond routine gratitude for the gifts of relief from
illness, psychotherapists became sensitized to the importance of boundary
maintenance in handling these transference feelings. Professional neutrality wasn’t merely an
expression of routine social discomforts about emotionalism, but disclosure
might obscure the client’s symptomatic needs to view the therapist unrealistically,
and failure to notice that in treatment might delay the process of cure. So, all manner of personal information and
contact outside of the therapeutic office became professional boundary issues
too.
In June of 2017, AASECT put on
an Ethics Workshop in Las Vegas addressing professional boundary issues in
dealing with the alt sex communities. Ruby
Bouie Johnson, Angie Gunn, and I were moderated by Reece Malone and AASECT
Ethics Advisory Committee Chair, Dan Rosen.
I went first and outlined some of the historical context I have
presented above. Noting that
subjectivity was privileged in kink in a way that it was not in psychotherapy,
I suggested that appropriate boundaries depended greatly on whether you
accepted the Freudian ideas that transference was ubiquitous, and addressing it
central to the process of therapeutic transformation. If you believed in
transference, then you needed to keep firm boundaries so that therapy was not
contaminated by what the client knows about the therapist’s life outside of the
consulting room. Ruby discussed process
for negotiating boundaries in treatment in the context of intersectional
cultural competence, and recognized that in her home state of Texas, some goods
needed to be sacrificed to the necessity of maintaining a license to
practice. Angie emphasized the sex
negativity of needing to hide our sexualities from our clients who were in the
process of trying to decide to come out about theirs. She maintained that authenticity required
open expression of one’s gender and sexuality.
Still, you could hear a collective gasp when she revealed that she
sometimes became nude with clients. In
the regulatory context of Portland, and with her clientele, Angie maintained
that touch was a boundary violation, but nudity was a good role modeling. Debate about this echoed for several weeks on
the AASECT Listserv.
If this was intense enough to be worth doing, you may not want the therapeutic consequences of needing to discuss it's impact on the client who saw you. |
Boundaries are not just about
what goes on within the psychotherapeutic consulting room, however. Among the most persistent inquiries in AASECT
from those serving the kink communities are questions about how proper
boundaries with that community are to be maintained. In many places the alt sex communities are
small, polyamorous, and it is not possible for kinky therapists to play near
where they practice without risking the possibility of running into
clients. Many clients would not be
offended and have no basis for objecting to seeing their therapist expressing personal
sexualities. But AASECT itself, and the
other psychotherapeutic professions have serious and cogent objections. Those of us who hold licensed professions and
who have signed our agreements to uphold the codes of conduct from our
professional organizations are contracted to uphold their standards of conduct. Often these were made with the recognition
that unethical therapists often used the intimacy of the consulting
relationship to meet their own sexual needs with vulnerable clients who were
seriously harmed by such behaviors.
While this may go a long way
towards clarifying the boundaries of professional behavior, it does not really
resolve Angie Gunn’s challenge about the benefits of clients who are coming out
about their sexuality. For myself I have
resolved this as follows:
1) About 70% of 2014 Consent Violations Survey
participants, all of whom discovered the survey either through on-line kinky
groups or their local BDSM social organizations, said they were not out to
family, co-workers, or other people with wom they interacted routinely. As important as the decision to be out can
be, under the prevailing conditions of social stigma, it is by no means a sure
sign of sexual authenticity for all clients to be out. I regard therapy as a place to explore such
questions where, as passionately as the client, or even the therapist may feel
about the issue, the opportunity is preserved for neutral discourse about it.
2) 150
years of professional sexology have failed to reveal enduring scientific
principles about how people choose their preferred forms of sexual
behavior. In this vacuum of good theory,
the dictum ‘first do no harm’ is better served by neutrality, and by trying to
privilege the client’s discourse over the therapist’s about such matters. In many cases, I refer clients to external sources
for their psychoeducation. Making clear
that these are the opinions of the writers, not my own, the client is invited
to discuss anything the readings may bring up.
3) While
at SSSS 2017, I saw data suggesting that early childhood sexual experiences
involving older, but non-adult participants, might account be correlated with
paraphilic interests relative to normative ones. This is the best data ever that some specific
historical factors might predispose a client to kinks. But even the biggest effect sizes accounted
for only a substantial minority of the variance between measures: about
30%. So even with such data, I would be
assuming a lot if I tried to apply this to clients who didn’t volunteer such stories
spontaneously in treatment. (Poster:
Associations between Paraphilic Interests and Early Sexual Experiences:
The Role of Partners and Perceptions – Lauryn Vander Molen, BA; Scott Ronis,
PhD; Raymond McKie, MSc; Terry Humphreys, PhD; Robb Travers, P.)
4) While
therapeutic transference has never been adequately demonstrated by properly
scientific means, it has been widely clinically understood for 130 years. For half of that period, it was seen as the
crucial factor in all treatment. If a
client’s feelings toward the therapist are crucial in many cases, I owe my
clients’ freedom from the burden of knowing about my sexual interests and behaviors,
even if this constitutes a kind of paltering that implies support for
cis-gendered heteronormativity I may not really support. I can only oppose conventional or alternative
practices in therapy if I believe that these represent a clear and present threat
to the client’s welfare or self-determination.
A client running into me at a kink event or a conventional one risks the
possibility of provoking them to realistically re-context our work. That has draconian implications for my
‘freedom’ to express myself sexually in place clients might encounter it, even if
I had their full foreknowledge and permission.
If I am to be an authentic professional, I must put client welfare
first, but I might still be an authentic kinkster if my kink did not require
the general public to know about it.
5) The
fly in this ointment of personal disclosure is power. I enjoy professional
power and privilege and a freedom to negotiate the boundaries of my treatment
with clients who, from their personal discomfort, suffering, and even
psychopathology, must turn to me for help.
In return for those powers, I must not demand of clients that they
assent to being exposed to my personal sexual choices. The professional consulting relationship
deprives them of the full freedom to say whatever they think about my sexuality,
no matter how hard I try to level the inherent power imbalances. When advocates demand that I ‘check my
privilege’, this is how I interpret the checking in question is to be accomplished.
6) Because
I cannot immediately effect the resolution of social power imbalances in American
society, I have a professional and ethical obligation to advocate against
arbitrary stigma. This may be a long and
arduous process, but it creates the possibility that a day may come when being
out or not will not be a risky hallmark of personal authenticity. When that happens, the boundaries we need
will change, and therapists and clients might enjoy greater freedom of sexual
expression. I do not believe that day is
yet here, but this essay is a tiny piece of the work towards bringing it about.
© Russell J Stambaugh, March, 2018, Ann Arbor MI, All rights reserved
© Russell J Stambaugh, March, 2018, Ann Arbor MI, All rights reserved
Deep, fascinating, challenging thoughts on kink, sex therapy and boundaries. I try to maintain clear professional boundaries with my sex therapy clients, and it's worked pretty well (in my "fun," bonoboesque fashion) for over 25 years, though I suppose I do it in a rather different way than most other AASECT therapists. I'm especially inspired by your next to last line: "When that happens, the boundaries we need will change, and therapists and clients might enjoy greater freedom of sexual expression." Yay! Something to look forward to.
ReplyDeleteThanks, Dr Suzy!
Delete