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"For Your Own Good"

Several moral principles have been repeatedly referred to by most ethicists and professional organizations' codes of ethics. Of these principles (i.e., respect for patient autonomy, non-malfeasance, beneficence, justice, and respect for clients' rights and dignity), detailed by Beauchamp and Childress (2001), the beneficence principle refers to an action done to benefit others. Under the guise of "therapists know best" and "for your own good", therapists have gained enormous amounts of power to lead, direct and force clients to go in the direction determined by the therapists (Breggin, 1991; Dawes, 1994; Proctor, 2002, Szasz, 1997). (See further discussion on the beneficence principle in "The Ethical Way" section, below.) Under the guise "for your own good", therapists have detained clients, force them to take powerful medication against their will, or have taken their children away.

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Transparency, Disclosure, and Power

The issues of transparency, self-disclosure, and the privilege of therapists to ask but not necessarily answer questions have a few significant ramifications in regard to the therapist-client power dynamic

The One Who Gets To Ask Questions: Therapists' professional role gives them the right to ask questions but not necessarily to answer them, which automatically elevates their power position relative to their clients. Asking probing, detailed, and, what may seem, intrusive questions definitely further elevates therapists' expert and positional power. Refusing, evading, or avoiding answering clients' questions is another way to create and maintain the power differential, because it creates a clear hierarchy between therapists and clients. Regardless of their theoretical orientations, many therapists have been trained and professionally socialized to respond to clients' questions with, "I wonder why you asked that?" or "We are here to talk about you, not me." In an interesting double standard, it seems that the therapists' have a "professional right" not to answer clients' questions, but when the client does not answer questions, he or she is often negatively viewed as non-compliant or "resistive."
Maintaining Therapists' Anonymity: Graduate school courses, supervisors and risk management literature have often emphasized the importance of therapists minimally self-disclosing and limiting their transparency. Combining analytic and risk management orientation, the forensic expert, Simon (1994), advocates that psychotherapists, at all times, "Maintain therapist neutrality. Foster psychological separateness of the patient . . . Preserve relative anonymity of the therapist" (p. 514). As noted by feminist (Greenspan, 1986, 1994; Rave & Larsen, 1995) and humanistic (Jourard, 1971) psychologists and other texts on self-disclosure (Milioni, 2007, Bloomgarden & Mennuti, 2009; Zur, 2007a, 2008b), the discrepancy in transparency creates a power differential. This is why humanistic, feminist therapists and those who work with ethnic minorities emphasize the importance of therapists' self-disclosure as a way to create more egalitarian relationships and level the (power) playing field between therapists and clients.
The Mystique of Therapy: "Unknown" therapists, or those who do not self-disclose and as a result are not transparent or known, inevitably become mysterious to clients. Such mystery often translates into power in the eyes of their clients. Facing unknown, non-transparent, mysterious therapists, clients are more likely to idealize them and project a more generalized power "authority" onto them. Like Dawes (1994), Proctor (2002) emphasizes that "False authority can be set up for therapists through mystification of their activity" (p. 14). The idealization and projection that develops towards mysterious therapists have partly to do with the clients' desire to believe that their money and time are well spent and partly to do with the aura that the therapists and their settings project. What may intensify the idealization of therapists besides their lack of transparency is that the process of therapy and counseling is often not clearly defined and is mysterious and confusing in itself. The cumulative effect of entering an ambiguous situation and encountering a non-transparent therapist results in a greater chance that the client will perceive the therapist as possessing unusual, magical or mysterious powers.

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Ways Therapists May Use Positional Power

Set the time and place: In their professional capacities, therapists are in charge of setting the beginning and end time of sessions. They can choose to extend the time, finish strictly on time or finish even earlier than schedule, if they wish to. Similarly, they choose, and can change, the venue of therapy. All this gives them power over their clients who, as part of the clients' role, must play by the rules that are determined by the therapists.
Set the stage: Therapists have the capacity to organize the seating arrangement in any way they wish. They can elevate their power by either sitting physically higher, sitting behind a desk, having a bookshelf behind them, putting a tissue box next to client, etc.
Right to ask questions: Therapists' roles give them the right to ask questions but not necessarily to answer questions. This discrepancy elevates therapists' power compared to their clients.
Maintain anonymity: The fact that most therapists know much more about their clients than the reverse gives them a significant power advantage. "Unknown" therapists can easily become mysterious and powerful in the eyes of their clients.
Power to name: The authority to label, name and diagnose is another form of power that therapists have over their clients. This also involves the power to suggest or interpret unconscious or conscious motivations. As part of the therapists' authority to name or label mental illnesses is the enormous power to define that which is normal and that which is not. As will be articulated below, the power to define what is normal gives therapists social power and control and is reserved to very few others in our society.
Authority to determine the rules of the relationships: In their role, therapists can determine the rules of therapy almost any way they wish. Some therapists choose to impose strict rules about many aspects of therapy, such as strict prohibitions against physical touch, gifts or bartering. Others are open to more flexible therapeutic boundaries and welcome appropriate gifts, fair bartering arrangements or healing touch. Yet, others may impose the "only in the office" rule of therapy, resulting in greater isolation and in increased risk of exploitation.

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Therapy is incredibly difficult but it made more difficult by not allowing yourself to have feelings and express yourself for the last 10 minutes of the session and the hours immediately. He said I was causing more pain for me not him he emphasized and was making it harder for myself. I cried I don't do it on purpose. My T said no I am sure you don't but it is something that keeps happening.

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I don't let others set boundaries around me because it affects me. I stay away. Just even letting him in as been work. I don't let people in. It is safer this way. I don't take others advice, I take my own. Once again, it's safer this way.

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You asked a great question about the boundary, no matter how it is presented, if I always feel the need to resist. I think I do...but I am unsure why. I don't let anyone tell me what I can and can not have...and I seem to push until I get it. (I am not saying this is okay to do)