‘If it's two o'clock I must be a therapist …’: some observations on boundaries and roles

I live in a small town, where I work as a group psychotherapist. In that town, there is an institution of higher education where I work as a full-time teacher and also do some work as a therapist. This paper is a musing on the difficulties of this latter situation, the successes and failures, and the lessons of the five years in which I have worked in this situation.

The psychoanalytic orthodoxy, of course, is that contact outside the therapeutic setting must be avoided, that the patient must know as little as possible about the therapist. Only in such a situation can the transference become clear and be brought into consciousness and worked through. The therapist is a blank screen, a tabula rasa upon which the patient writes his or her desires. I do not want to contest this orthodoxy, although it must be treated with some reserve, given our increasing awareness of countertransference, and what we might regard as normal boundary difficulties in training situations (see, for example, Modena 1986). Instead, I want to suggest that despite real difficulties this loss of anonymity can sometimes be useful; and by implication that the ideal situation, where the therapist is unknown, can leave some things hidden, or