Setting Limits

Everyone has limits. You just have to learn what your own limits are and deal with them accordingly.  - Nolan Ryan

I had the pleasure of teaching the interns at Marin Country Community mental health about how to observe and set limits with clients. It struck me how simple it seems in theory to be responsible for setting our own limits and communicating these effectively, yet many struggle with doing this. The responsibility for taking care of the therapist limits belongs to the therapist, not the patient. It is crucial that these limits be communicated in a clear, direct and timely fashion. For beginning therapist limits are often crossed before they are realized and this can be harsh lesson for both parties. Below I've included some bullet points on the observing-limits procedures checklist for therapist (adapted from Lienhan, 1993).

Observing- Limits Checklist - Do's

  1. Therapist monitors his/her own limits (on a continuing basis, with each patient separately).
  2. Therapist communicates his/her own limits to the patient honestly and directly.
    • with respect to phone call timing, duration, frequency.
    • with respect to violations of therapist privacy
    • with respect to infringements of therapist property, time, etc
    • with respect to aggressive behavior in sessions or directed at therapist
    • with respect to type of treatment therapist is willing to carry out or be a part of
    • with respect to therapist willingness to risk patient's suicide.
  3. Therapist extends limits temporarily when necessary.
    • Therapist gets professional backup or help when therapist is at edge of limits and patient needs more
    • Therapist gets patient cope effectively with therapist limits when patient is not in danger because of limits
  4. Therapist is consistently firm about own limits
  5. Therapist combines soothing validation and problem solving with observing limits.

Don'ts.

  1. Therapist refuse to expand limits on temporary basis when patient clearly needs more than usual from therapist.
  2. Therapist limits change and fluctuate in an arbitrary and/or unpredictable manner.
  3. Therapist presents limits as good for patient rather than for the good of therapist.

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This Thursday I will be speaking at the BPD Friends & Family Support & Psychoeducation Group is an open,drop-in group for friends and families with loved ones suffering from Borderline Personality Disorder (BPD) or other problems with emotional regulation, impulsive or self-harming behaviors, or interpersonal difficulties.

This Month's Topic: Limit Setting Everyone has different limits. Observing our own personal limits is simple in theory, yet can be difficult to practice.  Learn how to identify what you are willing to tolerate and what is not acceptable. Troubleshoot the factors that get in the way of setting clear limits with family or friends, and practice letting your expectations be known in clear, simple language.

Join us this Thursday evening, June 2, 2011, 7pm to 9pm for a discussion of limit setting. DBT Center of Marin 895 Sir Francis Drake Blvd. San Anselmo, California www.dbtmarin.com

For more information, call 415-459-5206x2.  Due to limited space, please park across the street at the Red Hill Shopping Center if you are able.