It’s April 2020 and the world is in the grip of a global pandemic. During this trying time, each of us needs help navigating this crisis. In this special episode Dr. Wendy McIntosh PhD, from Davaar Consultancy, discusses tapping into your support networks, the pressures of being at work during the COVID-19 pandemic, and the immense challenges of maintaining safe Professional Boundaries when we’re all operating under additional pressures. 

Wendy also talks about the stresses of working from home, teaches us how to use Box Breathing to get some relief, and how to use The Third Space model to use the shift between work and home to find a little peace, even when work and home are in the same location. 

Use the links above to subscribe in your favourite Podcast app, or click the play button to listen. Visit our Podcast page to see all episodes. Stay tuned for the Season Two, coming soon.

We hope you’ll enjoy our Professional Boundaries Podcast and learn from each episode. If you’ve ever wondered about your own boundaries in your Professional role, or been alerted about the risks of crossings or violations, this podcast will help you learn what to watch for, and ways to stay out the danger zones.

Dr. Wendy McIntosh welcomes both your interest and curiosity. Send Wendy questions at [email protected] or via Twitter, Instagram or Linked In

In this podcast series, Dr. Wendy McIntosh PhD shares insights and strategies about developing and maintaining professional boundaries. Professional Boundaries are not limited to the clinical or therapeutic arena. If you are in a professional role – a nurse, a teacher, support worker, doctor, police officer, a prison officer, council worker, healthcare worker, or hairdresser. If you are a volunteer or belong to a theatre group, a choir, a sports club, there will be something in this podcast for you and the relationships you have with others. Setting boundaries in our life is necessary for our emotional, psychological, spiritual and physical well being. Setting boundaries is about our safety.

Dr. Wendy McIntosh PhD

Since 2005 Wendy has been developing her knowledge and interest in the area of professional boundaries. Wendy delivers workshops on boundaries in Australia (where she now lives) and Internationally when invited to do so. She is continually integrating learning and insights she gains from the work she does in professional boundaries. Wendy comes from a nursing, and predominately psychiatric nursing, background.

Wendy consistently receives feedback on her passion, knowledge, and creativity as a presenter and facilitator. Enjoy exploring boundaries in this podcast series as Wendy takes you on your own reflective journey on your professional boundaries.

Music clips in this podcast:

References:

Dr. Adam Fraser: The Third Space

TED Talks: Kelly McGonigal – Make Stress Your Friend

Box breathing: https://www.youtube.com/watch?v=FJJazKtH_9I

WHO on Twitter: https://twitter.com/WHO?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor

ICN on Twitter: https://twitter.com/ICNurses?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor

Transcript: Special Episode – Boundaries and COVID-19

Hello to all our listeners, wherever you are in the world. Welcome to this special boundaries podcast – boundaries and Covid 19. My first message is that I trust you, your loved ones, colleagues and friends are staying safe. As safe as you can be in this rapidly changing scenario that our world and peoples of the world are currently experiencing.

I never in a million years envisaged that I would do an episode on professional boundaries and viruses, yet here I am. You would be correct to wonder – really Wendy where are you going with this one? Boundaries and virus that’s a new one. True there is so much “new” happening in the world just now. I will trust that whatever emerges from my writing for this episode is what is required to be shared.

My purpose for this episode is not to discuss the realities that are Covid 19. Information and updates on Covid 19 are well covered in much detail through many sites including media, government and health sites (country, state and territory specific), professional group sites and the World Health Organisation sites. It is good to find a couple of reliable sources that you trust for those updates. I follow twitter leads for the WHO and the International Council of Nurses – the ICN. I have given links to those two organisations at the end of the transcript of this episode. Transcripts for all our podcasts are available on our website: www.davaar.com.au

No, my purpose for this episode is to yarn with you about boundaries during this current climate. Specifically, I will interweave my ideas about the potential for increased risk of transgressions (over and under involvement) during this time and also, more importantly, to talk you through strategies for managing your boundaries and self-care on a daily, weekly and probably monthly basis as we travel with and get affected by Covid 19. Over involvement may occur because as professionals individuals want to do their job to the very best of their ability and in extraordinary times as we are currently in, to give more and more. Conversely under involvement may occur because an individual is overwhelmed, exhausted, given so much that they have no more to give.

Remembering that boundaries are about safety – your safety as a professional. Your safety in relationship to your clients and colleagues. Currently in the shifting sands of what constitute safety at work, at home, in society, then the context of boundaries also shifts and changes. It is important in the constant shifting to keep updated about policies and guidelines, changes in your organisation and scope of practice for the professional roles you are being asked to do.

I have been thoughtful about professional and personal boundaries since news of Covid 19 became more constant in our media. My reflections on boundaries and Covid 19 has ramped up further in the last two weeks as I have become more aware of the following:

reports of increased stress and distress in our health professionals coping with the demands that have been placed upon them, including lack of Personal Protective Equipment (PPE)

reports of how the context of the virus has been used in domestic violence relationships by perpetrators as another way to use control and fear

hearing about the stress of teachers who worry about their safety and the safety of children coming to school, providing education for children not attending school and a reality that for some children school may be the only place of safety for them, what happens when the option of going to a place of safety is removed from those children?

There are many more examples I can think of stimulated through discussions I have had with colleagues and family here in Australia and around the world. Each of you listening to this podcast will have your own experiences, your own stressors and your own means of managing yourself safely at this time.

I am aware that the focus of this podcast will have a sense of steering towards health professionals. It is important for me to acknowledge though that boundary transgressions could also occur across many professional groups at this time including, teachers, support workers, child care workers, police and prison officers.

I envisage that the podcast will also be relevant to those of you listening who are now having to work from home. There are still boundary considerations to be mindful of in the office space created in one’s own home. I envisage that the strategy content towards the end of this podcast encompasses you no matter what your working environment currently. I am also aware that some of our listeners may have become recently unemployed due to the impact of responses to Covid 19 from government strategies. This podcast is also for you, looking after you at this time of increased stress and distress.

So let’s look at – Red flags and potential reasons for boundary transgressions during the Covid 19 experience.

In episode five we explored reasons for transgressions using a four levelled model to assist us to understand the complexity of influencing factors in boundary transgressions. The fourth level, that of broader systemic influences is highlighted at this time. When the context shifts as rapidly as it is doing with Covid 19 – especially in terms of social mores, workload factors, safety fears for family members and safety issues due to lack of / or inappropriate PPE – there could be an increased risk of vulnerability to boundary transgressions for individual professionals and / or professional groups.

Potential pressuring influences such as social media, traditional journalism, changes in government strategies (country-specific), expectations from the community and expectations within professional groups may all contribute to increased vulnerability. A vulnerability to do more. A vulnerability to be more. A vulnerability to assist no matter the cost. The cost to self, psychologically, emotionally physically, spiritually and socially could be high at this time.

Internationally health professionals, especially nurses and doctors are grappling with how to do more with less. Health professionals are dying due to Covid 19 and lack of PPE has been identified as a major contributing factor for those deaths, according to regular updates from the WHO and ICN.

Doing more with less is not a new experience for nurses and doctors however the level of urgency, the large numbers of patients being admitted in crises at the one time and again lack of PPE has significantly increased the stress levels of the health workforce.

Increased stress is another factor that we know anecdotally increases the risk of boundary transgressions. When we humans are stressed and we experience being overwhelmed, our ability to think clearly, to consider options, to be discerning about our actions is significantly reduced. We do or say things in the “heat of the moment” that we later regret, we agree to action without thinking of the potential longer term impacts. We say “yes” and “yes” again because we do not want to let our colleagues or our clients down. Too many yeses however, without a break, without downtime, without time for self can have severe consequences for an individual and in the current reality with Covid 19, severe consequences for groups of people.

It is also important to remember that when there has been a movement towards and into over-involvement and overextending oneself out of the Zone of Helpfulness (refer to podcast three)– there is a potential consequence that there will also be a movement towards becoming under-involved, especially if an individual experiences symptoms of compassion fatigue also referred to in some literature as vicarious trauma.

We are hearing reports of burnout being experienced by health professionals around the world from WHO and the ICN and in recently published journals. I have no doubt we will see evidence of greater numbers of front line health staff experience compassion fatigue and burnout as Covid 19 continues its impact in hospitals around the world. I also envisage that a significant number of health professionals will experience symptoms of PTSD once the crises curves are over and their bodies and minds start to recover, to heal. When there is more time for them, there will be more time for their bodies and minds to remember and re-experience what they have been through.

I think now is as good a time as any in this episode to introduce what I experience as a very useful strategy for self-care – a breathing exercise that can be easily used in any given time and as many times as we remember to use it during a day. It is called box breathing taking slow and deep breaths and was originally developed by Mark Devine a former Navy Seal Commander to assist members of his unit control their breathing and clear their minds in extremely stressful and overwhelming circumstances. If the navy seals use it – then I say bring it on.

So I am going to take you through box breathing shortly, it takes about 3 minutes to do. Give yourself the treat of box breathing – 3 minutes in a 24 hour period would be good. Two lots of 3 minutes in 24 hours better still. Five lots of 3 minutes in 24 hours excellent and I guarantee 3 minutes of box breathing every 1-2 hours will assist you to manage stress you are experiencing, in a more controlled way. Control your breathing, decrease your stress levels, decrease your cortisol levels. In a companionship way as your stress and cortisol levels decrease you will experience; increased clearer thinking and perhaps more significantly an increased sense that you are doing ok and that you have control over you in scenarios where a sense of control may be difficult to identify.

So here goes, you can do the box breathing standing up, sitting down. Whatever position works best for you in the time that you choose to do it. The main thing is to have your back upright. You can have your eyes open or closed, whatever works best for you. I am going to talk through the steps and then I will do one set of the box breathing with you. The fantastic thing about podcasts, you can replay this section as often as you wish until you have trained and integrated box breathing into looking after you.

So the simple steps that I will take you through shortly are:

Begin with a deep breath in through your nose and then breathe out through your nose

Four seconds you will breathe in through your nose

Four seconds you will hold the breath

Four seconds you will breathe out through your nose

Four seconds you will hold

Then repeat three times

So let’s you and I do it together, I will speak it out, you can practice.

Big breath in, big breath out

Begin the cycle

Four seconds breathe in through your nose

Four seconds hold the breath

Four seconds breathe out through your nose

Four seconds hold the breath

Then repeat three times

Allow a big sigh at the end – sigh out that which you no longer wish to hold onto.

As you get used to box breathing you can increase the count from 4 to 5 seconds for each step or more.

Find a number that works for you.

Box breathing easy – easy and effective

On the theme of stress – it is clear in my discussions with folks that many are experiencing stress through the constant media updates that they follow on Facebook, Twitter, Linked In, Instagram etc. It is important to significantly decrease and if possible stop looking at those sites and updates. When a person is overwhelmed and the information they take in through reading and discussions intensifies that sense of being overwhelmed further – it is just not good for one’s state of well being. So rather than that minute or two, you would usually spend on your smart device – how about spending three minutes doing box breathing.

Another easy to integrate strategy at such a busy and overwhelming time is that of creating a safe and gentle image, a place that has meaning for you and to experience yourself being there. Add to the image a sentence that acknowledges and appreciates something about you at this time. As I write this I experience myself sitting on rocks at one of my favourite beaches at home in Scotland. As I sit and listen to the sea before me and the noise of the gulls flying around, as I take in the bigness of the world. I am grateful that I can sit here and recreate that experience, I settle into myself more. This is a safe and comfortable place for me.

What is your safe and comfortable place – create it now. Invite it into your day at any time.

In the boundary workshops that I deliver, there is a model I use that resonates with participants called the Third Space (previously referenced in podcast 6). This model developed by Adam Fraser focuses on creating a transition space between work and home. I believe the model has increased relevance currently due to the social distancing and stay at home requirements because for many people there will be less transition space between work and home. For those who now have to work from home – this model is also very beneficial – creating a transition between the “office room” and the rest of the home.

I will talk you through the model and perhaps if you are listening to this at home, you can even have the experience of the model. Choose three objects – can be anything – pens, cushions, books, toys, cutlery, leaves, sticks. If you are not able to get three objects because you are driving then you can still create the third space using your imagining, here we go.

I am going to talk you through the Third Space between being at work and going home – however, you can also do it the opposite way – home to work.

So if you are in a place where you have been able to pick up objectives. Put the first object on the floor this will symbolise you being at work getting ready to go home. In Fraser’s model, this is the First space. Stand at the object and experience your body as you prepare to go home (thoughts, emotions, movements in your body). Put the second object on the floor some distance from the first one this symbolises you being at home, in Fraser’s model this is Second space. Stand at the Second space now and experience in your body what it is like to be at home (thoughts, emotions, movements in your body).

In our busy, reactive and at this time stressful and worrying time we move between the first and second space without really taking time for us, of having a transition space, a settling space between work and home – what Frazer calls the Third Space.

So take the third object and place it on the floor between your first and second space.

Now briefly stand back at the first space you being at work, (experience what you experience).

Now go to your newly created Third space – your transition space. This is your space – no clients, no colleagues, no rush. You being with you. Perhaps use some box breathing just to help you settle further. In this third space acknowledge the workday you have had. Look back at the first space. Appreciate all that you did. Acknowledge at least one positive aspect from the day. Say goodbye to the working day. Experience your body settle.

Now turn round towards the second space that of being at home – in the place where you now stand your Third Space, experience yourself in this moment, be aware of your breathing, be aware of what you are leaving behind in the first space. Gently shake your body, release tension, perhaps more box breathing, create a gentleness for you in this third space, an appreciation and generosity for you in this space. Create how you want to enter your home, how you will greet other people in your home, how you will let them know what you need. Experience you in your body looking after you at this time. Keep gently shaking your body free from tension that may still be there. Bring your body to an upright position back straight, shoulders straight, chin up, notice your body settling.

When you assess you are ready to leave the third space to go to the second space (being at home) – do so. When you get to the second space – notice what is different in you and your experience of you from when you stood at your second space at the very beginning of this exercise. Notice any differences that you are experiencing in your body (thinking, emotions, body movement).

To integrate the Third Space into our lives we have to practice it on a daily basis. Allow and enable yourself to create a third space for you on the journey between work and home (or conversely home and work, of office room to the rest of home). If you can allow 5 minutes to be in your third space – fantastic. If you can allow 10 mins to be in your third space – fantastic. You will learn from your body how much time you need in your third space – trust your body it is perhaps the biggest guide to your well being that you will ever have.

I envisage much creativity rising in you as you create the third space for you.

I just want to summarise in a lid,t some of the main points I have presented in this episode

Revisiting risk factors and red flags that I identify as increasing the risk of boundary transgressions at this time:

And in that list we also have strategies these include:

Revisiting strategies

Decrease your experience of stress as you can through the following:

Box breathing – as often as you can during the day and before sleep and even when you wake up in the morning.

I have also included a link at the end of this transcript of a fantastic Ted talk by Kelly McGonigal titled Make stress your friend – well worth a visit when you have time

Third space – create at least one for you each day

Stretch exercises – it may be difficult due to workload, closed or decreased access to areas like gyms, walking – then exercise your body with some stretch exercise – your body requires you to look after it consciously at all times and especially in these current times

Switch off your devices – give your brain, your heart and soul time out from the constant barrage of updates

Getting regular sleep – where possible. The usual amount of hours that work for you and your well being. From some people that might be 4-5 hours, for others 7-8.

Your body will serve you well as long as you keep it hydrated, nutrition up and allow sleep.

Get outside as you can – remembering social distancing and guidelines from respective governments

Seek counsel, support – you do not have to carry the stress and burden of Covid 19, the stress of clients and their families on your own – utilise the support mechanisms that are in place, from the organisation you work in, the professional group you belong to and other support mechanisms available in the countries where you live.

Supporting colleagues – as it is psychologically safe for you to do so, by this I mean finding a balance between supporting a colleague in distress and being caught up in their need to overshare their distress with another person. Be there for a colleague and know when it is time to suggest and perhaps provide contact information for those support services that will be available for them.

As I move towards the end of this episode it is worth noting that scientific journals are now reporting positive impacts of Covid 19 on the atmosphere. Some ozone holes are starting to close, some water systems are becoming cleaner and running freer. Birds and fish returning to habitats they have not been seen in for many years. As our earth heals and the human cycle of recovery will occur – may we all work together in the creative ways that we can as human beings to look after the land and environment. My sense is that in doing that, we will all benefit longer term.

This podcast series has been written by myself Wendy McIntosh. A big thank you to family and colleagues who hear each podcast before it is released and who provide valuable editing feedback. Thank you to Nikki Fryn, my internet guru who has done the production for these podcasts. I always love to hear from you our listeners any questions, scenarios, reflections that you want to be discussed as part of a podcast episode. There is still much to learn and each question and scenario posed provides opportunities to expand learning about professional boundaries. My email address is [email protected], you can also contact me through our social media of twitter and Instagram. I would be delighted for podcasts to be as meaningful as possible to all who listen. So join with me.You can access our podcasts through a number of sources including our website davaar.com.au/pbpodcast

The spelling for Davaar is D for Discussion, A for awareness, V for Visceral, A for Action, A for Alert, R for Red flags.

Keep safe, keep strong, keep connecting with those you value in your life and connect with other people you have not yet met.

Thank you for listening.

In Episode 6, Dr. Wendy McIntosh PhD, from Davaar Consultancy, shares a Professional Boundaries scenario set in a child care centre. Although the lure of becoming friendly with the parents of the children who are cared for each day is attractive, it can be a pattern that can be tricky to reverse.

Wendy describes steps to remedy this awkward situation and some hints on ways to help refocus the attention back on the customer and their child, rather than the staff member’s family.  Also discussed are strategies for establishing better boundaries in collegial relationships, and how it’s important that front office staff also exhibit a unified boundaries front.

This is the final episode of Season One,  and rounds up our first season of the Professional Boundaries Podcast. Use the links above to subscribe, or click the play button to listen. Get access to all episodes here.  Stay tuned for the Season Two, coming soon.

There are 6 episodes in this first season of the Professional Boundaries Podcast and we hope you’ll both enjoy and learn from each of them. If you’ve ever wondered about your own boundaries in your Professional role, or been alerted about the risks of crossings or violations, this podcast will help you learn what to watch for, and ways to stay out the danger zones.

Dr. Wendy McIntosh welcomes both your interest and curiosity. Send Wendy questions at [email protected] or via Twitter, Instagram or Linked In

In this podcast series, Dr. Wendy McIntosh PhD shares insights and strategies about developing and maintaining professional boundaries. Professional Boundaries are not limited to the clinical or therapeutic arena. If you are in a professional role – a nurse, a teacher, support worker, doctor, police officer, a prison officer, council worker, healthcare worker, or hairdresser. If you are a volunteer or belong to a theatre group, a choir, a sports club, there will be something in this podcast for you and the relationships you have with others. Setting boundaries in our life is necessary for our emotional, psychological, spiritual and physical well being. Setting boundaries is about our safety.

Dr. Wendy McIntosh PhD

Since 2005 Wendy has been developing her knowledge and interest in the area of professional boundaries. Wendy delivers workshops on boundaries in Australia (where she now lives) and Internationally when invited to do so. She is continually integrating learning and insights she gains from the work she does in professional boundaries. Wendy comes from a nursing, and predominately psychiatric nursing, background.

Wendy consistently receives feedback on her passion, knowledge, and creativity as a presenter and facilitator. Enjoy exploring boundaries in this podcast series as Wendy takes you on your own reflective journey on your professional boundaries.

References

Alaric Hutchinson – https://www.goodreads.com/quotes/tag/present-moment

Brooke Deterline – https://www.youtube.com/watch?v=wzicXbnmllc-

Adam Fraser – The third space – https://www.youtube.com/watch?v=dpk_dssZXqs

Cambridge Dictionary – https://dictionary.cambridge.org/dictionary/english/recalibrate

Music clips in this podcast:

Transcript: Podcast Six – Strategies for Setting and Repairing Boundaries

Scenario

She worked with children at a child care centre. She had been used to sharing details of her own family including information about her children with parents whose children attended the centre where she worked. Initially, she had thought nothing about this self-disclosure. She assessed that sharing information about herself and her children assisted the parents to feel comfortable about leaving their children in her care. However, she had become aware that she was uncomfortable about sharing such intimate information with some parents. Being curious about this, she started to question her actions. She read about professional boundaries and discussed questions she had about her self disclosure with friends.

With greater awareness and appreciation about boundaries, her concern grew about the patterns of interactions she had established in her relationships with the parents at the centre. She experienced increased discomfort with parents who would start each day asking her about her children. She realised that the focus had become about her and her children – the roles had reversed.

She wanted to create greater separation between her home and work. She wanted to be able to leave her children at home where they belonged not in her workplace. How could she protect them, when she had been so disclosing of their experiences growing up. She felt a pang of disquiet that she had transgressed her children’s rights to confidentiality and privacy. She wondered what she could do to change her relationships with the parents. She was concerned that if she established boundaries on her self-disclosure that it could have a negative impact on the relationships she experienced with the parents. Perhaps even a negative impact on the centre.

How could she stop the patterns of conversation that were now so well established in the meet and greet each day?

Welcome to this Podcast series – Professional Boundaries, Your safety, your wellbeing.

I am Wendy McIntosh from Davaar Consultancy and I am delighted that you are joining me on another journey into the world of professional boundaries. This podcast series invites you to reflect on your Professional Boundaries and to appreciate how knowing the five foundation stones of boundaries can assist you in the everyday work that you do. This is our sixth episode and today I focus on strategies.

Strategies for you individually

Strategies when you witness or become aware that a colleague has – or is about to transgress a boundary

Strategies for organisations

This is a good time to remember the four foundation stones that we have discussed in previous episodes. Reminding ourselves that when we understand those four stones in relation to the context in which we work, then we already have some strategies at hand. The four foundation stones that we have previously discussed can be informative guides in our professional boundary journey.

Definitions (from episode 2)

Professional Boundary framework (including over and under involvement and categories of concern) (from episode 3)

Red Flags (from episode 4) and,

Reasons for transgressions (episode 5)

As I have stated on previous episodes I wanted the podcasts to be as interactive as possible and I have been inviting listeners to email me any questions, scenarios or reflections you have about boundaries. Thank you to those who give me scenarios to work with. I will continue to build them into episodes we produce.

Keep your interactions coming and if you have any feedback that you want to put up on the various sites where you can access our podcast we would love you to do so. Contact details for ongoing discussions or questions with me are given at the end of this episode.

Keep putting the word out about the podcasts to your colleagues, peers, family and friends. We are delighted that as well as our growing numbers of listeners in Australia, we welcome listeners from Europe, USA, Jamaica, Tanzania and South Africa. Brilliant. I am appreciating that the theme of professional boundaries is pertinent no matter where in the world we work. Whilst contexts will vary – professional boundary themes resonate no matter the country, the profession, or the organisation.

This episode introduced a scenario that is common for participants who attend my workshops. With knowledge, awareness and insight about patterns of behaviour and potential risks of those patterns, participants are keen to change the interactions in the relationships they have with clients, colleagues, or family members of clients. The area of self-disclosure and how to adjust that especially in longer-term professional relationships is worthy of exploring. As always any enquiry about a potential or actual transgression leads with my four boundary questions. Remember them?

What was/is the intent or the purpose of the action / the content of the speech?

Whose needs are/were being met?

Were/are there other options available? (Generally, there will be a minimum of five options for each event)

And the question I believe is essential – what stopped the person using another option?

For this episode, we are going to get back into the car for a journey like we did in episode three when we discussed the boundary framework. So buckle up safely. Get comfortable and enjoy the learning. Remember if you have any questions, reflections or stories you want to share – don’t be a back seat driver – come up front with me and yarn.

There are three main billboards ahead – Strategies for self, Strategies for colleagues, Organisational strategies. Many of the strategies presented in this episode come from the data I collect at the end of each workshop on boundaries. Consistent strategies emerge no matter the organisation or professional group that I work with. The strategies are consistent with articles written on professional boundaries. The strategies are consistent with those identified by participants who complete our internet tool on boundaries.

We are going to stop at all three billboards and take time to absorb what they have to tell us, let us start with strategies for self.

Strategies for self

Preparing for the journey that is professional boundaries.

I remember early on in my psychiatric nurse training one of our lecturers being very clear with us “You are not here to get your own therapy, you will not use the patients for that purpose, you need therapy … you go pay for it”. Few of us had any understanding about what she meant, however at various stages in our training and careers, most of us have had an experience that gave us that “ah ha” moment. This is what I love about the “ah ha” moments. We can have many of them at different times in our lives. Then one day, there is enough of the “ah ha’s for a particular behaviour that we actually get the big AH HA. The one that really creates a new link in our neural-pathways. This lecturer also wanted us to be very clear about our reasons for becoming psychiatric nursing students – “get to know the real reason you are here” she would say to us. It took me about 10 years to get very clear on why I was there. Self-awareness and insight is not necessarily an easy process but in terms of professional boundaries, I believe they are essential.

Self-awareness

I believe that understanding, effectively developing and maintaining professional boundaries is difficult if we do not have an awareness about our own motivations for the things we say and how we act in relationship to other people. Boundaries are much easier when the professional is very present to each moment in relationship with the client. For me, this includes the preparation to be with the client, the time after an interaction ceases and staying present when writing up a progress report about the client.

I believe that it is important to keep checking in with self about how the relationship is progressing, being present with self is key to being present with another person.

Being present

Being present to the power – vulnerability dynamic in the professional relationship. Being present to one’s own vulnerability in the relationship. Showing up in the relationship. Life Coach Alaric Hutchinson stated – Bravery is the choice to show up and listen to another person be it a loved one, or perceived foe, even when it is uncomfortable, painful or the last thing you want to do. I have identified a number of showing up questions that helps to guide the work I do with an individual:

Am I well enough to be at work today?

Am I being triggered in this relationship and if so what is /are the triggers?

What am I required to attend to in my responses to the other person?

What am I contributing to the energy between us?

Self-awareness, insight and being present top my list of strategies for self.

What follows is my go-to list of strategies for self:

OK, I am almost ready to put the car into gear and move to the next billboard, however, before I do, take some time to consider the strategies you currently have in place for you. Are there some on the list you had not thought about before that you could integrate into the work you do currently and in the future? Note them down.

Participants I see are always keen to have specific scripts that they can use when developing confidence in their professional relationships, especially when setting boundaries. I try not to be prescriptive in the work I do with them. I encourage each person to develop their own scripts that they will feel comfortable using. Like learning to drive a car, it can take many attempts before they feel comfortable and confident using new boundary scripts. Like learning to drive the car – sometimes the words will come out in a splutter, too fast, or too slow. It takes time, it takes practice to develop a new set of responses to the conversations we have with other people. As we sit at this billboard for self strategies here are some suggestions I offer re scripts:

When setting and maintaining boundaries – keep what you are saying short – no more than five words – pause.

Allow time so that what you have said reaches the other person. At all times hold great respect and dignity for the other person. Avoid what I call “a storytelling rationalisation” for the boundary, for the limit setting. Too much information and you will lose the importance of setting the boundary. Time and time again in workshops when we role-play with individuals to change their script they quickly become aware of the power of keeping to the purpose, keeping sentences short. It takes time, it takes practice, to change habits of a lifetime.

Thinking about the scenario at the beginning of this episode – boundary setting is definably easier when we have boundaries in place from that first meeting. What is important in this scenario is that the person herself wants to change the dynamic. Changing patterns of behaviour with customers is harder when an employee is directed by a supervisor, employer, or regulatory body to make changes. That is why having self-awareness and insight enables changes to be more congruent for the person. In workshops, I talk about the need to recalibrate the relationship with the customer and to do that effectively we need to recalibrate our relationship with ourself. Recalibrate to change the way you do or think about something (Cambridge Dictionary)

I imagine as I sit here with you in the car a few possibilities. As we sit here – you are the parent, and I am the employee in the child care centre. I am going to call you Belle, your child is called …Ross. The usual pattern is that you initiate the conversation with me when you arrive at the centre, you get in early with a question about my children. Today I am going to recalibrate our relationship. Today I am going to initiate the conversation with you and direct it.

“Hi, Belle great to see you. Hi Ross, lots of activities for you today. Belle is there anything you need to know about Ross and what we will be doing today?”.

Or words to that effect. The focus is on the parent, on the child. Get in the driver’s seat take charge. Drive with presence, drive with safety.

You say to me but what if Belle manages to get in and ask about your children what then?

Great question – we get in the driver’s seat again.

“Belle, I am keen from now on that we focus on Ross being here and how we can make this a good experience for him and you” … and keep the focus on Ross.

You say to me but what if Belle persists in asking about your children.

I respond….. well she may well do, after all, that is what I have allowed to happen. I have set up the expectation in the relationship. With consistent new messaging, however, Belle will get it that the focus is on her son and we will both move on.

And so we too will move on – to the billboard on Strategies for a colleague. Let’s go.

Strategies for a colleague

In many respects developing strategies for a colleague who is about to or has transgressed a boundary is more challenging than managing our own boundaries. The very act of approaching a colleague about a transgression can create much stress and distress for many people. If a person comes from a family which had open communication and family members were celebrated for bringing forward concerns then it could be easier to approach colleagues with concerns. Similarly, if workplaces have open and transparent cultures that encourage employees to approach one another – then that permission can assist individuals to approach a colleague with great ease.

Examples of Intrapsychic questions which can emerge for a person who wants to approach a colleague to discuss a potential or actual transgression they have witnessed include:

What do I do?

What do I say?

What if I have it all wrong?

What if my colleague gets angry?

What right do I have to say anything?

For a start, no one wants to be a dobber – right? Not sure what a dobber is – well according to the Collins Dictionary it is Australian slang for an informant or traitor. I have worked with many professionals who have not wished to report unprofessional and unethical behaviour of a colleague because they did not want to be viewed as a dobber. This intensifies in workplaces where there has been perceived punishment for employees who have raised concerns or reported a colleagues behaviour. For many the fear of ostracism and being made a scapegoat for reporting a colleague is stronger than making that courageous move, to put a boundary in place.

What if we changed the intrapsychic narrative to say something different for example:

I am doing this to support a colleague.

The client requires me to be an advocate for them

This is my duty of care

I would want a colleague to let me know

My profession requires me to do this

The question of what to actually say to a colleague can also create turmoil for some individuals. In workshops, I talk about being curious with a colleague. If you approach with curiosity in tone of voice and words – then you may wake up a curiosity in your colleague. A curiosity about their behaviour, a curiosity about their intentions, a curiosity to ask further questions about what has been observed/heard. There are many folks I have seen who had been reported for boundary transgressions who had just not realised that their behaviour had been transgressions. No colleague approached them, no colleague gently challenged them, no colleague said: “I am concerned for you”. Post the event – they wish a colleague had approached them. They rationalised that because nothing had been said then there was no problem with their actions and they kept going. So many times professionals have said to me “I wish someone had told me that what I was doing was not ok”. “I didn’t know that what I was doing was a transgression, colleagues saw me and said nothing”.

In previous episodes, I have slowly been teasing out the experience I had with a female patient when I put my body between her and a wall. In the episode on the boundary framework, I discussed Categories of Concern one of those being the giving and receiving of gifts. Well over many weeks I received different hand made gifts from her. She was an artist and I considered her work exquisite and beautiful. At no time in my receiving of a gift – did a colleague say to me – “watch out”, or “what are you doing” or “you know receiving gifts is not ok”. Perhaps when that relationship was in play in the 1980s when we were not so aware of boundaries – receiving gifts was no big deal. I suspect, however – if a colleague had been curious with me and wondered aloud with me what was occurring in the relationship, I may also have got more “present” about what was happening for me intrapsychically in the relationship. Perhaps I had not reached that 10-year mark of self-knowing for me.

Now many organisations do have policies and or guidelines in place about giving and receiving gifts and this is good. It has become very clear to me over my years of doing boundary work if there are no clear policies or guidelines in place – staff will make up their own guidelines based on their own moral compass, based on their own sense of right and wrong. Familial and cultural patterns that they have experienced.

What follows are some suggested statements that could be made to a colleague. A statement made with a curious tone of voice. A tone of interest rather than judgement or assumption. A tone that invites curiosity from the colleague. A tone that wakes them up to someone being genuinely present with them

Strategies for approaching/supporting colleagues are enhanced in organisations which support and encourage staff to challenge one another about boundaries. The following are other strategies that can enhance a more cohesive approach to boundaries.

We are just about to move onto the third billboard – Organisational Strategies and before we do I want to clarify that when approaching and or reporting a potential or actual boundary transgression

in a colleague ensure that you follow your organisations policy and guidelines on same.

Organisational Strategies

I trust that as we drive toward Organisational Strategies that you have been developing a list based on the previous two billboards. In order to ensure individual and collegial boundaries are in place, it is imperative that organisations have informative and perhaps even instructive policies and guidelines in place.

When exploring organisational strategies it is important to understand the ways in which organisational culture can both challenge and complement professional boundaries. A fantastic TED talk that I share with many participants is that by Brooke Deterline. In her presentation, Brooke invites employees in organisations to become aware of patterns of unethical behaviour in the workplace culture and then to develop creative ways of challenging the cultural norm. Inspiring.

Yes, I absolutely accept that challenging the cultural norm does come with risks. For some those risks can be high, including the potential to lose one’s employment. However in my experience working with participants on boundary issues – not challenging unethical or unprofessional practices comes at too high a cost including challenges to one’s integrity and one’s sense of self-worth. Challenges to the purpose of one’s being. Other workplace factors that can influence professional transgressions towards clients and indeed collegially include; shame and blame cultures, vicarious trauma, workplace bullying and moral distress. I will discuss most of these in more detail in part two of our boundary seres, yes stay tuned more on that at the end of this episode.

So what strategies can organisations have in place to ensure staff, customers and the organisation … kept safe boundaries.

First and foremost it is necessary to have clear policies and guidelines on professional boundaries. Inclusion of information about the five foundation stones provides staff with good information to assist them.

Ensure role modelling of boundaries through all levels from CEO’s, Managers, team leaders and …

Role modelling collegially and with customers. Mixed messages of saying one thing and role modelling something different creates boundary disturbances and trust is eroded – eroded within the organisation and experienced by customers.

Good education/training on boundaries for all staff. It is clear at the end of one-day workshops that I conduct that participants want more. In one day they are appreciative of what they have learnt and they are hungry for more. Hungry for more information and skills on boundaries. They are awakened to the importance of boundaries. They are excited about what they can do to change their own behaviour and to return to their units, their teams, their organisations to implement changes. I see the benefits in yearly refreshers. As I said in an earlier episode developing professional boundaries skills takes time and practice. Lots of practice.

I encourage teams to use the workbooks I have developed as conversation points. I invite them – next time you are together as a group – choose a page, explore the questions posed together – are you on the same page (in the workbook, but also in terms of role modelling boundaries to clients). Yarn, discuss, agree, disagree, yarn more.

It is also beneficial that staff have easy access to Employee Assistance Programs as a safe and confidential place that they can go to for counselling and support when they identify a need for themselves or a colleague.

I believe that organisations have a Duty of Care to their staff to ensure that they have regular breaks, over the course of a shift. That when employees leave work at the end of a shift – they leave work. Phones turned off, no expectations that they will do work – especially if they are not being paid to do work. To enhance professional boundaries – employees need a break from their work – when work comes home at night with them they are not having a break. A line has been transgressed.

When organisations transgress lines with their staff – it is a powerful message that is delivered.

A more powerful message would be – we value who you are, we celebrate that you have time away from work for you, for your family.

Well that us just about the end of this journey. The end of part one of this podcast series on professional boundaries. I have enjoyed sharing this podcast series with you. I am excited to prepare for part two. I have continued to learn about boundaries with each episode I have written. What a privilege for me that you have travelled with me.

As I warm up to thinking about part two I have already identified specific themes I want to cover. At this point the

As I warm up to part two of this podcast series I have identified a number of themes that I want to cover – so far these include:

I and my team look forward to producing part two for you.

This podcast series has been written by myself, Wendy McIntosh. A big thank you to family and colleagues who hear each podcast before it is released and who provide valuable editing feedback. Thank you to Nikki Fryn, my internet guru who has done the production for these podcasts. As I said earlier I would love to hear from you our listeners any questions, scenarios, reflections that you want to be discussed as part of a podcast session. There is still much to learn and each question and scenario posed provides opportunities to expand learning about professional boundaries. My email address is [email protected], you can also contact me through our social media of twitter and installer. I would be delighted for podcasts to be as meaningful as possible to all who listen. So join with me. You can access our podcasts through a number of sources including our website davaar.com.au/pbpodcast

The spelling for Davaar is D for Discussion, A for awareness, V for Visceral, A for Action, A for Alert, R for Red flags.

Thank you for listening, let’s meet again in part two where we uncover, explore and discuss more professional boundary ideas.

In Episode 5, Dr Wendy McIntosh PhD, from Davaar Consultancy recounts a Professional Boundaries scenario about a Police officer in a small town and the various events that led to his transgressions.

You’ll hear how, in hindsight, it was clear that unresolved issues from his own history left him at risk of this particular boundary violation. 

Learn about how taking a candid look at our own history might give us hints about Red Flags warning us of likely vulnerabilities before problems transpire.

Wendy also discusses Consistency or the lack of it, a particularly powerful Red Flag that usually deserves our immediate attention.

This is the fifth part of a dialogue that be will be continued in the following episodes. Use the links above to subscribe, or click the play button to listen.

There are 6 episodes planned in this first season of the Professional Boundaries Podcast and we hope you’ll be back to enjoy and learn from each of them. If you’ve ever wondered about your own boundaries in your Professional role, or been alerted about the risks of crossings or violations, this podcast will help you learn what to watch for, and ways to stay out the danger zones.

Dr Wendy McIntosh welcomes both your interest and curiosity. Send Wendy questions at [email protected] or via Twitter, Instagram or Linked In

In this podcast series, Dr Wendy McIntosh PhD shares insights and strategies about developing and maintaining professional boundaries. Professional Boundaries are not limited to the clinical or therapeutic arena. If you are in a professional role – a teacher, support worker, police officer, a prison officer, council worker, hairdresser. If you are a volunteer or belong to a theatre group, a choir, a sports club, there will be something in this podcast for you and the relationships you have with others. Setting boundaries in our life is necessary for our emotional, psychological, spiritual and physical well being. Setting boundaries is about our safety.

Dr. Wendy McIntosh PhD

Since 2005 Wendy has been developing her knowledge and interest in the area of professional boundaries. Wendy delivers workshops on boundaries in Australia (where she now lives) and Internationally when invited to do so. She is continually integrating learning and insights she gains from the work she does in professional boundaries. Wendy comes from a nursing, and predominately psychiatric nursing, background.

Wendy consistently receives feedback on her passion, knowledge, and creativity as a presenter and facilitator. Enjoy exploring boundaries in this podcast series as Wendy takes you on your own reflective journey on your professional boundaries.

References:

Sir Walter Scott Quote – https://www.ncbi.nlm.nih.gov/pubmed/12678303

Recommended reading on Transference

Music clips in this podcast:

Transcript: Podcast Five – Reasons for transgressions

According to Aristotle – “All human actions have one or more of these seven causes: chance, nature, compulsions, habit, reason, passion, desire.”

Scenario

He was a few weeks into his positing and he was enjoying his new role. He was taking some time to establish a network of friends. He was the only officer in the village, his colleagues operated out of the main station which was 50 kilometres away. One night he received an emergency call to attend a domestic disturbance in the village. He knew the address, he had met the young woman who lived there and he liked her. He had heard through the village grapevine that her partner would beat her on a regular basis. The protocol was that he had to wait for other officers to arrive to assist him rather than go into such a situation on his own. He knew his colleagues would take some time to get there.

There was protocol and there was his reaction. He did not wait. He drove to the house, jumped out of the car and as he entered the house, he announced who he was.

Welcome to this Podcast series – Professional Boundaries, Your safety, your wellbeing.

As I have stated in previous episodes I wanted the podcasts to be as interactive as possible and I been inviting listeners to email me any questions, scenarios or reflections they had about boundaries. I am delighted to say that I now have podcast listeners contacting me with scenarios they wish explored during an episode and two folks who have approached me to ask that we have an episode specifically on collegial boundaries. So thank you for that, we will build your themes into future episodes. Keep your questions, scenario, and reflections coming. Let us keep boundary discussions alive and robust. Contact details for ongoing discussions or questions with me are given at the end of this episode.

I realised as I was thinking about content for this episode that there was one theme that I had not yet integrated as a thread through my previous episodes. That thread is consistency. Consistency in the way a professional works with a customer they see on a regular basis. Consistency in the work a professional does with a number of customers. Consistency in a team approach. Consistency modelled throughout an organisation.

Boundaries are more challenging to have in place – when an organisation is loud about its mission statement, vision statement and expectations about how employees conduct themselves and then team leaders, supervisors, and management team – loudly role model something quite different. Talk about setting up moral distress in a workforce. Talk about taking work home. Talk about feelings of unfairness and injustices. Talk about employees wanting to do more for a customer than what the professional role requires. Well, we will talk about these further as we continue on our boundary journey.

In today’s episode, we explore foundation stone number four – Reasons for boundary transgressions. I have developed a multilevel model to explore and explain the reasons for transgressions. I find that factors from all four levels contribute in some way to influencing a transgression. The four levels that I focus on are the Intrapsychic, Interpersonal, Organisational, and Broader System. I will give a brief introduction about each level and then using the scenario of the police officer I shall describe each level in greater detail.

Let’s start with the Intrapsychic Level

At the core of the Interpersonal level is the relationship between the professional and the other person, for example, the professional and a client, the professional and a colleague, the professional and a client’s support person. This level includes the dialogue, the interaction, the communication, the spoken and the unspoken, the dynamic of power and vulnerability, the social roles ascribed to each person such as nurse-patient, hairdresser-customer, support worker-customer, teacher-student, counsellor-client, police officer-customer.

At the Organisational Level– it is important to consider how policies and procedures, guidelines, mission statements, job descriptions, Duty of Care, resource allocation, and expectations can challenge or compliment professional relationships. Expectations of supervisors and team leaders of their staff, expectations of staff about their team leaders and supervisors, collegial and peer expectations in a team. Sometimes it is just too tricky to sort out expectations from .. well ..expectations. Other themes to consider at the organisational level are workplace cultures, is this a safe place in which to work, is this a shame blame workplace or one that is transparent and open. Is there accountability role-modelled at all levels? How are professional boundaries modelled in this workplace?

Finally the Broader systemic considerations – by this I mean the factors that impact the work of the organisation such as relationships and expectations of other services who have a reliance on or partnership with the organisation. Broader systemic influences could involve legal, criminal, educational, health, housing, Centrelink. Broader systemic factors can influence the organisational factors, this in turn impacts on the interpersonal relationship, this, in turn, can impact on the intrapsychic experience of the professional and the client. Let me explain further.

In boundary workshops, I set up a sculpture of the four levels using materials, objects, and participants. Representatives in each level have a voice and address the professional who has identified a scenario they wish to explore. The busy noise, confusion and conflicting expectations come alive as many voices state what they expect from the professional in terms of their relationship with the patient. It gets so loud that many times the voice of the patient goes unheard as the professional tries to manage the needs of all the stakeholders that they have identified as being involved in the service provision for the patient. All those stakeholders that are symbolically“in the room” with them and the patient. In this experiential presentation of the four levels I ask the professional to notice what they notice in response to the busy noise – a common experience is relayed – “this is too much, I cannot meet everyone’s demands, I have to focus here on the relationship with the patient, at the time that I am engaging with them”. I have to pause, I have to breathe, I have to sort out the priorities of what is expected of me in relationship to my patient”

This exercise allows a very big “ah-ha” realisation for some individuals, the push and pull effect of different expectations from many of the stakeholders who have some invested interest in the relationship between the patient and the professional. Sometimes those expectations are unrealistic. Sometimes those expectations could be in conflict between stakeholders, between stakeholders and the professional. A common expectation conflict I explore in workshops is the wishes from family members that the professional do more for “the patient”. Do more than what the professional can do either in terms of their employment and in some cases their professional regulations. In the wishes to have their needs met, family members do not consider the organisational or professional restraints that could be there for the professional. The family just want their needs met, their loved one to be looked after. Generally, it is after the fact – when a professional has given more, done more, gone the extra length to meet the family’s wishes that a complaint is made. Basis of the complaint – the professional was getting too close to the patient. It is also worth considering – here – whose needs are really being met by the professional attending to the families’ wishes rather than setting a boundary that is required for them to stay in the zone of helpfulness expected by the organisation and / or regulatory body?

Consistency is key. Consistency in the way a professional works with a customer they see on a regular basis. Consistency in the work a professional does with a number of customers. Consistency in a team approach. Consistency modelled throughout an organisation.

So let me now explore the initial three levels in greater depth using the scenario with the police officer to assist me.

In the intrapsychic level, there are a number of personality types (also referred to as complexes, or syndromes) that are at greater risk of transgressing professional boundaries – these are named as – martyr, saviour, rescuer, rogue, opportunist, psychopath. Common intrapsychic wishes for personalities who fall into the martyr, saviour or rescuer roles include a wish for magical powers to make things better for the customer and or the hope of being admired or idolized by the customer. When I explore with participants the origins of their rescuer role, many identify childhood experiences related to the family of origin dynamics as the beginning of that role response for them.

In some professional relationships, the customer can idealize the professional and this may completely complement the professional’s wish to be idealized. So begins a relationship of fantasy with expectations that can never be truly met. Gutheil in 1989 wrote … “the sealed off environment in which therapy often takes place can turn into a “magic bubble”, a collusion of mutual admiration and / or mutual need that becomes impervious to the restraining influences of consultation, supervision, good judgment, and common sense”. Although Gutheil had written this specifically about the therapist-client relationship, I have worked with professionals from many different professional backgrounds who have also experienced the magic bubble of collusive admiration and need. This is especially true in situations where the professional is working in rural and remote areas, isolated from peer groups, distanced from their families.

Away from supervision and professional counsel, there can be an increased risk of developing familial relationships with customers as the professional seeks to find a connection that has meaning for them. To have a sense of belonging somewhere – that belonging may then be the development of a friendship or sexual relationship with a customer.

If we consider the young police officer in the scenario at the beginning of this episode, there are a few red flags waving. His own experience of childhood trauma, his wish that he could have done more to stop his father’s violence, working in a town 50 kilometres away from colleagues. Difficulty establishing connections in his new environment.

Our scenario continues …….when the young officer entered the house – the couple were standing a distance from one another – voices were raised, however, there were no obvious signs of physical contact at the point the officer entered the house. He raised his voice, he raised his gun. He does not remember much else until he heard another voice and gradually recognised it to be the sergeant from the other station.

We will return to this progressing scenario later.

Many times when I have replayed with some participants their transgressions where a customer was physically harmed by them, they describe having no clear memory of events, rather they describe a reactive process to a situation. Raising their voice to a shout, hitting out at the other person, in one instance kicking a client who had fallen to the ground. As we slowed down the replay of their behaviour individuals were more able to fill in some gaps as to the triggers that led to the transgression and more importantly to make links between their past experiences and what had occurred in the transgression.

Those “ah-ha” moments so integral to awareness and potential for change.

It may well be that a professionals vulnerability to transgressing a boundary arises from the very motivation that led them to their chosen profession – the hope of escaping one’s own problems by focusing on those of another person, the hope of meeting one’s own dependency needs vicariously by attending to those of the client. For example, Miller (1981) explored the theory that many psychotherapists were compelled as children to satisfy their parent’s unconscious expectations at the expense of their own emotional and development needs. Could this also be true of some police officers, lawyers, council workers, members of parliament, health professionals? Driven unconsciously by a desire to do better, be better, whilst moving further along the over-involved road. I wonder. Was the young officer’s actions motivated by childhood wishes to protect his mother played out as a police officer – acting to protect another woman he considered vulnerable and at risk?

I also consider in this Intrapsychic level, the impact of health, family and work stressors that can result in internal conflict and thus increase the potential for boundary transgressions, let me tease this out further. When an individual is experiencing symptoms of a psychiatric or medical illness there can be an impact on decision making, emotional responses to situations and behavioural changes they can all increase a vulnerability to create a boundary transgression.

Many participants I have worked with for boundary transgressions discuss current relationship stressors including, controlling partners, partners or children with a mental illness or disability, a medical condition, financial difficulties all of which again have influenced decision making in terms of the professional relationships including accepting “loans of money” from clients to help pay bills, having clients become lodgers in their homes for extra “rent money.

A common enough theme for individuals I see who have become over-involved with a client is that of a history of childhood trauma that has included experiencing domestic violence, neglect, physical and or sexual abuse. I am not saying here that every professional boundary transgression occurs because the professional has a history of childhood trauma because I do not think that is the case. However, there is a common enough theme in the work I do for me to highlight it. What I will say here however is that I have found that when there is intrapsychic conflict about what an individual wants to do vs what they are required to do by their organisation and or their professional regulatory body – they are at greater risk of acting reactively in the professional relationship with another person.

Consider for example a scenario where a professional is given an invite to attend a birthday party of a child whom they have been providing care for. The professional’s intrapsychic self is thrown into conflict. Personally, the individual wants to say yes, professionally they know they should not. In the intrapsychic conflict, there are significant biophysiological changes stimulated by the release of Cortisol into their body. In a nanosecond, a new motivating factor emerges that of not wishing to let the other person who gave the invite down – so the professional accepts the invite. Another intrapsychic level of conflict is then triggered – the professional then worries about what their team leaders response will be if they find out the professional attended the event. That worry may further intensify the intrapsychic conflict which results in the professional not attending the event.

Post the event a potential new consequence presents, a question from the person who gave the invite – “why did you not come”, perhaps an expression of anger and or disappointment is directed towards the professional, “you have let me down”. That comment can hurt deep inside if I have a wish to be liked or idealized by the clients I serve. I will experience hurt. Sometimes a more painful comment is made such as “our child was so disappointed that you were not there, they had a specific gift to give you” – ouch that one can really hurt.

Remember context is important. It’s worth checking in with the organisation you work for. Can I attend a birthday party, a funeral? Do I attend in my own time or paid time? Do I wear my uniform or civvies? Always good to check these things out at an organisational level. Context is important.

Scenarios like this are good times for those reflective boundary questions – Why this child, why now? Why accept this invite when I have said no so many times previously to invites of other children I look after. Perhaps the red flag is waving saying – there is something different here, I am not being consistent.

Consistency is important. Consistency in the way a professional works with a customer they see on a regular basis. Consistency in the work a professional does with a number of customers. Consistency in a team approach. Consistency modelled throughout an organisation.

In the interpersonal level, it is good to be curious about the unconscious dynamic relationship that could be occurring and this is where models such as Transference and The Drama Triangle provide many “ah ha” moments for individuals I work with.

The officer was reprimanded for his behaviour and for not following protocol. He rationalised with this sergeant that he appreciated he acted inappropriately and that he would ensure he would never take such action again. At no time in the discussions between himself and his sergeant was his childhood discussed. At this point in the young officer’s professional journey – he was not making any clear links between his childhood and his actions at work.

A few weeks later he accidentally met the young women at a petrol station, they got into conversation. She asked him if he wanted to go with her for a coffee. He was off duty, he said yes. They had coffee in a public place.

In the initial social meeting – they did not discuss the night that he had come to the house. Rather the conversation focussed on common interests they found they both had. The woman terminated the conversation saying she had to get home before her partner returned from work.

That began regular meetings between them and as the relationship grew the woman disclosed more about the relationship she had with her partner. The officer’s concern for her safety was heightened each time they spoke. He was aware of but did not make any links about the feelings of fear and anger that were surfacing in him. He started to talk with her about leaving the relationship, he would keep her safe, that they could move away together.

One week after their last meeting – the officer was asked to go to a meeting with his sergeant. A complaint of stalking had been made against him by the partner of the woman. The complaint focused on the time that the officer had spent with the woman. The woman stated that the officer had been pressuring her to leave her partner against her wishes. Further, she stated that she had not wanted to argue against the officer because she was not sure what he would do to her or her partner.

What was the purpose or intent of the officer’s actions with the woman?

I trust that I have provided enough information form previous episodes that you have come up with some responses to those questions using the boundary framework. I am now going to introduce you to The Drama Triangle to help us explore the role of rescuer, perpetrator, and victim that played out in the relationship between the officer and the woman and her partner. I will then consolidate further with using the transference model to highlight unconscious expectations, wishes, and desires operating at the time.

If you are unfamiliar with the drama triangle you may find it useful to access a short video through the link provided at the end of the podcast transcript which is available on our website.

The drama triangle grew out of the larger framework of Transactional Analysis. It was developed by Karpman in 1968. Karpman suggested that if possible we avoid getting into the triangle in the first place through awareness about our intrapsychic self, the relationships we are in and relationships we want to be in. Good boundaries and good support mechanisms in organisations we work in. Karpman was keen that as individuals we understood our process of introjection and projection. Introjection refers to the ideas and attitudes of others that we adopted. Projection is where we project our feelings or characteristics onto another person in the current relationships we have. Karpmen was clear the professional’s usual gateway to the triangle is through the role of rescuer, at some point the professional will be perceived in the role of perpetrator and then will end up in the victim role. In the victim role, the professional has experiences similar to the person they “rescued” such as a sense of hopeless, feeling unsupported, perhaps experiencing anger and resentfulness.

In debrief sessions that he attended the police officer was able to see how he had enacted all three roles and that he had ended up in the role of victim. In the beginning of his relationship with the woman, he had assessed that she was a victim in need of rescuing. In his rationalisation he was ideally suited professionally to stop the abuse because he was a police officer. Personally, he was of an age and body size to stop the abuse – something he had not been able to do for his mother. Before long he moved from the role of rescuer to that of perpetrator – a complaint was made against him that he had been stalking the woman. Within a much shorter time frame, he moved from perpetrator to victim.

In the work I have done with professionals I have consistently seen the drama triangle played out. Professionals come to the attention of their organisation and or regulatory body for boundary transgressions. Acts of perceived kindness in the professional may well be viewed through the lens of perpetrator by those looking in. Those other stakeholders including a family member or support person for a client perceive a very different relationship to the one the professional sees. Those other people get concerned and they make a complaint. Sometimes it is the complaint that really raises those red flags that had gone unnoticed or ignored in the interactions between the professional and the other.

There is an important role for organisations to offer employee assistance of employee support programs – be that counselling and or supervision to assist staff to understand the intrapsychic motivating factors that can end with boundary transgressions. In order to effect change, change in thinking, it is important that bridges, connections be made between relationship experiences from childhood and what is experienced in professional relationships with other people, clients and or colleagues.

Now let’s go a little deeper interpersonally for the police officer and explore his behaviour through Freud’s theory of transference. Originally transference referred to the emotional responses of a client towards their therapist. Falling in love, idealizing the therapist, a wish that the therapist would rescue/save them from whatever internal or eternal perpetrator they were experiencing. Internal refers to an intrapsychic perpetrator role (self-talk, self-belief), external refers to another person. When the client perceives that the therapist cannot save them, or more damagingly believes that the therapist is acting in the same way as someone in their past or current personal life that then becomes a transference of anger, betrayal, enragement and even annihilation.

I experience transference as a really useful process to reflect on work I do with individuals. Content that emerges in interactions be that verbally, behaviourally, unconsciously can be red flags that there is something requiring attention in the relationship.

Although transference was originally developed for the therapeutic relationship I see transference being played in everyday professional – client relationships and with colleagues. How many times have you been disappointed when the team leader does not live up to your expectations? How many times as a supervisor have you experienced frustration because your team members do not do what you asked them to do? Intense emotional responses to what – yes the here and now – the adult to adult, professional to professional ….. I propose however that if we ask ourselves the following questions when we are in a heightened emotional response with a colleague there is a good chance that the present, the here and now interaction has triggered a much older role system response in us – that of the disappointed or enraged child. That of the hurt wounded child. Questions we can ask ourselves “how old am I right now” “what relationship do I know this from?” These are good questions to also ask when we experience intense emotional responses to the clients we work with. Our responses to the questions may well highlight the transference we are experiencing.

The police officer was able to reflect that he had been enraged about the behaviour of the woman’s partner to her, even although he himself had never witnessed physical abuse, he had heard through the village grapevine, he had heard what the woman shared with him. He had the stories, he did not have actual visible data. However much older memories and experiences were being triggered for him, that of his relationship with his mum. He was also surprised to experience that he was angry with the woman because she had not left her partner. With some burrowing down – he also gained insight into the anger he experienced that his mother had never left his father.

With support provided by the police service – the officer gained valuable insights – painful as they were, they were significant “ah ha” bridges between the unmet expectations and wishes from his childhood to his current personal and professional experiences. Another significant insight was that he had been vulnerable as the only police officer in the village. He had experienced a sense of isolation such as he had experienced in childhood. He understood that meeting with the woman had no sexual connotations for him, what was driving his actions was a wish to rescue and in equal measures a wish to connect. His transference towards the woman and her story was very strong. At some level, his needs were being met.

In discussions with his sergeant, it was decided to move the officer from the isolated role into a setting where he had greater access to both supportive peers and ongoing counselling services. His organisation was able to work with him to maintain him in a police officer role and also support him personally. We have explored the scenario of the police officer through the levels of the Intrapsychic and Interpersonal, now we will continue to discuss through the organisational level.

Organisational Level

Without a doubt, if there is inconsistency in teams and in organisations there will be an increased risk of boundary transgressions. If there is a lack of policy or guidelines on boundaries then staff will do what humans do well. As individuals, as groups, they will join dots to make sense of the situation from what they know to be truths from their family, their community, their previous life/work experiences. In the workplace, if there are no clear guides about how to establish, maintain and effectively cease professional relationships, within the context of that organisation and professional role required, then employees will make up the relationship rule of engagement that works for them. They will bring in their own mores, moral compasses, and beliefs. After all, that’s how we survive as humans.

The police officer was new to his role, he had recently graduated to the position. Like many professionals who read about boundaries in policies and codes of conduct, like many students who hear stories from lecturers about the risks of boundary transgressions, the officer thought he understood what was required in his professional role. At one level he did. At a much deeper intrapsychic and interpersonal level he did not.

Consistent feedback from participants I see informs that boundaries are not explored in any great or robust detail in the organisations in which they work. Boundaries is a topic for a tick box in orientation. As I trust has been described in these podcasts, boundaries can be as easy as a tick-box, yes I understand, however, the complexity is – boundaries are not tick-boxes, boundaries are about me, I in relationship to myself and to the other person. Boundaries require more than a tick box. Boundaries require Sherlock Holmes inquisitive curious hats and times given in workplaces to explore and understand those complexities. More about that in the next episode.

Back to the police officer, as a beginning practitioner in his new role, there was professional inexperience and naivety about such a highly emotive situation. There was also the reality of his isolation professionally and personally and the lack of immediate support for him to access.

It is important that team leaders and supervisors understand the team dynamics. That team leaders and supervisors role model the boundaries they are asking their staff to demonstrate. Role model and discuss and be curious.

Other workplace factors that can influence professional transgressions towards clients and indeed collegially include; shame and blame cultures, vicarious trauma, workplace bullying, and moral distress. I will discuss these in more detail in episode six when exploring strategies and solutions.

Before I move to finish this episode, I have some more questions to pose to you about the scenario with the officer.

Was the transgression a boundary-crossing or violation?

Have a think and I shall give you my responses to those questions in the next episode.

This podcast series has been written by myself, Wendy McIntosh. A big thank you to family and colleagues who hear each podcast before it is released and who provide valuable editing feedback. Thank you to Nikki Fryn, my internet guru who has done the production for these podcasts. As I said earlier I do love to hear from you our listeners any questions, scenarios, reflections that you want to be discussed as part of a podcast session. There is still much to learn and each question and scenario posed provides opportunities to expand learning about professional boundaries. My email address is [email protected], you can also contact me through our social media of Twitter and Instagram. I would be delighted for podcasts to be as meaningful as possible to all who listen. So join with me. You can access our podcasts through a number of sources including our website http://davaar.com.au

The spelling for Davaar is D for Donald, A for awareness, V for Visceral, A for Action A for Alert, R for Red flags.

Thank you for listening, let’s meet again in episode six.

In Episode 4, Dr Wendy McIntosh PhD, from Davaar Consultancy shares another potential Professional boundary transgression scenario, the red flags that were apparent, and how responding to those red flags in a different way could have prevented a challenging situation for a male teacher.

In this episode, Dr Wendy discusses what the alerts that we call Red Flags might look and feel like, in more detail and some clever ways to respond to them.

This is the fourth part of a dialogue that be will be continued in the following episodes. Use the links above to subscribe, or click the play button to listen.

Listen to Episode 5 here.

There are 6 episodes planned in this first season of the Professional Boundaries Podcast and we hope you’ll be back to enjoy and learn from each of them. If you’ve ever wondered about your own boundaries in your Professional role, or been alerted about the risks of crossings or violations, this podcast will help you learn what to watch for, and ways to stay out the danger zones.

Dr. Wendy McIntosh welcomes both your interest and curiosity. Send Wendy questions at [email protected] or via Twitter, Instagram or Linked In

In this podcast series, Dr. Wendy McIntosh PhD shares insights and strategies about developing and maintaining professional boundaries. Professional Boundaries are not limited to the clinical or therapeutic arena. If you are in a professional role – a teacher, support worker, police officer, a prison officer, council worker, hairdresser. If you are a volunteer or belong to a theatre group, a choir, a sports club, there will be something in this podcast for you and the relationships you have with others. Setting boundaries in our life is necessary for our emotional, psychological, spiritual and physical well being. Setting boundaries is about our safety.

Dr. Wendy McIntosh PhD

Since 2005 Wendy has been developing her knowledge and interest in the area of professional boundaries. Wendy delivers workshops on boundaries in Australia (where she now lives) and Internationally when invited to do so. She is continually integrating learning and insights she gains from the work she does in professional boundaries. Wendy comes from a nursing, and predominately psychiatric nursing, background.

Wendy consistently receives feedback on her passion, knowledge, and creativity as a presenter and facilitator. Enjoy exploring boundaries in this podcast series as Wendy takes you on your own reflective journey on your professional boundaries.

References:

References

Music clips in this podcast:

Transcript: Podcast Four – Those red flags – what are they and do I really want to listen to them?

“Notice the red flags in your body – they are there for you to be conscious of the relationship dynamics” (McIntosh 2019)

Scenario

Welcome to this Podcast series – Professional Boundaries, Your safety, your wellbeing.

I am Wendy Mcintosh from Davaar Consultancy and I am delighted that you are joining me on another journey into the world of professional boundaries. This podcast series invites you to reflect on your Professional Boundaries and to appreciate how knowing the five foundation stones of boundaries can assist you in the everyday work that you do. This is our fourth episode in a planned series of six podcasts and I stay open to producing more as required.

I would love to have your input through questions, scenarios to explore or reflections from each episode. One of my aims for these podcasts is to have you engaged in the process with me. I know from experience that having discussions about boundaries and what it means for us in the work and services we provide is an important step in assisting us to understand motivations for our actions. Contact details are provided at the end of this podcast.

I want to thank listeners who have already made contact with me through email. I am delighted with the positive responses coming back to us about our podcasts. I am equally delighted that team leaders from two organisations have said that they will be encouraging all their staff to listen in. This is what I wanted to create – a broader platform from which robust and reflective discussions about boundaries can occur. So thank you, keep your emails coming.

In today’s episode we explore foundation stone number three – red flags.

As I was writing this episode I had an image of the flags of countries being carried during the initial and final march of Olympians for the Olympic games. The flags are held high, they move with the movement of the holder, with the movement of the breeze, with the movement of energy in the excitement and trepidation of the occasion.

Similarly, the red flags of professional boundaries move in front of us alerting us that something is occurring in the relationship for us to pay attention to. The red flags are the alert systems of our intuition or of other people’s observations. The red flags wave to us saying – slow down, pause, take a breath, check-in. Check-in with yourself, check in with a colleague, check-in with the patient.

The waving of the flags asks us to pay attention to the intense emotional responses that we may have towards a patient. The movement of the flags invite us to take stock, to ask – what am I about to do here, whose needs are being met, what options do I have right now in terms of developing/sustaining a respectful boundary with this other person?

Conversely, rather than questions, we come up with red flag commentary, “ok that was not such a good thing to say”, oops I might have crossed the boundary there” “I will have to be more careful in future with this patient”.

There are several red flags that I will explore in this podcast. They include the red flags of:

I will begin by discussing the red flags of intuition and movement in/of our bodies

Intuition is defined in the Collins Dictionary as unexplained feelings that a person has that something is true even when there is no evidence or proof of it. Our intuitive messages will start as a whisper, a gentle teasing – then will grow in volume and movement if we continue to ignore, dispel or even argue against our knowing. Our intuitive alerts – you know the ones – rising hairs on the back of your neck, the swirling in your stomach. Other intuitive responses in our body include pressing fingers above our eyebrows, tightening of our jaws, neck pulling back, hand outstretches facing upwards, pulling on one of our earlobes, a feeling of sickness. It is as though our body is waving red flags that say – drawing back, keep quiet here, anchor yourself down.

These are the hunches, the gut feelings. Perhaps there are words that go along with the feeling such as “something is wrong here”, “this is very strange”, “this does not feel safe”. For me, intuition can invite us to waken up, to don that Sherlock Holmes curious inquirer hat. In boundary work, it is important to recognise the alert centres in our bodies and to listen in to the messages our bodies are giving us.

There are many participants whom I have worked within boundary training who learnt from an early age not to listen to their intuitive self. To quieten their intuitive alert system. For some, it was dangerous to share their experiences with others especially their caregivers. Individuals who had been told in childhood that “they got it wrong” that what they were feeling “was not true” have a greater struggle in their professional role when their intuitive alert system says “watch out here”.

For those individuals, the boundary work with themselves becomes the most integral work they do with me. Professional boundaries starts and ends with the individual, with I, with me. I in relationship to myself and with the other person. In order to effectively manage the boundary with the other person, I have to learn to manage the boundary with myself. I have to erase old teaching about not trusting myself and integrate into my being – I have to trust that my intuitive self is wise and knowing. To trust that I am enough.

What was/is the intent and purpose?

Boundary training requires us to understand the motivations behind the actions that led to the transgression/s. It requires us to acknowledge old role responses in us – the scripts and behaviours from childhood, from our family, our tribe, our community, our land. To recognise their part in getting us to this place in life where we now find ourselves and to change what is required to keep us safe in our professional role. To maintain our well being.

I believe that boundary work requires us to notice the movement of our arms, our hands. Noticing the ways our bodies react to the invites or criticism of other people we are interacting with. The movement of our bodies becomes the red flags when we are aware of what the movements mean for and to us. The subtle and loud changes in our body that can lead to significant changes in a relationship. Changes that we might not take notice of and yet the client reads something different in the movement. Perhaps that subtle movement sets up a fantasy about possibilities in the relationship that the professional would never consider.

I reflect with participants about the movement in their body – the body moving to accept an invite, arms reaching out to initiate or reciprocate a hug – a movement that occurs before a thought enters consciousness. It is so important to recognise the movement in our body and to then create a pause and to allow questions to emerge internally – what am I doing here, what other options do I have?

I know from the work I do – that this taking stock, this having a pause, this creating space to let the question in, does require a retraining in our bodies.

Taking work home – red flag…..

The clarity of a child’s expression into the busyness of our working life can be very sobering. It could be that the truth-speaking red flag from our children resonates more with us than anything a colleague says to us. As I say to participants – when we are in the depth of a relationship with clients we might not always be aware of how our behaviours and speech content is perceived by others. It is not uncommon that someone else in our lives will notice the depth we are earlier than we do.

The child or other family member experiences the red flag of our distraction, of our concentration being elsewhere. They experience in the relationship with us at that moment that we are not actually present with them – we are in fact focused on that client at work. That focus could be intense feelings that we have about the client and or the system we work in – anger, rage, despair, frustration, love, loyalty, unfairness. In the bulge of emotions, it is more difficult for us to pause and to ask – what is going on for me here, what is happening for me in relationship to this client that I have taken them home with me. I have psychologically and emotionally taken them in through the front door of my home and sat them down in between myself and my family. What is it about the relationship, about this client that I have brought them home? What follows are a number of steps/strategies that I assess are integral to effective boundary work.

First step – being aware of what is happening internally and how that is being experienced externally by others.

These are some steps/strategies that we can put in place for ourselves as we wander the boundary landscape. Ensuring as much as possible that we do not get to close too the edge and certainly to halt us stepping over the edge. I will discuss strategies more fully in podcast six.

Other take-home red flags include –

I want to revisit the scenario with the teacher and the student and add some further context.

He made a decision that in order to keep his professional relationship with the student safe that he would never be alone with her and if she made approaches towards him in any way he would decline.

What he was less aware of, however – was that in ensuring that he was careful not to give the student any mixed messages or any messages that he was interested in her, he was gradually moving further away from the Zone of Helpfulness into the under-involved area of the boundary framework.

He would turn away from her when she approached him. When he was addressing the class he would never look at her. If she did approach him to ask questions about the content of the classes he would be (in her words) “short with me, as if he didn’t care about my work, I got really nervous about approaching him to ask any questions about what we were studying”.

In discussions with his Principal, the teacher was able to reflect in greater depth about his communication responses to the student. He appreciated that her experience of him probably was right. He had not identified that he had been so obvious, he had not realised the red flag that was waving in front of him. That of communication – the verbal and nonverbal responses that can tell a story and be interpreted in multiple ways.

The teacher was able to link the feelings he had for the student with a much older role system for him. In the counselling sessions, the teacher developed greater awareness of his communication style with the student and the genesis of his communication approach to the student.

So let’s take some time to explore communication in professional boundaries further. It is important that we look here at two way communication – professional to patient, patient to professional. Two way between colleagues. This red flag of communication also considers the tone of voice, volume, speed and use of silence.

A consistent theme that participants in workshops express to me is their discomfort with silence. One strategy to manage their discomfort is to start talking, talking about themselves, their family, their interests. It is important for them to fill the silent gaps. I think the answer to the question whose needs are being met in filling the silence is clear here.

This is an area where that exquisite boundary training is necessary – to learn through experiential learning that being silent in a relationship with another person can be ok. It might take a few experiential tries for some folks, however each time they practice being silent their body settles a little bit more and then when they state “ah ha, I’ve got it now”, they appreciate how empowering for the other person silence can be. An integral process in the retraining of an old role – is that they are not being rude by not answering immediately – that in fact creating a pause before answering has much better outcomes for the professional relationship.

Other communication red flags that have been identified includes that of self-disclosure, asking questions of the client that will not have any clear benefit to the professional role, but again allows the professional to feel comfortable. Questions are better than silence, right ….mmm not always.

being too close in someones personal space,

Comments from others – students, clients, clients family members, colleagues, own family.

Red flag comments from clients can include:

Red flag comments from clients to a colleague about you:

Red flag comments from colleagues to you:

Red flag comments from family members of clients:

So we will now take some time to further explore the scenario with the teacher and use the red flags to assist us. If we look at the red flag of the intuitive and behaviour – it was clear that the teacher had acted on his intuitive warning signal that he was experiencing unprofessional feelings towards the student. That was good – he listened and he acted.

The experience of the feelings he had was in itself not a transgression – as people, we have a variety of feelings for other people that are not always comfortable or appropriate for that context. What is more relevant is what we do with the feelings we have at that time. And this is especially important when considering professional boundaries and clear power – vulnerability dynamics. The teacher was in a position of power, the student was vulnerable. Other power – vulnerability considerations could be age and gender differences. In this scenario, the teacher made the decision that in order to protect himself he would switch down on being interested in the student. His actions, however, are another way in which he demonstrated his use of power.

If we look at the red flag of communication – the student clearly articulated what she had experienced and the negative impact that had had on her and her learning. The teacher was open to accepting the feedback from the student and recognised that his communication skills in managing role conflict in himself required him to do some counselling.

The take-home red flag only became clear as the teacher reflected on his actions. He had tried so hard not to think about the student at home that in fact “trying hard not to think about her” became a focus for him. On his hour drive to and from work each day he would reflect on his interactions in the classroom. He was pleased that he had not “lead her on”. He had not appreciated the cost of his under involvement with her and as it transpired with himself.

If you were to consider yourself in the role of the teacher – what strategies would you put in place for yourself?

At the end of the previous podcast, I left you an invite to consider my actions with the female patient. I want to add another bit of context which I think will assist further. I had made a commitment to myself early in my career that I would not work overtime if requested to do so. I had made this commitment to myself appreciating in terms of my physical, psychological and emotional well being one shift was long enough. On the day of the incident, I had been working an early shift. The management team in consult with the treating psychiatrist had made a decision that the patient was going to be under constant observation for 24 hours. Staff who were on shift were asked if anyone would like to work overtime. My hand went up.

That was my big red flag and I ignored it. I forgot the commitment I had made to myself to my well being, to my safety. I did not pause long enough to reflect on the invite to do overtime. I did not stop to ask “why this patient, why now?

Had I listened to that big red flag – the outcome could have been different.

On the boundary framework – I had stepped right out of the Zone of Helpfulness and was driving fast down the road of over-involvement. As I kept driving away further away from the zone, I was also professionally under involved with the patient. In reflection, my transgression was a violation, my actions driven by my wishes, my needs, my clinician had gone to sleep behind the wheel.

If I consider my actions under the categories of concern – I had stepped away from my professional role when I put my body between the patient and the wall. Did I enter into a dual relationship with the patient? Well here is another complexity to boundaries. In the context of what dual relationships actually means in the professional literature – no I was not in a dual relationship. If I consider however unconscious dynamic processes and especially that of transference and countertransference then I absolutely was.

Did I access or disclose information not required for me to provide the care I was being paid to give? Well, my behaviour disclosed much even if my speech did not. The final category of concern Was there an exchange of gifts, services, money between myself and the patient?

Well, that’s for another episode…

As I draw towards the end of this episode I invite you to consider your red flags. The ones that guide you and perhaps, more importantly, the ones you ignore. Consider the ways in which the red flags can guide you in your well being and your safety as you establish, maintain and as necessary end the professional relationships that you have with other people.

This podcast series has been written by myself, Wendy McIntosh. A big thank you to family and colleagues who hear each podcast before it is released and who provide valuable editing feedback. Thank you to Nikki Fryn, my internet guru who has done the production for these podcasts. As I said earlier I would love to hear from you our listeners any questions, scenarios, reflections that you want to be discussed as part of a podcast session. There is still much to learn and each question and scenario posed provides opportunities to expand learning about professional boundaries. My email address is [email protected], you can also contact me through our social media of Twitter and Instagram. would be delighted for podcasts to be as meaningful as possible to all who listen. So join with me.

Thank you for listening, let’s meet again in episode five.

In Episode 3, Dr Wendy McIntosh PhD from Davaar Consultancy shares another Professional Boundaries scenario and ways to identify when a professional’s behaviour risks boundary crossings or violations, or if a transgression might already have occurred.

Listen as Dr Wendy explains the Professional Boundary Framework model she uses in her workshops to help participants get a visceral feeling of the Professional Boundaries continuum.  This episode introduces powerful and specific questions to ask while examining situations that are ripe for crossings or transgressions and delves deeper into the reasons that they occur. The discussion of Red flags continues in this episode.

This is the third part of a dialogue that be will be continued in the following episodes. Use the links above to subscribe, or click the play button to listen.

Listen to Episode 4 here.

There are 6 episodes planned in this first season of the Professional Boundaries Podcast and we hope you’ll be back to enjoy and learn from each of them. If you’ve ever wondered about your own boundaries in your Professional role, or been alerted about the risks of crossings or violations, this podcast will help you learn what to watch for, and ways to stay out the danger zones.

Dr Wendy McIntosh welcomes both your interest and curiosity. Send Wendy questions at [email protected] or via Twitter, Instagram or Linked In

In this podcast series, Dr Wendy McIntosh PhD shares insights and strategies about developing and maintaining professional boundaries. Professional Boundaries are not limited to the clinical or therapeutic arena. If you are in a professional role – a teacher, support worker, police officer, a prison officer, council worker, hairdresser. If you are a volunteer or belong to a theatre group, a choir, a sports club, there will be something in this podcast for you and the relationships you have with others. Setting boundaries in our life is necessary for our emotional, psychological, spiritual and physical well being. Setting boundaries is about our safety.

Dr. Wendy McIntosh PhD

Since 2005 Wendy has been developing her knowledge and interest in the area of professional boundaries. Wendy delivers workshops on boundaries in Australia (where she now lives) and Internationally when invited to do so. She is continually integrating learning and insights she gains from the work she does in professional boundaries. Wendy comes from a nursing, and predominately psychiatric nursing, background.

Wendy consistently receives feedback on her passion, knowledge, and creativity as a presenter and facilitator. Enjoy exploring boundaries in this podcast series as Wendy takes you on your own reflective journey on your professional boundaries.

References:

Gutheil, T. G., & Brodsky, A. (2008). Preventing boundary violations in clinical practice. The Guildford Press: New York.

Music clips in this podcast:

Transcript: Podcast Three – The professional boundary framework – where possible keep in the Zone of Helpfulness

Scenario

Welcome to this Podcast series – Professional Boundaries, Your safety, your wellbeing. I am Wendy Mcintosh from Davaar Consultancy and I am delighted that you are joining me on another journey of exploration, revelation and for some, consolidation, on the theme of professional boundaries. This is our third episode in a series of six. Each episode focuses on a different aspect of professional boundaries and aims to extend your understanding of professional boundaries. Further, the podcast explores ways in which Professional Boundaries can assist you in your work and perhaps even in your everyday life. Feedback from participants who have completed training with me, share how insights and learning they gained about professional boundaries has assisted them with boundaries in their personal relationships.

I would love to have your input through questions, scenarios to explore, reflections from each podcast. One of my aims for these podcasts is to have you engaged in this process with me. I know from experience that having discussions about boundaries and what it means for us in the work and services we provide is an important step in assisting us to understand motivations for our actions. Contact details are provided at the end of this podcast.

The beginning is the most important part of the work – Plato

Major benefits I see to understanding the boundary framework in the context of professional relationships is that we can use it as –

a risk assessment framework (we can pose the question – where on the continuum am I)

I am thinking that it would be useful to describe the framework to assist you have a picture of it as I invite you to wander up and down exploring the two scenarios presented at the beginning of the podcast, revisiting my scenario from podcast two – Caring enough to put my life on the line and also reflecting on relationships you have with patients and or colleagues. For an image of the boundary framework similar to what I use in the workshops I deliver, you can visit our website and in the podcast section, you will be able to see the framework. For the purpose of this podcast, I will explain it as though we are in a car driving.

Imagine you are at an intersection on a road, in boundary land this intersection is the Zone of Helpfulness also referred to as the Safety Zone and Therapeutic Relationship Zone. If you turn left you are going into the over-involved area, if you turn right you are going into the under-involved area. In this road, the interaction is actually the safest place in which to practice. At either end of the left hand or right-hand turn, there is a big road sign that says illegal. We definitely do not want to end up there. As we look in either direction what we see is that the roads are an ever-darkening shade of grey until the endpoint here the word illegal is black.

If I turn left into the over-involved road – some commonly reported behaviours will be demonstrated – spending unpaid time with a client, lending a client money, interacting with the client on social media, giving gifts to the client that could include, food, clothing, tickets to the movies. On the over-involved road, the professional may spend a lot of time thinking about the client and how to make things better for them, perhaps there is some magical thinking about how to make their circumstances better for them. Better – as perceived by the professional.

If I turn right onto the under-involved road common experiences are a disinterest in the client, talking about them in negative tones, use of pet names – such as pet, darling, dear. An emotional distancing that is cold and rigid. There may also be neglect and abandonment of the client’s needs.

There are four large billboards which have important messages for us to consider in terms of professional relationships. Each is a guide to assist the professional reflect on the context of their role. These billboards are visible on both the over and under involved roads.

The largest billboard is World considerations – such as the Universal Declaration of Human Rights

The next billboard is Federal and state legislation on safety and professional regulatory expectations (laws relevant to the countries in which you live and work)

Another billboard represents organisational policies, procedures, and guidelines with professional boundary expectations in there.

The final billboard represents the job description and expectations of the professional role

These four billboards (represented as circles in the image we present on our website), and all they contain, form the CONTEXT of what is required in the professional relationship between a professional and a client. Be that as an employee such as a support worker, teacher, police officer, council worker, health professional or an independent practitioner such as a counsellor or health professional.

There is another element to the road – that is a pathway that also goes left and right that forms the intersection. The pathway is uneven. This pathway symbolises the actions and speech content of the professional and the interpretation/understanding that the client has, about what was said, what occurred. Remember from podcast two my assessment that what I did was a careless thoughtless act, the patient’s interpretation – someone cared enough about her to put their life on the line.

Let me explore that idea of the interpretation of actions with some further discussion on the scenario from this podcast. I shall begin with some context.

The customer was in her 70s. She was known to the support worker because they lived in the same community. Prior to the commencement of the professional role their interactions had been brief community interactions when they met at social events. The only family member the lady had was her daughter who lived in another town and could only visit her mother every month when she would stay overnight with her. The support worker’s paid role was to visit the client twice a week to take her shopping, ensure she had enough food and to help her prepare meals if required.

When the team leader inquired as to the extra time and meals provided the support worker responded “well she is so lonely, I just did what any caring person would do. The customer always tells me how much she enjoys my visits”.

It is so easy for two completely different interpretations, two different meanings, two different stories to be created in a single act, in a single sentence, in a pattern of behaviour.

When the team leader talked with the customer – she responded “she is very nice to me, other support workers have not done that, come to visit me or bring me meals. She is like my daughter – that’s what my daughter does for me”. The customer also made another comment to the team leader which amplified a red flag for the team leader. The comment was “I feel so sorry for her. You know she lost her own mother just over a year ago”.

So I now pose some questions to you –

When we briefly revisit the definitions discussed in podcast two, we are reminded that a crossing occurs once and is generally considered to be thoughtless or inadvertent. A violation is a pattern of behaviour where the needs of the professional supersede the needs of the client.

Based on those definitions we could assess that in the scenario – the boundary transgression was a violation. Was the transgression over or under involved, or indeed both? Well, that question may take some time to discuss. So we are going to pause here to consider this very important question – was the behaviours of the support worker over or under involved or both?

I have learnt through the hundreds of sessions I have conducted with professionals, through scenarios presented and explored in the workshops I conduct, that an over-involved professional boundary actually informs us that it is the person who is over-involved, not the professional. Hang in with me whilst I explain further.

If I am acting in the requirements and expectations of my professional role in the context that I am employed then I cannot actually be professionally over-involved, however, I absolutely can be personally over-involved. I have become personally over-invested in the person and in the relationship I have with the other person.

Now, this is where I really appreciate the complexities that are professional boundaries – if I am personally over-involved then there actually is a very good chance that at the same time I am professionally under involved. The personal aspect of the relationship has become so important to me that I stop noticing what I need to be noticing in my professional role, the role that I am being paid to do.

In all examples of where I have worked with individuals due to over-involved transgressions when we explore the under-involved aspect of service provision – whilst hard and confronting to hear – individuals appreciate that the professional objectively switched down or off and the emotional personal got going.

You could use the framework right now to further understand the complexity of being personally over-involved and professional under involved by reflecting on a situation from your professional role, historically or currently. It is always beneficial to consider an over-involved scenario and then identify – am I also under involved here.

Place yourself on the framework – how far away from the intersection – that safe Zone, that Zone of Helpfulness – have you travelled with your client. Look back and notice that the further away from the intersection you are, the further away you will also be from providing the care, the service that you are being paid to do – thus, you are also under involved.

Context is important.

If we consider those four important boundary questions from podcast two we can also get further data:

1. What was the intent or purpose of the support worker’s actions?

2. Whose needs were being met?

3. Was there other options for the support worker?

Had the support worker had an awareness of her actions she could have spoken with her TL before continuing on the journey she had started.

The support worker stated that she had understood the code of conduct content in terms of boundaries – yet her actions demonstrated this was not the case. She really was surprised to learn that not only had she transgressed the boundary – she had violated the boundary. Her prior understanding of boundary violation was that it must be close to or an actual illegal activity, such as fraud, assault, neglect. She thought that developing a sexual relationship would also be considered a violation. She had never contemplated that visiting the customer in her own time and providing meals would be considered a violation. For the organisation in which she worked, it was. Context is important.

4. What stopped her using another option?

It was clear when data was collected that the support worker had not acted out of malicious intent, she had however used the power of her role to get her own needs meet. She had not fully appreciated the organisational requirements regarding boundaries. At no time was she curious about her pattern of behaviour or what it might mean for the customer or her daughter, or indeed for herself as a support worker, her employer or her colleagues.

I am just going to let that seep in for a little while and at the same time introduce another element that is integral to the boundary framework, and that is Categories of Concern.

Wearing our Sherlock Holmes inquiring hat – I see that the categories of concern element invites us to ask further curious questions to assist us to solidify was there a transgression and if so what kind.

The four categories of concern are:

Professional Role (or Therapeutic Role)

Dual / Multiple relationships

The second dual relationship to consider is when there is a pre-existing relationship – family members, neighbours, sing in the same choir, play in the same football team and then one person becomes a client of the service to which the professional belongs. In such circumstances it is important that the professional discusses the pre-existing relationship with their team leader and look at options of service delivery – perhaps another person on the team can attend to the client. If that is not possible due to limited resources then the professional would have to talk with the client about “this new role relationship” they were about to commence and establish clear boundaries about that relationship. It would also be important that the professional is supported by the TL due to the increased complexity of the relationship.

Multiple relationships are also a reality in small communities where a professional providing services to the community such as as a teacher, health professional, police officer, etc also live in the community – and have other roles with a client such as a neighbour, attend their children’s school activities together, attend the same drama group, shop in the same shops.

It is ok to be in multiple relationships, it is the reality when working and living in a small community. The responsibility for the professional is to always ask the questions what role am I in just now and how do I respond to that question, that invite, that feedback from the other person. It is always the responsibility of the professional to be clear with the individual that they are engaging with. It will always be the responsibility of the professional to maintain the boundary and reset limits when and if transgressions occur.

The third category of concern to consider is that of – Access to / disclosure of information

How much is not enough, how much is too much – will be directed by the context. The important questions to ask as professionals self disclose to the patient is:

I have learnt that in asking such questions the answer about whether or not a transgression is about to or has occurred is revealed.

The final category of concern is that of Giving and receiving gifts, services, money.

Context is important.

We can now use these categories to concern to further explore the scenario with the support worker and the customer.

In having contact with the customer in her own time – had the support worker stepped out of her professional role?

Was the support worker operating in a dual relationship with the customer? – yes she was

Did the support worker disclose information that was not required within her job description?  Yes. One red flag being the information provided by the customer that the support worker’s mother had died a year previously and she knew this because the support worker frequently talked about her mother when they were together.

Was there a giving and receiving of gifts services, finances – yes the meals would be considered both a gift and a service.

So in this seemingly innocuous transgression – the support worker had actually triggered all four categories of concern.

Again I repeat she was not a malicious person. She did not act with intent to use the power of her role with the customer’s vulnerability. However, that is actually what had happened.

A consistent comment made to me during workshops on boundaries is – “I don’t want to become robotic, I don’t want to lose my humanity, I don’t want to stop caring about the clients I see”.

I allow the comments to sit for a while because they are an expression of genuine concern for participants. Then I bring forward the notion that if we actually understand and appreciate the complexities that are boundaries, when we stand firm in the knowledge that each foundation stone provides to us when we engage in robust discussions about boundaries with colleagues and in the organisations where we work – then individuals experience a more authentic, generous and respectful relationship with the other person or persons.

The foundation stone that really assists participants appreciate the wonder of this – is that of the reasons for transgressions. When participants understand the dynamics that influence the patterns of behaviours they have with clients, those ah-ha moments free them up to be much more discerning in those professional relationships.

Before I move towards the end of this podcast – I would like to invite you to start considering strategies that could perhaps have been of assistance to this support worker, to decrease the risk of her transgressing the boundary with the customer. Just as importantly, if you were her team leader what would your next steps be with her.

I see that it is essential in that first meeting between the professional and the client to discuss the context of the professional roles and to invite an exploration of the other person’s understanding of what is being said and what the expectations are. In subsequent meetings it is important that the professional checks in with the client that the understanding is clear, looking for red flags that may indicate that a boundary transgression is about to occur or indeed has occurred. Commentary from a client such as “you are just like a friend to me”, “you are the son I never had”, or “I wish all nurses were as kind as you” may indicate that curious questions are required about the relationship. Ah yes, those red flags. I will be waving them loudly in the next podcast.

I have one further question to pose to you now that you have information about the boundary framework and categories of concern. When I stood between the patient and the wall, was my action a boundary-crossing or violation? Was the transgression over or under involved or both?

I will share more about my reflections on those questions with you in the next podcast.

You may recall in the previous podcast my reference to a list of needs that could be operating in the professional when they transgress a boundary. The list of needs include:

Physical including hugging, kiss on the cheek, hand on should, hand on the back

One book that I have found very useful, and to which I refer to many times is Preventing Boundary Violations in Clinical Practice by Gutheil and Brodsky. Whilst the focus of the book is on the therapeutic relationship, it contains many gems to help extend an exploration of boundaries and what it means in the professional encounter.

This podcast series has been written by myself, Wendy McIntosh. A big thank you to family and colleagues who hear each podcast before it is released and who provide valuable editing feedback. Thank you to Nikki Fryn, my internet guru who has done the production for these podcasts.

As I said earlier I would love to hear from you, our listeners, any questions, scenarios, reflections that you want to be discussed as part of a podcast session. There is still much to learn and each question and scenario posed provides opportunities to expand learning about professional boundaries. My email address is [email protected], you can also contact me through our social media of twitter and instagram and LinkedIn. I would be delighted for podcasts to be as meaningful as possible to all who listen. So join with me.

The spelling for Davaar is D for Donald, A for awareness, V for victor, A for awareness, A for Alert, R for Red flags.

Thank you for listening. Let’s meet again in session four.

In the Professional Boundaries Podcast – Episode 2 – Definitions and language of Professional Boundaries, Dr. Wendy McIntosh PhD from Davaar Consultancy shares a potential Professional Boundaries crossing scenario from her own nursing career, revealing some of the risks of crossings and transgressions when working with clients, customers, patients, and colleagues.

In this episode, boundary crossings are explained, and how they can so easily slide along the over-involvement and under-involvement continuum into transgressions and some of the reasons why. Wendy also begins the talk about Red flags – what they might signify, and how to spot them.

Listen as Dr. Wendy continues her discussion on maintaining Professional Boundaries, and why the context of the relationship is so important.  This is the second part of a dialogue that be will be continued in the following episodes. Use the links above to subscribe, or click the play button to listen.  Listen to Episode 3 about the Professional Boundaries Framework here.

There are 6 episodes planned in this first season of the Professional Boundaries Podcast and we hope you’ll be back to enjoy and learn from each of them. If you’ve ever wondered about your own Professional Boundaries behaviour, or been alerted about the risks of crossings or violations, this podcast will help you learn what to watch for, and ways to stay out the danger zones.

Dr. Wendy McIntosh welcomes both your interest and curiosity. Send Wendy questions at [email protected]

or via Twitter or Instagram

In this podcast series, Dr. Wendy McIntosh PhD shares insights and strategies about developing and maintaining professional boundaries. Professional Boundaries are not limited to the clinical or therapeutic arena. If you are in a professional role – a teacher, support worker, police officer, a prison officer, council worker, hairdresser. If you are a volunteer or belong to a theatre group, a choir, a sports club, there will be something in this podcast for you and the relationships you have with others. Setting boundaries in our life is necessary for our emotional, psychological, spiritual and physical well being. Setting boundaries is about our safety.

Dr. Wendy McIntosh PhD

Since 2005 Wendy has been developing her knowledge and interest in the area of professional boundaries. Wendy delivers workshops on boundaries in Australia (where she now lives) and Internationally when invited to do so. She is continually integrating learning and insights she gains from the work she does in professional boundaries. Wendy comes from a nursing, and predominately psychiatric nursing, background.

Wendy consistently receives feedback on her passion, knowledge, and creativity as a presenter and facilitator. Enjoy exploring boundaries in this podcast series as Wendy takes you on your own reflective journey on your professional boundaries.

References:

Music clips in this podcast:

Transcript: Podcast Two – Definitions and language of professional boundaries 

Scenario She had a history of self-harming. Banging her head on walls was one form of self-harm that caused distress to the patient and to staff looking after her. One shift I was in a room with her, she was my allocated patient – she made a quick movement towards a wall. I also moved quickly and put my body between the patient and the wall. I asked her to stop moving She did Neither of us were hurt, both of us could have been. My self-assessment – Wendy that was a thoughtless careless action you just did Her assessment – someone cared enough about her to put their life on the line for her We were worlds apart in our assessment of what had happened….. or were we?

Welcome to this Podcast series – Professional Boundaries, Your safety, your wellbeing.

I am Wendy Mcintosh from Davaar Consultancy and I am delighted that you are joining me on another journey of exploration, revelation and for some, consolidation on the theme of professional boundaries. This podcast series focuses on you and ways in which Professional Boundaries can assist you in the everyday work that you do. I have planned for six podcasts and I stay open to producing more as required. We plan to have a new podcast each week. I would love to have your input through questions, scenarios to explore, reflections from each podcast.

One of my aims for these podcasts is to have you engaged in this process with me. I know from experience that having discussions about boundaries and what it means for us in the work and services we provide is an important step in assisting us understand motivations for our actions. Contact details are provided at the end of this podcast.

Family, friends, and colleagues who have travelled with me over many years frequently identify what they refer to as Wendyisms. Words, sentences, a way of speak that emerges from me at different times when I yarn. I envisage there will be a few Wendyisms that present in these podcasts. Enjoy them when you hear them.

This is our second podcast and following from the first one, today’s session focusses on definitions and language used to assist us to explore, explain and understand what professional boundaries mean for you and the work you do. There will be four main definitions which I will tease out in this podcast these are: boundary transgressions, boundary crossings, boundary violations, and sexual misconduct.

Victor Frankel – stated – Between the stimulus and response, there is a space. In that space is our power to choose. In the scenario just presented, I did not create enough space to make a conscious choice. I reacted to some old response in me that I could not fully understand at the time. In reality, it took me many years of working in this space of professional boundaries before I had my “ah ha” moment. Before I could really appreciate whose needs were being met by my actions. We can only know what we know – until we learn something different.

Like many participants I work with I have wrestled with the definitions used in professional boundaries. I have had to dissect many scenarios, be challenged by many folks, and have read much literature in order for me to reach a place where I can say with some certainty – yes that was or that was not a boundary transgression. Yes, that was a violation, not a crossing or vice versa. I trust that this session will assist you the listener understand the definitions and to make sense of them in order that you may integrate them into your work. I believe that when we understand the definitions we can also have a different dialogue with colleagues about potential or actual transgressions that they have done. Individual interpretation of what constitutes professional boundaries can be problematic especially when social and professional contexts change.

Gardner & McCutcheon (2016 p33) argued that “Professional boundaries are constructed social phenomena that are open to interpretation, individuals within a defined professional group may have different expectations to their colleagues”. These authors argued that professional groups and regulator bodies may struggle to determine what constitutes a professional boundary transgression.

What follows are some comments from participants who completed boundary training with me either one to one, in workshops or through our online tool on boundaries. I see that the comments also highlight that sometimes individuals don’t know what they don’t know until they learn something new. From one participant, “Prior to commencing this course, my understanding of professional boundaries was indeed very limited. My understanding was only based on over-involvement crossings with no clear divide in my mind between boundary violations and boundary crossings” another participant “Having completed the online course, my understanding about professional boundaries is that boundary violations in working relationships is one of the more difficult ethical dilemmas you may be confronted with”. And finally “Prior to commencing this training my understanding of professional boundaries was blurred, I knew that boundaries existed …. I was reliant on watching the clinicians around me which offered a wide variance of acceptable boundaries. In retrospect, I see there were quite a few transgressions occurring”.

I argue that understanding the definitions of professional boundaries can enable us to be mindful of the spaces we are in, of the choices we make. To start our exploration about definitions there is some benefit in considering – what constitutes a boundary? A boundary is a border, an edge that marks the limits of an area. In the therapeutic relationship a boundary is the edge of appropriate behaviour at a given moment between the professional and the patient. If you reflect on your professional role, your workplace, your social group, your volunteer group – what is or are the borders that define the expectations of your role or roles? Interacting with other people means there will be many grey areas. The borders of the relationship may not be as clear cut as say the edges of lawn or the coastline around an island.

If you struggle with identifying the boundaries of your professional relationship then clear guidelines, role modelling, and clear professional expectations can assist you to stay safe. I reflect that if I wander aimlessly to the edge of a cliff and do not pay attention to where my next step takes me – it could be dangerous for me. I could fall off the cliff. Who knows what the consequences could be. Likewise wandering aimlessly in a professional relationship (be that professional to customer, or collegially) could take a person to the professional edge of safety and the next step could have serious consequences for both people in the relationship.

The most common definition of professional boundaries found in the literature is the “limits which protect the space between the professional’s power and the client’s vulnerability” (NMBA Guidelines 2010). According to Farmer, (2017) in health, the perception of a client’s vulnerability is deeply rooted in history with the professional being recognised as having the power, the influence, access to information about the client and their family and specialised knowledge, skills and at times a professional language. The power invested in the professional occurs through legislative, professional and organisational requirements.

Transgression refers to an act that goes against a law, rule, or code of conduct and there will be situations were transgressions could be a criminal offense. Professional boundary transgressions happen along a continuum between over and under involvement with clients (and in some instances family members of the client). The transgressions can be either crossings or violations or a combination of both. Professional boundary transgressions can also occur between colleagues. So let’s explore the three main boundary transgressions cited in the literature, boundary-crossing, boundary violation, and sexual misconduct.

Professional boundary crossings are considered to be a departure from the usual norms of the specific professional relationship they are – “brief excursions across boundaries that may be inadvertent, thoughtless or even purposeful if done to meet a special therapeutic care or need”. Crossings are considered to be harmless and non-exploitive. A crossing occurs once, a mistake, generally considered to be an unconscious mistake without intention to cause harm to the client. When a behaviour occurs more than once it is no longer a mistake, it is nor longer a crossing. Repeated behaviour is a pattern and in the burrowing we find intent. Repeated boundary crossings should be avoided this includes either crossings with the same client and /or repeated behaviour by the professional with a number of clients.

Professional boundary violations are not done for the well-being of the client and can result in significant harm to the client, violations – can result when the professional confuses their needs with the needs of the person in their care. In a violation, there is exploitation of the vulnerability of the client. A violation can occur in one event, or even in the initial encounter between a professional and the other person. Or a violation can be a series of encounters over a period of time, in some reported cases over many years. In a violation, the needs of the professional are more important than the needs of the client.

There is quite a list of needs to examine when considering professional violations. These include and are not limited to: physical, psychological, sexual, emotional financial. I will discuss these needs in greater detail in podcast three. There is a slippery slope between a crossing and a violation. The slippery slope can be as short as a couple of seconds or as long as weeks or months.

Sexual misconduct is generally preceded by relatively minor boundary transgressions and is “an extreme form of boundary violation which includes behaviour that is seductive, sexually demeaning, harassing or reasonably interpreted as sexual by the person who is the recipient of the behaviours from the professional.

So a couple of take-home points about crossings and violations. Crossings occur once Sometimes a crossing can be in the best interests of the client. And as I say to folks I do boundary work with – have good data that supports your rationale for the boundary-crossing you did. Violations can be a one-off event or a pattern of behaviour Violations are never alright Violations are never in the best interests of the client.

A theme consistently challenging for participants I see is where they have conducted what they assessed to be an Act of Kindness with a client. When that act is viewed by others – be that the professional’s supervisor, their regulatory body, the customer or family member of the customer – as a boundary transgression this can create a dissonance for the professional. The greyness of boundaries means that much will depend on the interpretations of witnesses to the behaviours in the context of the relationship or roles between the two people concerned. Context is important.

This is an area of struggle for professionals I see. They are astonished, angered, appalled and many feel ashamed to experience that what they considered and perceived to be a kind act, done for good and for the benefit of the customer, can be viewed by others as a boundary transgression. I believe that generally when a professional interacts with a customer they are not always considerate of how many people can be affected by those interactions.

I say to participants that I work with, in any interaction with a customer there are more than the two of you in the room. There are many other people who have a vested interest in how you are conducting yourself in that relationship. You just cannot see those other people sitting in the room with you, they do however have a presence in that relationship you are engaged in. There are many perceived acts of kindness, that have taken professionals to the edge of the border. Caught in time the individual is able to walk back from the edge and find someone to talk with about what they have been doing. With guidance and support from team leaders and supervisors, they have been able to do what I term recalibrate the relationship with the customer. For others stepping over the edge has come at a cost for them, their families and for the customer and their families. Context is important.

Acts of kindness can range from buying some extra food for a client with the professional’s own money to allowing a client to stay in their home to avoid homelessness. Another example could be when a client is in distress and tearful and even although the allocated time is up and there are other clients waiting to be seen, kindness is there to stay with the distressed client longer, however that can result in a negative outcome for the client who is now waiting to be seen. The kindness might be giving a movie card to a young person to go to the movies because the professional knows how much going to the movies means for that young person. The card is given as a gift and a comment “here you go enjoy this”.

Finally, an act of kindness, fuelled by a knowing that the elderly client loves roses, loves the smell and the colours of roses. The client talks about how much roses bring back many fond memories of their childhood. The professional also loves roses, loves the smell and grows roses and frequently presents the client with a bunch of freshly cut roses from his / her garden for the client to enjoy. The professional then enjoys the enjoyment of the client. But what I hear you say is wrong with giving a client roses from the professionals garden? My response at this point is to say, Context is important. And I invite you to take time to consider the question – whose needs are being met in the act of presenting the roses. First default – the client’s needs – they love roses. Roses bring back fond childhood memories. What’s not to applaud in the act of the professional when he/she gives the roses to the elderly client.

Remembering that boundaries are as complex as they are simple – what other intents could be there if we burrow down further. We will explore the act of giving and receiving gifts (which the roses are) in podcast three when we explore categories of concern. These acts of kindness can take people to the edges, to the borders of the professional relationship placing both people at risk of consequences that can not yet be visualised, perhaps not even conceptualized. Context is important.

Some crossing may be alright if it is in the best interest of the customer at the time. A crossing occurs once, a violation is a pattern of behaviour. Context is important. So using the definitions that we now have let’s explore that scenario at the beginning of this podcast. I want to introduce you to four main boundary questions that I consider to be essential in exploring an individual’s actions to assist determine – was that a transgression and if so – was it a crossing or a violation?

The four questions are: What was/is the intent or the purpose of the action / the content of the speech? Whose needs are/were being met? Were/are there other options available? (Generally, there will be a minimum of five options for each event) And the question I believe is essential – what stopped the person using another option? And don’t worry I will be repeating these questions numerous times in future podcasts.

What was my intent when I put my body between the patient and the wall? First default – to stop the patient harming herself Burrow down – I did not want her to hurt herself whilst I was “looking after her” Whose needs were being met? First default – the patient, I did not want her to harm herself. Burrow down – I was distressed, I did not know what to do, I had to do something. Did I have other options available to me? Always – I could have used my voice earlier, I could have let her go to the wall and maybe she would have started hurting herself or not, I could have pressed the emergency buzzer, I could have discussed options with the patient earlier in the shift – if this happens whilst I am in the room what could we do? I could have yelled STOP

What stopped me using another option? When I really burrow down – the assessment of the patient was correct – I did care enough about her to put my life on the line. I did care enough about her to put my life on the line. Let me just reflect here a bit longer with you adding some further context to the scenario. I had provided nursing care for this patient over many shifts. I did not realise at the time, not did colleagues talk with me about the potential of my becoming over-involved with her. At this time in the early 1990s we did not have the depth of information that we now have on childhood trauma and the impact for an individual’s development through life.

We knew very little about vicarious trauma or compassion fatigue, the term empathetic distress had not yet entered the professional language. I was experiencing what has been referred to by some authors as the empathy of pain. The patient’s pain, my pain. I experienced her pain and I wanted to be the one who could help stop her pain, I would do just about anything to assist her in her flashbacks, her intrusive thoughts, her painful emotions. In that brief yet highly significant couple of seconds – my caring about her was to put my life on the line. In retrospect when I burrow down deeper – the distress I wanted to ease, the person I wanted to save was myself. What I did not realise at that time was that my experiencing the empathy of pain was a red flag that I was becoming over-involved, over-invested in her care, her wellbeing.

I did not realise then that had I listened to, had I paid attention to the red flag, I may have chosen to act differently in the space that was there. I will discuss and give examples of red flags in more detail in podcast four. And here’s another question that I want to pose, was I really experiencing empathy?

Really what is empathy? How does empathy play out in the relationships we have with others? To me, empathy and boundaries have such an exquisite relationship that does require time to consider in detail. We will venture into empathy more when we discuss reasons for boundary transgressions in a future podcast. There I will return to the question was I really experiencing empathy in this scenario? If not empathy what was happening for me? Burrowing down, was there something in the patient’s story that resonated with my story? In that flash of time, what I refer to as a nanosecond or a split second, in that flash where a decision was made – there was a walking towards that edge, actually a running, I moved fast, the edge of the professional relationship.

It was fortunate that neither of use were physically hurt by my actions. However, there were other consequences that neither of us could have imagined from that couple of seconds of transgressions for me. Did I walk over, did I walk back? We’ll find out in podcast five.

I am enjoying my journey of writing these podcasts. Each time I write and reflect a deeper understanding occurs for me. I look forward to sharing session three with you where we will delve into the boundary framework in greater depth. In that session, we will explore Categories of Concern and Over and Under involvement. I will present some scenarios to you and ask you to put on your “Sherlock Holmes Professional Boundary curious hat”– what answers will you come up with as you start to integrate your learning from foundation stones one and two?

This podcast series has been written by myself Wendy McIntosh. A big thank you to family and colleagues who hear each podcast before it is released and who provide valuable editing feedback. Thank you to Nikki Fryn, my internet guru who has done the production for these podcasts. As I said earlier I would love to hear from you our listeners any questions, scenarios, reflections that you want to be discussed as part of a podcast session.

There is still much to learn and each question and scenario posed provides opportunities to expand learning about professional boundaries. My email address is [email protected], you can also contact me through our social media of twitter and instagram. I would be delighted for podcasts to be as meaningful as possible to all who listen. So join with me. The spelling for Davaar is D for Donald, A for awareness, V for victor, A for awareness, A for awareness, R for Red flags.

Thank you for listening, lets meet again in session three.

In this very first episode of the Professional Boundaries Podcast, Dr. Wendy McIntosh PhD from Davaar Consultancy shares a short story from her own career and talks about Professional Boundaries and why it’s so important for you to be aware of them when working with clients, customers, patients, and colleagues.

In this episode, Boundary transgressions are explained along with under-involvement and over-involvement and why they matter. Listen as Dr. Wendy begins a discussion on strategies to avoid transgressions and crossings. A conversation that Wendy will continue in the following episodes. Use the links above to subscribe, or click the play button to listen to Episode one.

Ep.2 Definitions and language of Professional Boundaries

There are 6 episodes planned in this first season of the Professional Boundaries Podcast and we hope you’ll be back to enjoy and learn from each of them.

Dr. Wendy McIntosh welcomes both your interest and curiosity. Send Wendy questions at [email protected]

In this podcast series, Dr. Wendy McIntosh PhD shares insights and strategies about developing and maintaining professional boundaries. Professional Boundaries are not limited to the clinical or therapeutic arena. If you are in a professional role – a teacher, support worker, police officer, a prison officer, council worker, hairdresser. If you are a volunteer or belong to a theatre group, a choir, a sports club, there will be something in this podcast for you and the relationships you have with others. Setting boundaries in our life is necessary for our emotional, psychological, spiritual and physical well being. Setting boundaries is about our safety.

Dr. Wendy McIntosh PhD

Since 2005 Wendy has been developing her knowledge and interest in the area of professional boundaries. Wendy delivers workshops on boundaries in Australia (where she now lives) and Internationally when invited to do so. She is continually integrating learning and insights she gains from the work she does in professional boundaries. Wendy comes from a nursing, and predominately psychiatric nursing background. Wendy consistently receives feedback on her passion, knowledge, and creativity as a presenter and facilitator. Enjoy exploring boundaries in this podcast series as Wendy takes you on your own reflective journey on your professional boundaries.

Music from https://filmmusic.io

Professional Boundaries: Your safety, your well-being

In the Professional Boundaries Podcast, Dr. Wendy McIntosh PhD from Davaar Consultancy shares insights and strategies about developing and maintaining professional boundaries. Using examples from her own experience, Wendy will describe and explain Professional Boundaries for anyone in a public-facing job or role.

There are 6 episodes planned in this first season of the Professional Boundaries Podcast and we hope you’ll enjoy and learn from each of them.

Dr. Wendy McIntosh welcomes both your interest, and curiosity. Send Wendy questions at [email protected]

Professional Boundaries are not limited to the clinical or therapeutic arena. If you are in a professional role – a teacher, support worker, police officer, a prison officer, council worker, hairdresser. If you are a volunteer or belong to a theatre group, a choir, a sports club, there will be something in this podcast for you and the relationships you have with others. Setting boundaries in our life is necessary for our emotional, psychological, spiritual and physical well being. Setting boundaries is about our safety.

Since 2005 Wendy has been developing her knowledge and interest in the area of professional boundaries. Wendy delivers workshops on boundaries in Australia (where she now lives) and Internationally when invited to do so. She is continually integrating learning and insights she gains from the work she does in professional boundaries. Wendy comes from a nursing, and predominately psychiatric nursing, background. Wendy consistently receives feedback on her passion, knowledge, and creativity as a presenter and facilitator. Enjoy exploring boundaries in this podcast series as Wendy takes you on your own reflective journey on your professional boundaries.

Music from https://filmmusic.io