Stirring the Pot: Some Clinical and Ethical Implications of Blurred Boundaries

Over the past 70 years, seminal leaders of group have developed sophisticated and effective theory and technique to help members resolve conflicts about emotional intimacy. However, they seemed to have suffered a blind spot. The premise of this article is that the frame of group treatment is as important as theory and technique in understanding the healing power of analytic group therapy. This is based on the assumption that authentic emotional intimacy is not possible in group therapy, or in real life, for that matter, without emotional separateness. Leaders who blur boundaries, consciously or not, diminish anxiety, but at a high cost. They risk losing leverage in interpreting all members' negative treatment reactions as transference and resistance. Maintaining the frame may shield members from at least seven potential dangers: (a) breaches of confidentiality, (b) dumping, (c) looping, (d) gaslighting, (e) overstimulation, (f) the “Emperor's New Clothes” effect, and (g) scapegoating. The potential danger is that the leader's decision to blur boundaries may interfere with the group's willingness and ability to adhere to the treatment contract, which in group therapy is to put all of one's thoughts and feelings toward the others, and why one feels that way, into words. This problem can be ameliorated if leaders are willing to consider that impasses in blurred boundary environments may be more related to the treatment than had previously been thought.