How to have boundaries when socialising as a mental health professional

by Dr Marianne Trent, Clinical Psychologist

Welcome along to the Aspiring psychologist blog. This post is an adaptation of episode 37 of The Aspiring Psychologist Podcast.

I recorded this during the school summer holidays, and my children had just gone to the park with daddy. I had to go to the dentist shortly. So, I had time to record this podcast episode that had been floating around in my head for a few days. So here I am. Where are you? I hope you are living your best life right now. And if not, you have plans to unwind and de-stress and make yourself feel much better.

Something that can make us feel better, or sometimes make us feel worse, is socialising and getting out and about. You will know whether that is a good thing for you. You will know whether that makes you feel a bit uncomfortable and not entirely like you are thriving. We are all different.

“The pandemic showed us that sometimes stepping back from social pressures can be a good thing, but other times it makes us feel like we are not really connecting to people if we are not meeting people and getting out and about. For some people, zoom just does not cut it.”

And like I said, you will know where you are at on that. I am very much looking forward to this coming Friday when I'm going to be meeting up with one of my very loveliest friends who I actually trained with, and then life and children have somewhat got in our way, and also the pandemic. But we are going out for dinner this coming weekend, and I cannot wait.

Do not underestimate the value of having things to look forward to and things to be excited about. My sister-in-law uses her fridge as a method of helping her feel really excited about life. She likes to have a little list of things she has booked. Once that list starts looking a little bit light, she makes sure she books new things to be mindfully excited about them in advance. Every time she opens or closes the fridge! That might be a little technique that you find helpful. It is like having a dream board, isn't it? But for her, it is on the fridge, and it is definitely going to happen. You could put things that you dream about as well. You could well set your goals for psychology on there so that you see it day in, day out, and it becomes part of your daily fabric.

“Anyway, this is my roundabout waffle for helping us get on track with thinking about being social and being a psychologist. How does that work for you? Do you tell people what you do for work?”

Do you tell people if you are working in mental health or if you are working in education? If you work in forensic services, how does it make you feel when you share this with others? Does it make you feel exposed, or does it make you feel good? Do you like being the garden party psychologist? Do you like having people ask your opinion and helping them feel different or better about things? Or are you finding that you welcome complicated questions you would rather not answer when you mention your job? Maybe you are finding that your viewpoint is very different from the perspectives of people you are socialising with. Perhaps in your culture or friendships, there is not much of an understanding of mental health. Maybe there is a ‘pull up your socks and get on with it’ kind of mentality. Maybe there is just a lot of stigma, shame, and guilt-inducing stuff around people who need your service. Maybe people are even shaming.

“You might think you ought to be the service user, not the person offering the services.”

Maybe other people find it hard to take you seriously as a grown-up offering useful stuff. Perhaps you find it difficult to take yourself seriously in that regard.

As an Assistant Psychologist, I did not feel like me on paper. My life looked as professional as I wanted. I had been given the level of responsibility I wanted in my job. So, with the things that myself and my friends got up to at the weekends - Laura, I am thinking about that trip to The Bradlaugh!' There was definitely a sense of life mismatch. I was doing really important stuff. But I absolutely treat all of those escapades as being really important, fun, and part of what has led me to be this qualified psychologist before you. That was the case during training as well. When I first moved for training, I was just renting a room from one of my brother's friends. It just did not feel like I was a proper enough grown-up. Actually, when I moved out the next year and got my own place, it felt much more holistic as a grown-up experience. If that even makes sense, I felt like I needed to have all of my ducks in a row.

This episode was inspired by the recent news about SSRI medication and depression. A number of my audience have found that people taking the medication are reaching out to their friends, i.e., maybe you as the most senior kind of mental health professional that they know. It is important for us to think about the impact this can have on ourselves and the weight of responsibility we carry in our roles. This is also linked to episode 36 of the podcast with Dr. Tara. We discussed what it even means to call yourself a psychologist, who should be using this title, and whether it necessarily infers a professionally trained qualification.

People who trust you in your friendships or family might well seek your opinion on this kind of issue. People are wondering whether they should continue to take their medication after what has been in the news, and it is complicated. It would be good if they gave us a heads up that this was coming out because it obviously sends patients, friends, and family into turmoil. It can bring up all sorts of complicated feelings. Have I been misled? Is it just me then? So, if it is not a chemical imbalance in my brain, am I broken? Am I the problem? Should I be feeling responsible? There might be guilt and shame.

“If you are having these conversations, it is always really useful to direct people back to their GP or whoever is prescribing that medication.”

It might be that their medication is prescribed by an adult mental health team or a children and adolescent mental health team. These questions must be directed back toward those healthcare providers. It may be helpful to suggest that you do not know much more than what is in the press and that your take on medication, diagnosis and presenting problems is based on several bespoke factors like formulations around the person. As you do not have privy to all of that history, it is not appropriate for you to be the person to advise them. So, you can talk through options.

“You may not choose to! You might not want that in your life. You might want to be your friend's friend. You might not want to be your friend's sounding board for mental health. And that has to be okay.”

Otherwise, what might happen is that you are holding a caseload of everybody in your work environment, but you are also carrying a separate caseload of your friends, family, and random people you meet along the way. Of course, you would not be supervised for those impactful relationships, nor would you be insured if they took advice based on your discussion. So, I think it is absolutely important to recognise that you can say no. You are not being cruel. If you do refuse to comment or suggest that you are not the most appropriate person to comment. That's absolutely okay. It is good to talk through things with someone that is impartial. You will not be impartial toward a member of your friends, family, or even a colleague, because you will have history with those people and be invested in the outcome. Whereas you know, a therapist or a GP is more removed and able to be just there for the person to hear them with any luck. So, I am absolutely not suggesting that you could not do it, but it is whether you should do it and whether it is kind to you and the client to do that.

“You could recognise with them that you can see that this is causing them some distress and that it's okay to reach out for support and advice in times like this, that it does not say anything bad about them if they do and that you would encourage them to do that. It is really important to be able to have these open, honest communications.”

It can be difficult before you are qualified. Although you might feel that you have a professional opinion, it is important to consider whether it is appropriate to share it with people. I have absolutely been at parties when I have had a couple of glasses of wine and people ask me questions. It has been like being on the therapy couch with Dr. Trent, and it is not that appropriate, is it? But people have said to me how much they valued those chats and that it was any conversations they had with anyone else.

It is not always about therapy. People may sometimes value my stance on the world; it is just thinking about what is appropriate. What is professional? What is within your current qualification realm? We do not want to be a total renegade punting out advice left, right and center. Possibly for people who have not even asked for it.

When I am working with clients and looking at the window of tolerance, they notice when they start to feel better because they start to notice how unregulated the world is. They find themselves wanting to soothe and regulate the world.

“It would not be appropriate to walk up to a stranger and tell them that they are outside their window of tolerance. They have not asked you for that help.”

Sometimes the power of being qualified or experienced in mental health is that we can observe what might be needed in the future, but it does not necessarily need to be us who says that at this moment.

People are not necessarily going to know the difference between your job titles: Psychological Wellbeing Practitioner, Assistant Psychologist, Higher Assistant Psychologists, Mental Health Support Worker, Trainee Clinical Psychologist, or Trainee Health or Counselling Psychologist. People might just hear the word psychological, mental health, or psychologist. They know you have been to uni and think that you must know your stuff. They do not know that you are perhaps not the most appropriate or experienced person they could ask.

I would love your thoughts on all of this. I would love to know what you do when you are asked for your opinion, whether people do ask or whether you tell people that you work in a supermarket! When you meet strangers, do you tell them what you do? Let's have a conversation about this. Come and join me on my socials! Come and join the free Facebook group, The Aspiring Psychologist Community, and join in the conversation around this so that we can really make sure we are thickening the narrative here.

You might also find that people find you online and connect with you. They sense that you are a great listener, and before you know it you are drowning in life stories that can feel quite heavy or unwelcome.

“You might feel like you only wanted to come to the party and drink mojitos! Not be therapising. Again, that is okay.”

You might find that people see the word psychologist in your title online and ask you to get involved with different things! Could you talk about this? Could you do that? Maybe you do not feel that comfortable with it. Maybe you feel it is inappropriate for you to be offering that. It is okay to say no and to direct people to other areas of support, other people that might be able to support. You are not mean for being boundaried. It might be helpful for you to refresh your memory of episode eight of the podcast, where we discussed boundary setting for yourself and your clients. Speaking of boundaries, my friends it is time that I get out of my jogging bottoms and into my jeans to go and see the dentist.

I hope you found this helpful, and I would really love your ideas on what you might do in these situations. What do you think? What are your thoughts? Do you come and discuss this with me over on the Facebook group, The Aspiring Psychologist Community with Dr. Marianne Trent. That is where lots of good stuff happens. It is totally free to join. So, come and do that, won't you? In the meantime, do come and connect in all the good places through my linktree.

Thank you for reading and thank you for being part of my world.

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