I was surprised to find “Good Will Hunting” on our DVD recorded movies list. Apparently my oldest son, Matt recorded it thinking it was about guns. A great movie, and it was the bit at the end that settled an eternal question for me. Matt Damon hugs Robin Williams and says: “Doesn’t this violate the doctor/patient relationship?” and Robin Williams replies, “Only if you grab my arse.”

So, let’s get to the bottom of this once and for all. If it is OK for therapeutic couples to hug, then here are some types of therapy room hugs that might be considered appropriate:

The Stealth Hug: This happened for me about eight years ago. I saw her in the corridor wearing a green jumper and a black pleated skirt and I made a snap decision, so when I got into the room, I launched myself at her. She was quite startled, but put her arms around me and hugged. That, by the way, is the only correct response when a client stealth hugs a therapist. Had she refused, my mortification factor would have been stratospheric and I would have had to leave immediately – never to come back again. When a therapist refuses a client’s stealth hug it can make the client feel contaminated at best and the embodiment of evil at worst.

At my last therapy session my therapist turned into a savage rottweiler; baring her sharp teeth at me, picking me up by the scruff of my neck and shaking the living daylights out of me. The doggone woman deliberately picked a fight about nothing, provoked me into a snarling row, called me a liar and then threatened to sue me for slander.

Interpretation of unfolding events is always a personal perception. I have been seeing her again for some workplace issues that need resolving. I was having problems accepting constructive criticism from the top dog in my organization. I found I was getting deeply triggered when told I was not achieving what I was supposed to achieve in the way she wanted it achieved and I was getting my feathers ruffled in a big way, getting upset, huffy and resolving the issue by fleeing or freezing.

So when within five minutes of arriving, my barking mad therapist activated every button on my panel and almost blew us both up, I almost called her a bitch, walked out the door and planned on brooding, ruminating and plotting impotent revenge against her for the rest of my natural life. Talk about an idealizing transference killer.

Learning how to accept criticism graciously is a form of art, but for me it is a work of art in progress. This is because I was diagnosed with borderline personality disorder and part of that syndrome is being unable to tolerate critical comments, no matter how well-meaning.

So what happens when I get criticized? No matter how mindful my brain wants to be, my body has an anaphylactic reaction. I feel as though someone has thrown acid in my face. I feel my body disintegrating and my internal organs shutting down and psychological and physical death is imminent. Does that sound familiar to you?

This isn’t planned, this isn’t about me being a Drama Queen or a Princess with a slipped tiara; it’s about staying alive. I go into survival mode where I have to sit in a chair, breathe deeply, count my fingers and toes and make sure that I am all here. I have to detoxify my body before I can even start to work out cognitively what was said, why it was said and what the ramifications of the criticism were.

At what point does a therapist decide to terminate a client because their relationship has broken down? Over the past three years writing my blog I have received many emails from therapy clients telling me that their therapists terminated them, either for no reason or for a small infraction within the relationship.

Are therapists being over-sensitive or are clients diagnosed with borderline personality disorder unaware of their own personal lack of empathy towards someone who is on their side? Being terminated for relationship issues with the therapist does not make sense to me. The entire reason we are in therapy is because we have huge external relationship problems and this plays out in the therapeutic relationship and the therapist should be aware of this.

When Borderlines and Narcissists clash, it makes When Worlds Collide look like two butterflies locking wings together in a mid-air prang. As someone diagnosed with Borderline Personality Disorder I had the misfortune to run up against a Narcissistic Personality Disorder and I would describe the experience like running full speed, head first into a brick wall without a helmet.

For me, it is exceedingly rare to come under the microscopic scrutiny of a dangerous and mentally unhinged person who appears to be made out of concrete in such a manner that a nuclear bomb would be unable to dislodge their black and white thinking. For this person it was either night or day, there was no pearly pink twilight or early misty mornings.

This person was highly and appropriately right and I was incredibly stupid and wrong. I know this because it was hammered into my skull at every given opportunity.

The therapy “hour” is anywhere from 45 – 60 minutes, which is clearly not nearly enough time to arrive, get down and get dirty before you have to leave, half way through, without finishing what you started out and feeling like something has not been completed. The therapist might be left gasping and glowing with satisfaction, but essentially if this was sex you’d be faking your orgasm and walking out with your head held high and having to wait till next week when you get to do the same old frustrating exercise all over again.

If the session was 2 hours long, I might start to feel as though the earth had moved for me as well. It would be wonderful if you could just radiate in the afterglow of the warm therapeutic space that had been created by the two of you, but after 45 – 60 minutes it’s time for you to get out still feeling hot and bothered (and for the next client to come in cold) all the time brooding and ruminating that the earth might just move for them in a way it did not for you.

It used to be that if I ever ran into my therapist at a café, at the airport, in a restaurant, or walking down the street, I would have to walk out, catch a different plane, leave my meal or cross the street and get hit by a bus. She once said to me that I would have moved on when I could pass her in public, either wave or not wave, and my care factor would not be there.

So how do I avoid either the impending feeling of doom and chaos or the sheer guilty pleasure and excitement of seeing my therapist outside of therapy for free? I have had a mixed reaction on the handful of occasions I have seen her or her car out in the wide, wide world.

When therapy is over and you are healed to the best of your ability, is it time to mourn or celebrate the end of the therapeutic relationship?

Dear XXXXX,

I thought it was safe to let you know how I was doing. I thought it was safe to email you about what my thoughts were regarding brief psychosis –v- depression (which is something I have finally made sense of and wanted your opinion on because I trusted you). I told you what my current working life was like and I felt as though I got a rubber stamp response because nothing in your email referred specifically to what I had actually said or achieved.

In therapy once, you asked me to always let you know how I was doing because you didn’t want me to move on and disappear out of your therapy life. You also once told me you loved me and trusted me deeply and that you would never abandon me.

With those bold statements comes a considerable amount of post-therapy responsibility to clients, even to the most adjusted but vulnerable client who has left your therapy and your rooms. With that comes a duty of care to accept that sometimes the client who wants to move on feels much dissonance, ambivalence and an overwhelmingly disproportionate sense of obligation and responsibility to her former therapist to keep her informed lest she feels abandoned by her.

Over the years, I’ve been fired, resigned or walked out (before I was pushed) on more jobs than there are symptoms of Borderline Personality Disorder.  I never understood why this was happening to me and I always thought it was the company’s fault, the other employees fault or that the Universe hated me.

There was always a honeymoon period where I fitted in for a couple of months, then came unstuck when the first small drama occurred.  This was always followed by a huge behavioural reaction from me.  I had not learned how to accept the vagaries of how companies operated, the diverse range of personalities concerned and my own borderline reaction to real or perceived workplace situations.  I reacted before I reasoned.