14. Best Friends Forever
Season 1, Episode 14
Kathryn is back with another bad therapist moment! Today she shares how she handled her son becoming friends with one of her clients, as well as many other ethical dilemmas she navigates while living and working in her rural hometown.
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Episode Transcript - Best Friends Forever
Kathryn Esquer 00:02
Allie, you know, I live and work in a pretty small town, right? And
Allie Joy 00:06
Yes. I love hearing your stories about working and living in your very rural hometown, and how that plays out for you.
Kathryn Esquer 00:13
Well, yes, so I do. It's actually yeah, I do live and work in my rural hometown, I left for about 10 years and came back for many, many reasons. And I'm happy to be here. And so this story is not actually about which I can, I will absolutely share stories on future episodes about how growing up where I work now presents its own unique set of challenges. But this story it actually involves my kids. So I'm super excited to share it with you guys. I hopefully it's relatable, and you get a few laughs along the way. But just a reminder that this episode is for entertainment purposes only, and is not meant to be a substitute for supervision, consultation, ethical guidance, or therapy itself.
Allie Joy 00:56
All right, well, this is episode number 14 of Am I a bad therapist, let's dive right into it.
Kathryn Esquer 01:04
So when I moved back to my small town, I was quite like seven or you know, maybe six or seven months pregnant with my first son. So I move back and join my integrated healthcare practice, which you know, right away, so I joined well, before I had children not well before, couple months before I had children. And it feels like well before children that seems like forever ago, but it wasn't. And so immediately when I started, my hometown does not have a many therapists, counselors or psychologists at all. So it was very quick to fill my caseload and one of my first clients was a, you know, just someone in the community and at a town over for mine who was coming in with some pretty severe depression and suicidal ideation. And so we we really clicked off the bat, we really did good work together, we worked together for several years, actually, I would say about two years. And then we went down to some maintenance, some maintenance schedules. And, you know, when stressors would pop up in this client's life, he would he would come back in for, you know, a couple of sessions in a row. And, you know, just keep that keep that door open. But he was doing really, really well. And I really enjoyed our work together. You know, we don't have favorites, but he was one of my favorites. This all takes a pretty unusual twist in turn, when my toddler son, I enroll him in a gymnastics program at our local Athletic Center. Again, pretty rural hometown, but we do have some neat children's like museums around and we do have some really great children's programming. But there's not a lot of options. And I was really, really thrilled to get into this toddler class that worked with my schedule at a at an athletic center near my house. So we show up, we go in, you know, my son's been a little wild at the moment, and who works at this Athletic Center. But my very, very, very long term patient. And I think I knew I knew he worked at the Athletic Center, but it has several locations. I didn't know exactly what location he was at. And so I was immediately shocked, as I think most of us are when we see our clients in the wild. And I think the clients are equally shocked when they see us in the wild, right?
Allie Joy 04:11
It's like a teacher, you're like, wait, outside of the school, it's like same for the therapist, don't you sleep on your couch. Why are you here?
Kathryn Esquer 04:20
Oh my God, you have a toddler throwing a tantrum I think all mom therapists can relate to that. And so we walk in and obviously, you know, I know how and I have this conversation with all of my clients at the get go just because it is so common to run into them in unexpected settings because it is a small area. And so, you know, I knew and he knew that, you know, I don't acknowledge him. He acknowledges me first. And he says hi. So I say hi back and we go in and do the gymnastics program. No harm no foul, typical, you know, recovered quickly didn't really ruminate on it. Fine dandy moved on with life. And the thing about this gymnastics program is it is a recurring program. So my son goes twice a week for several weeks in a row. And every single time we say hello to my client, or I should say my client says hello to us first. And eventually my son takes a liking to my clients. So he begins to start to ask about Mr. Bill. And what's Mr. Bill doing? And I wonder what Mr. Bill's doing at the Athletic Center. And oh, Mr. Bill, can you come play with me? And Mr. Bill, this and Mr. Bill that and so my son takes this really like my son's actually quite shy. So for him to be like going outside of his comfort zone and like connecting with not a stranger, but someone who's not as familiar with a big like developmental step and attachment step for us as parents. So here I am caught between like my son, who's really taking a liking to Mr. Bill, and Mr. Bill, who's my patient, and it's super awkward.
Allie Joy 05:58
Oh, my gosh, that is, I can't imagine what's going through your mind. And at this point, you were still in that maintenance mode, right? Like you hadn't fully terminated with this client? Is that correct?
Kathryn Esquer 06:10
That is correct. So in this particular client, I would prefer to continue to do maintenance for a multitude of reasons, not close the case. And so this, these interactions began to develop into this, like, deeper, Mr. Bill was responding in like a very supportive, friendly way where he wasn't like, you know, get away from the kid or don't talk to me, he was engaging with my son, too. And so this like, relationship between my patient and my son began to develop in between our maintenance appointments. So I didn't couldn't be like, address it in session with him, because he didn't have an appointment coming up, I didn't feel like it was that detrimental to call him and reach out to him in between the sessions. So here, I think I was the most uncomfortable out of every other three of us involved. Because here, Mr. Bell is working at an athletic center, which has lots of kids programming, and my son who's like making a new friend and like, they were fine with it, I was the one weirded out and getting uncomfortable with it. It was, it was, you know, very, very interesting to have to interact with my patient who I know, for a very long time on a very deep level. And, you know, we have a really solid rapport, but not let on that we have that solid rapport, because there's also other families coming in and checking into the athletics program. And, you know, letting my son like, you know, talk to him and engage with him. Like he engages with the other kids. It was a very, you know, interesting situation to have to be in for that, that period of time in between our next appointment.
Allie Joy 07:49
Yeah, I can imagine and were you always doing pickup and drop off or staying for the duration? Was it always you?
Kathryn Esquer 07:56
It was always no, I should say my husband absolutely participated in pickup drop off, but we always picked up drop off, we didn't stay. So, but my son, you know, came to nope, that's actually really great point, my son introduced my husband, to my patient to Mr. Bill. And so, you know, it went in one ear and out the other with my husband. Um, but to me, it was like this very big thing that like, my son has a relationship with my patient to my husband. To my husband, it was just Oh, our son, you know, says hi to this, these people at gymnastics class. It wasn't a big deal to my husband. And I also didn't really want to or could reveal it to my husband because you know, this particular patients member of the community, there is that dual relationship already there. So I couldn't even talk about my discomfort or like my awkwardness to my own husband walking in and out of, you know, gymnastics pickup and drop off.
Allie Joy 09:26
Yes, that was what I was wondering if you know your husband, because obviously, you know, we can't and this is like one of those tricky situations as therapists is to protect HIPAA and client confidentiality. I feel like to a non therapist, I wonder what they would think about this, but like, it's our responsibility, but it's like, you can't even tell your husband that your son is forming this relationship with a client and then my mind of course, you know, I love the hypotheticals I'm like, Oh my gosh, what if they started to connect and what if he was like, oh, cool, like Mr. Bill is great. How are you and like, oh my gosh, my mind is just like rolling with the possibilities.
Kathryn Esquer 10:03
So we will get into that in another episode, a situation like that did happen. And I need to think through that one to be able to share it. Of course, yes, there is living and working in a small town, there is there are many overlapping relationships, and I call them overlapping. Because they don't necessarily put me in an in a push pull situation with my client or with someone connected to me, they really are just relationships that overlap. And there's awareness of that, that makes it extremely uncomfortable for me. And it was, you know, I did consider talking to my husband about it in a vague way that, you know, didn't necessarily reveal the patient's identity, but releasing like some discomfort around something at a gymnastics class. And there was no way I was also going to cancel this gymnastics class, because my son loved it, it was the only one in the area, it worked with my schedule. And so I did think about like, how to mitigate it. And I think it really just came back to my discomfort, my discomfort is well worth protecting the patient's confidentiality, really all the consequence was was my discomfort, there were no other major consequences that I could foresee or that were happening, other than me being awkward. And so I said, you know, I can deal with this awkwardness, protect confidentiality, and for my son to have a good class, this is something I can manage as a practicing therapist in a small town.
Allie Joy 11:31
Yeah, of course. So what happened in the next session with Mr. Bill?
Kathryn Esquer 11:39
So Mr. Bill, at this point, has seen me and my son and my husband out in public. Well, should I say at his employer like, many dozens of times at this point, so we've had many public interactions in between our sessions. And so at the next session, we obviously talked about, I think, I should say, maybe like a year prior, we did talk about the possibility of running into each other in public or specifically at his employer, because it was like a community spot. And so you know, I address Hey, that thing we talked about, like is happening and like, how are you feeling about it, I kind of just left it open. And, you know, he, we had a really great discussion about like, the seen each other in public and our own like transference and countertransference. How, like, I at times, like, enjoyed it, seeing that he was well, and seeing him at his employer, you know, succeeding and thriving in life, which was the different place that when I first met him, and how enjoyable that was for me, and, you know, and he shared that he was not uncomfortable, and that it is, you know, you know, a normal part of having dual relationships, or seeing people who knows at his employer. And so it was an open conversation, although I don't think that he really fully understood the magnitude of it, and how difficult it was, it's different than seeing, you know, your, your grade school, your former grade school teacher at your employer, like there's no confidentiality there. So it's, it's, it's a little bit different. So I think it was a minimal thing to him. But it was a very big thing to me. And so that definitely showed up in our conversation.
Allie Joy 13:26
Yeah, of course. Now, how was it for you? I'm curious, like your thoughts and experiences, because I think I've had everything back to how I have felt like maybe where you run into somebody. And I imagine as a mother, were you thinking like, How do I look as a professional? How do I look as a human? How do I look as a mom, but I'm this person therapists like what was your personal and, like, professional balance that was running through your mind with this?
Kathryn Esquer 13:52
That is an excellent question. And that is part of what came up in our in our touch base session together, which was, you know, hey, like, I sometimes drop off my kid in like yoga pants or sweatpants, or sandals that are inappropriate for the weather, because I'm running out the door. You know, and I did say, I was like, Do you have you had any thoughts or reactions to see me and how I interact outside of the therapy room? You know, you know, you know, what car I drive now, like, did you have any reaction to the fact that I drive a 2009 really old car, like, what are your thoughts about that, you know, and he, you know, really did not share much other than, you know, like, I noticed it and, you know, I just, it's really neat to see you as like a regular person outside of here with a family. And it is something that I think, again, was not a big as big a deal. And I think they're thinking back to a former supervisor. I have my former supervisor, if I were to be sharing the story would be like, No, he totally thought it was a big deal. You need to dig deeper. So I didn't dig necessarily as deep as maybe I should have. But it is something that during every touch base session, I do bring up and I asked if there's anything that came up for him about our work together or about me or our relationship in between the sessions. Yeah. And I trust I trust him to be able to bring up relevant, relevant reactions and topics, but I absolutely thought of, oh my gosh, how am I presenting as a person as a mother, thankfully, my son is somewhat well behaved at times, and, and there's also other kids around having meltdowns. So it was a normal part. But, you know, I definitely thought about how do I look as a person to him as his professional, right? As I coming flustered juggling things, not having my shit together? How does that look? And it was a neat conversation again, I think I felt I had bigger feelings about it than he did.
Allie Joy 16:00
Yeah, of course. And I feel like that makes so much sense I think about when I have maybe bumped into somebody like a client in public. And same thing, like maybe if you're running out really quick, your hair's a mess, like outfits like cozy comfy, you know, not the professional book that they're used to like, again, I think that's more of our internal stuff. But it is important to explore. But I know when I think back to interactions like that, I would imagine high 90% and above is like just my own stuff, like rolling through my head of like, oh, my gosh, my hair, I didn't wash it in three days, or this or that, or all those things.
Kathryn Esquer 16:36
Absolutely. And I think, you know, this is something that we can all relate to. And then when our family members getting involved, it just complicates things it makes an honestly, in this particular situation, I was really grateful to have such a good group of peers to consult with, because it was super isolating. I couldn't, you know, I couldn't talk to my family about it, who was there when I was coming home from drop off and pick up at the gymnastics center. And you know, I didn't really have anyone else to consult with other than peers who are in the field who kind of get what this is like for us. And it was, I was really grateful to not have not feel as isolated as I did during the pandemic when, when this occurred.
Allie Joy 17:23
Yeah, that was my next question. Because you had said, you know, we know you couldn't talk to your husband about it. It's funny, though, because then the network, I know, we've seen this topic come from other therapists who even work in larger communities, but somehow it feels very small, where you run into people. I know, so many people can relate to this small or large community, and it's so valuable to share. And it's valuable to have that peer support. Like you're saying, too, because we can't really share these things with our friends and our family. So I'm glad you had the peer support.
Kathryn Esquer 17:54
Absolutely. And I'm also glad that this was a situation where I wasn't, I also think about the what ifs the hypotheticals. What if I was uncomfortable? Or what if I didn't feel as trusting with a former or current client supervising or being around my kid? Like, what would I what would I do that or what would I feel if I didn't want my son to be interacting with with a former or current client, you know, and I'm really grateful that this is a situation that was fairly easy to navigate even given the this was this was a straight up dual relationships. But you know, I think about that, and I'm sure it will come up, I'm sure sure. Sure. It will come off in my work. I love serving my community, and I don't plan to stop. And I also don't plan to stop to limit my life and what my kids choose to engage in. So I'm just waiting for that. And then I'm sure we'll have another episode.
Allie Joy 18:46
Yeah, well, that is something that I even think about myself, like I share all the time. You know, I work with a lot of college students and young adults. And something that comes up for me is you know, we talk about music a lot in sessions, things like that my husband and I love to go to shows now that the world's a little bit more open. And I there's a show coming up pretty local, for this band that I know two of my clients love. And my husband's like, we should buy tickets to this concert, we should go. And in my head, I couldn't help but be like, Okay, this is a really small venue, are they gonna go and it's like, you don't want to limit your life, but you don't want to be uncomfortable and you don't want your clients to be uncomfortable. And I feel like we get in that really gray area and that sticky situation. And then there's been situations to where a client will come back and be like, Oh, I went to the show this weekend and I'm like, oh my god we almost bought tickets to go to that like it's so it's you don't want to put the brakes on your own life. It's this is a it's very tricky to navigate. I think for us as therapists and I know other people have stories they can share and if you're a listener send in the application we want to hear about it and how you navigated it because it is so tricky.
Kathryn Esquer 19:52
Oh my gosh, I think we could have a whole podcast just the whole podcast not just episode an entire podcast unjust all relationships are overlapping relationships. Absolutely. If you've story, please join us on the show. Um, you know, to talk about more what you what you were, like referencing Allie about how, you know, we don't want to live in our lives, we don't want to be uncomfortable. We also don't want to make our patients or any get I used to turn patients because they come from integrated primary care or clients uncomfortable. But you know, the thing that I sit with is there are seven, is it worth the discomfort is is the event or the class or the situation worth discomfort? And there's so much like it's not an out black or white? Like, yes, this concert is worth the discomfort. Well, how much discomfort Are you going to have if client a shows up versus client B? Right? So you have to consider like the discomfort of the particular situation with a particular client with a particular joy it's bringing or benefit it's bringing into your life. And so for me, it's like in my community, it's a constant evaluation of is the situation is the disc? Is my discomfort worth it? Is are there implicate? Obviously, are there implications to the client? If there aren't any, if the only implication is my discomfort? Is that worth it? And you know, sometimes it's no, like, I think if I were I do not enjoy working out. So I think if I were in a workout class with a client, I would leave because it's not worth it, because I gotta go. But if it is a concert that I had been waiting all year for, or since the pandemic, that might be worth a discomfort to me, and it might not be to you at all, I think it all depends. It's the best therapist answer there is.
Allie Joy 21:38
Yep, case by case basis. Of course, so Kathryn, and I know we kind of touched upon it, but what would you say to someone who was experiencing something similar? Or even like we chatted about? If they're anticipating any, you know, dual relationships or things like that? What advice would you give?
Kathryn Esquer 21:55
I think I'm gonna give a very specific piece of advice, or at least thoughts to think about, about if you're thinking about serving a community that you are close to whether you're in this community, and this could be a sub community within a larger city, within a larger town, or for me, it's my specific geographical town, my commute my actual community. And I would say, you know, yes, obviously, we need to consider dual relationships and minimize the implications in our clinical work and absolutely prevent harm to the client that might come from dual relationships. But I also don't think dual relationships. I think I think there's benefits to be better, you can bring a lot of benefit to the community that you're serving, if you are close to it. And so really now entire communities or populations, just because you're a member of them, I think is not doing not doing the ethical navigation justice, I think you should really think about, you know, the the nuances and see if there is a way for you to carve out a niche or carve out a service that minimizes doesn't cause harm to clients, and allows you to bring your unique perspective of being a close member or an adjacent member of this community. serving them, I think you can bring a lot of good to that community being so close to it. I don't know I was a little bit of a tangent. I don't know if that makes sense. But I guess more along lines of have an open mind when thinking about serving communities that you're close to, and take it as a case by case basis. Absolutely seek consultation, but don't write it off. seek consultation is the best way to be able to navigate it. And those gray areas and talk to your client about it.
Allie Joy 23:36
Of course, well as always sound advice and I'm glad we could hear another of your bad therapist stories. As we've shared, we both have a list going of our stories that we will continue to share as we go through the podcast and thank you everyone for listening again. Thank you, Kathtyn for sharing.
Kathryn Esquer 23:52
Absolutely. We'll see you next week.