Lying On The Couch Sparknotes

Lying on the Couch Final Book Report
Stacy Bloch
North Central Technical College
Boundaries and Ethics in the Helping Professions
99VC
Ms. Christina Lucas
May 20, 2018

Lying on the Couch Final Book Report
While reading the book Lying on the Couch by Irvin D. Yalom one would come to realize that there are ethical and legal issues that get in the way of numerous counseling sessions. The novel focuses on the struggles that any therapist can come across while working with their clients. Although with this storyline the boundaries and legal issues may have been taken to the extreme, it strongly depicts what could happen if one would choose to make unethical decisions. One must also have a sense of the true meaning of the counseling sessions

with our clients. Being aware of our own perceptions as well as our clients is one way to have effective counseling session.
Summary
Dr. Trotter who has chosen to confide in Earnest Lash is a psychoanalyst has been involved with the Stanford Hospital Medical Ethic Committee until he decided to have sexual misconduct with a thirty-two-year-old female patient. This behavior had ultimately cost him his career for breaking one of the codes that professional counselors standby, and that it: 1.09(a) Sexual Relationships: (a) Social workers should under no circumstances engage in sexual activities, inappropriate sexual communications through the use of technology or in person, or sexual contact with current clients, whether such contact is consensual or forced (NASW: National Association of Social Worker website, 2018, expression 1.09). This whole situation could have been avoided if he would have chosen to be ethical and follow general guidelines or the counseling profession. Instead he had chosen to tell Ernest Lash, a new an up-coming therapist, “What techniques did I employ? Afraid you missed my point. My technique is to abandon all technique! And I’m not just being smart-assed, Dr. Lash - that’s the first rule of good therapy and that should be your rule too, if you become a therapist” (Yalom, 1996, p. 7). Dr. Trotter was ultimately known for not following the ethical guidelines as well getting caught up in legal issues with the board.
Dr.

Earnest Lash, who is fairly new to counseling and has been working with Justin, who has been talking about leaving his wife, Carol, for many years. Until one day, he goes into Dr. Lash’s office and announces that he is going to take the plunge and leave Carol for another woman. This has Carol questioning what kind of therapy Dr. Lash was doing with Justin as he chose to leave her. Carol has decided to seek out Dr. Lash for counseling in spite and try to gain revenge and Dr. Lash tries a new counseling method which entails telling the client the truth through-out the sessions. While in the process, she attempts to seduce Dr. Lash which in turn he enjoys and engages in conversation about his concerns. There have also been moments where he pays attention to what he wears, exchanging hugs, has sexual dreams about her and looks forward to their meetings. Due to the physical contact with Carol, Dr. Lash had also crossed the boundaries regarding NASW: National Association of Social Worker, 1.10 Physical Contact, “Social workers should not engage in physical contact with clients when there is a possibility of psychological harm to the client as a result of the contact (such as cradling or caressing clients). Social workers who engage in appropriate physical contact with clients are responsible for setting clear, appropriate, and culturally sensitive boundaries that govern such physical contact” (2018). Dr. Lash had inappropriate feelings for Carol which had put him in a difficult position during the counseling

sessions.
Lastly, Marshal Streider was a therapist who was supervising Dr. Lash until he got caught up in his own issues. Marshal was working with a client named Peter Macondo, whom had swindled him into investing in business deals that did not exist. To keep Marshal quiet, he had purchased a Rolex watch and overpaid for services so that he would feel loyal to the whole situation, which had ultimately put him in a tough position. By choosing to invest with Peter, Marshall had broken a code of conduct that one should follow. According to NASW: National Association of Social Worker website, 1.06 Conflicts of Interest (c), “Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries” (2018). Not only was Marshal scammed by Peter once by twice since he set out for revenge due to the money he had lost in the fraudulent investment. For Marshal to be an ethical counselor, he should never have offered to invest in the bike helmet company, which ultimately cost him more money and probably his sanity.
Personal Opinion
While reading the novel I found myself question how many more ethical boundaries that either of the characters could violate and whatever happened to believing in self-care and ethics. According to Corey, Schneider Corey, Corey, & Callanan, “Self-care involves taking adequate care of ourselves so that we are able to implement the moral principles and virtues that are fundamental ethical concepts” (2015, p. 19). Yalom states, “Earnest found himself being attracted to Carol, Earnest had a problem: Carolyn was beginning to arouse him. All his adult life Earnest had felt unattractive to women. All his life he believed he had to work hard, to use his intellect, sensitivity, and charm, to overcome his neardy appearance” (1996, p. 226). During the counseling sessions, Earnest often mentions to Carol that if only they had met under different circumstances he would probably be interested in her. There were also times when Carol acted like his therapist when Earnest was talking about his issues that he has experienced during his lifetime. By having these issues, he has proven that he is unable to provide consistent care for Carol since his personal issues/feelings are getting in the way.
As a professional it is important to be knowledgeable about self-care and how we deal with it daily. In my current position at the prison I must make sure that I am taking care of my own issues either with school, work, or even my personal life to make sure that I do not implement them into my sessions. When working with our clients it should be only about their concerns ad that is all. If we are bringing our own problems into the mix, it could potentially cause harm to our client. As a professional one must be aware of their self to make sure they can effectively work with their clients.
Boundaries
When working with clients it is necessary to maintain clear boundaries so there are no violations during the counseling sessions. A boundary violation is a serious breach that results in harm to clients and is therefore unethical (Corey et al., 2015, p. 260). When I work with clients there have been times when they have either asked for favors, treats, or other special treatment and I have turned them down. After the client has made the request I had a conversation with him/her about why I am unable to do so. As we are faced with uncomfortable issues we as professionals must have the conversation with our clients. Our clients must be are aware that it is not acceptable and if it continues they could be up for a referral to another counselor or professional.
This novel had me sitting back and thinking about all the ways that a counselor could be manipulated into participating in unethical behavior. Every time we meet with a client, we our putting our license on the line so one must be aware of the surroundings as well as the client’s intent. Sometimes we get so caught up in the moment of helping our clients that we can easily slip into situations where the boundaries could be questionable. As a professional one must be aware of the ethical boundaries and codes that protect us while working with our clients.