Episode 27: Detanging the Self: Implications of Practitioner-Client Enmeshment

Kayla: Welcome back to your Clinical Supervisors Coach podcast, and I’m your host, Kayla Das.

In today’s episode, Haley Moore, registered social worker and clinical supervisor will share the implications of practitioner-client enmeshment in therapy.

Hi, Haley. Welcome back to the show. It’s so great to have you here again.

Haley: so glad to be here, Kayla. Thank you for having me on again.

Kayla: So Haley was here just over a month ago to discuss how to manage imposter syndrome in practice. It was such a great conversation. It was Episode 24: Confidence versus Confidence Managing Imposter Syndrome in your practice. If you haven’t already listened to that episode. Head back after you finish this episode and take a listen.

I know regardless of which stage you are in practice, self-doubt of feelings of imposter can certainly show up for many of us, and Haley provides some really great tips for managing it.

So Haley, for any listener who hasn’t listened or heard your last episode, please introduce yourself and tell us a little bit about your practice and clinical supervision journey.

Haley: Absolutely. Thanks Kayla. I’m a registered social worker living in Toronto and working with clients across Ontario. I started my private practice as a solo practice in 2021, and have expanded to a group practice in 2023. I have been a clinical supervisor for the last few years and discovered a new passion in teaching the thing I love to do, which is working with clients.

Our clinic helps adults through individual therapy, couples therapy, group therapy and workshops, life coaching services. And I’m really excited to continue to grow our capacity to support others moving forward.

Kayla: So first of all, what is enmeshment and how can enmeshment present in a therapeutic relationship? In other words, how would a therapist know that they are enmeshed with a client?

Haley: Absolutely. So enmeshment involves the clinician’s sense of self being combined with the clients. It’s no longer that separate identity as an onlooker or a helper, a guide, but they feel actually actively a part of the client’s experience.

So, of course, we know that empathy and attunement are essential and needed to be a compassionate and caring therapist, but enmeshment becomes confusing and dangerous to the client and the clinicians while being, and the therapeutic alliance itself.

So we are supposed to be attuned to our client’s experiences and their emotions, and we are supposed to have empathy towards their struggle. This is what makes us good at what we do, but it actually crosses a line when we start to feel like we are a part of the client’s experience. This blurring of boundaries and clarity in their emotional experience versus our own can really cross some professional boundaries as well as violate the client’s rights to have ethical and compassionate care.

So enmeshment is different than countertransference in that. Countertransference happens when a therapist unconsciously experiences emotional responses to their client’s story or their experience. And this usually is relating to their own unresolved struggles or their history.

This is different than enmeshment. In that enmeshment is usually a change in the therapist’s behavior. Either they blur boundaries, maybe they reach out to a client after a session when they normally wouldn’t do that, or they feel excessively responsible for that client’s wellbeing. Maybe they reach out and give a personal referral to somebody else, or they help that client find a new gym. These extra little steps that they wouldn’t normally do for clients that really do cross boundaries and they may have difficulty separating themselves and their experience from that of their clients. It feels like they are actually a part of the client’s journey with them. Again, not as that helper or onlooker, but actually as a part of the process.

So how do you actually know if you’re in mesh with a client?

So as a therapist, of course you do care about your clients. It’s part of our job to really, truly care about our clients and their wellbeing. That’s a part of what makes us good at what we do. But it’s again, that difference between caring and feeling like we’re doing favors for the clients. We’re treating them differently.

A great example of this is if you have one client that texts you often between sessions and you respond to them. Could you do that for every one of your clients? And if the answer is no, and the answer is no, I don’t do that, and no, I could not possibly do that, then you’re probably crossing some boundaries. And that might indicate that you’re a bit enmeshed with that person.

You might feel personally attached to their wins and losses to a greater degree than you normally do. And it’s normal to feel emotions when a client tells you that they’ve had a tough day or that they’re going through a tough time, or they’ve had a traumatic experience, that’s human. But when you over identify with a client’s story and blur their experience with that of their own, and you may have actually find it difficult to stay neutral or objective, that’s when you might be becoming overly involved and invested and enmeshed with your client’s experience.

You might find yourself thinking about this client frequently between sessions or yet you might have a over pronounced fear of the client terminating therapy. Which actually can impact the session. If you don’t want to confront the client and give them the feedback that they deserve because you’re afraid they might leave you, that is actually going to impact what you do with them.

Another great example of enmeshment can be when you blur that boundary and give a client extra time in sessions or give them a lower fee that you give others clients. And again, a really great question, we’ll talk about this more in a little bit, but how would I be able to do this for all clients? And if I can’t, then I probably shouldn’t be.

Kayla: That’s a really important statement to reflect on for us in our practice, and I talk about that more from a business perspective. When we think of specifically sliding scales, I’ve heard a lot of therapists want to give sliding scales in their private practice, and there’s nothing wrong with doing that at all.

However, would you give all of your clients that same access?

So usually, I tell people from like a business perspective, it’s better to say you have five available spots and then once they’re full, you don’t give anyone else outside of that five spots. When those five spots clear up, you can put more clients in them.

However, when we start saying, okay, well I’m going to give Johnny a discount, but I’m not going to give Jimmy a discount. It’s like, okay, like how is this fair? And like how are we balancing who is deserving of which. And again, is it based on I like this client more. This client I feel deserves it more? Maybe the other client also needs it, but just hasn’t really verbalized it.

Haley: Yeah, exactly. And I agree with you, Kayla. And that’s actually part of the reason why I created an affordable therapy program through my practice, because it was getting complicated for me. I did feel this pull to give everyone a cheaper rate, but then why do I have my rate set as it is? And that’s something a little bit different than enmeshment. That’s actually more of a business value system of what is my time worth and all of those things.

But it is really an important topic. Why do I choose this client over that client? And if I don’t have a system in place, like you said, five clients, or I can have this amount per month, or whatever it is that we do, if we don’t have a system in place, we’re more likely to fall into that empathy trap where we want to give more clients than we should, that experience of having a sliding scale. So I agree with you there. Yeah.

Kayla: So why does enmeshment happen when working with clients?

Haley: So the first piece of it is that therapists are usually pretty attuned and empathetic by nature, which makes them susceptible to feeling things deeply at a baseline, right? I’m sure we all have an experience of having a friend in a different field or a different expertise that they just don’t feel things as deeply as we do, and we’re often confused like, wait, you didn’t feel this huge intense emotion when something came up?

So we have to understand that humans as a whole interpret their environment via their own experience. It’s only natural to interpret your world based on the parameters that you have to go by. And therapists are no different. Our training allows us to keep that distance, but our nature as humans will always be just under the surface.

So because of this background, we often do have this underlying capacity to become enmeshed with a client to just care, like quote, unquote, too much. And we often bring our own baggage to sessions. You often don’t become a therapist because you’ve had a perfect life. We get into this field because we want to help someone, usually because we would’ve either wanted that help ourselves or because we had that help from somebody and knew how important it was. So when we bring that baggage with us, it occasionally does fall in line with a client’s experience as well, or a client’s emotional experience, even if it’s not the same kind of situation that we’ve been through ourselves. And this overlap can be really useful in sessions if you navigate with intention and ethics at the forefront.

But what can happen is that if a therapist hasn’t already processed and healed from their own trauma. Or they feel really connected to this client for some other reason. It may come to surface in a session with a client. So for example, if you have a child around the same age as that client that you’re seeing and your child is at the forefront of your mind and you’re thinking about your child experiencing the thing that your client is experiencing right now. The likelihood of you swooping in as mama bear and wanting to protect that client is way stronger than if you don’t have a child the same age, or you haven’t had a similar experience of worrying about that kind of experience for someone you love.

So those kind of things are natural and normal. Of course, we relate things to ourselves and that is how we understand the world. But because client relationships are inherently so intimate and emotional, we want to make sure that we don’t overstep. So something that is really important for us to understand is that countertransference is an unconscious experience until it becomes conscious. And this is where we come back into clinical supervision and reflection and all of those good things. But if we don’t notice, it’s really easy for our smart brains to convince ourselves that we’re just doing this extra favor for our client one time because they’re struggling and it isn’t a big deal. But when we cross that boundary again, and again, and again, these super intimate and close relationships can just become inappropriate. And when we have inappropriate relationships, the likelihood of our clients actually not benefiting from this anymore and actually being harmed by it is actually pretty big.

Kayla: You know, I appreciate that. And I just want to go back to the example we talked about earlier, just because it, it’s kind of relevant here, is when we think about, say, sliding scales, how would you feel if Johnny went out into the waiting room and told Jimmy that he’s getting a sliding scale? And then Jimmy comes in and says, how come he gets a slightest scale? And I don’t. Do you have an answer to that?

I mean, obviously there’s confidentiality, but the point is can you actually answer that if someone asked. I mean, if you have a system, you’re like, yeah, well I have five spots and they’re full, right? That’s your answer. If your answer is, I don’t have an answer, then it might not necessarily be helpful.

Haley: Yeah, and I think it’s actually important to think about it in the reverse too. So if Jimmy and Johnny, and I can’t remember which one was which, but if they are friends outside or they meet each other in the waiting room and become friends and one person realizes that they’re getting lower fee and the other person is paying a higher fee, they actually might feel. They are being treated differently in a bad way, right? Like, I’m actually less than, and that’s why I need this help and this person doesn’t need it, right? There’s so many complex pieces here, and you’re right. If you have a system to fall back on of, I have five clients, they’re all full. Or I put my fees up on January 1st and this client started afterwards and this client started beforehand. If you don’t have those easy answers, clients start to ask if it is personal and they have an intimate, close relationship with us as their therapist. So it’s only normal for them to start to wonder if there is something that they’re doing or something about them that makes them different than another client of yours.

Kayla: Absolutely, and I just think of if I went to a dentist and found out I was paying more than another client, I would be pretty upset and probably would not go back to that dentist.

Haley: Yeah, exactly. Absolutely. Why would you’d want to go elsewhere, for sure. Yeah. Good example.

Kayla: So what are the impacts on clients and the practitioner, if a practitioner becomes enmeshed with a client?

Haley: So I think that the most important thing for us to focus on when we think about being in mesh with clients is that we might lose sight of our client’s goals and replace them with our own goals for that client. So, for example, if a client comes in because they really want to work on gaining confidence at work, but we realize their relationship with their mother is just way too close to home, and we really want to help them have a better relationship with their mother. I think it’s really important for us to make sure that the reason that they’re coming to us is actually upheld and that we’re focusing on what’s best for them based on what they think is best for them too.

And of course, as clinicians, we always have our own opinions and our own clinical interpretations of what we think the clients may benefit from. But unless it’s a collaborative agreement, it’s actually really inappropriate for us to impose our own goals on that client.

Now an impact for us as practitioners and as the clients as well, is that if we are overinvesting in a client and we’re crossing those boundaries, maybe we’re texting them on the weekends or answering their calls after hours. This can build expectation that might not be able to be upkept, and this could actually hurt the client and disappoint them in the future, but it also could make us feel like we need to upkeep this kind of standard and that becomes impossible. Burnout and compassion fatigue are really likely when we continue to feel enmeshed and we continue to cross boundaries for clients over time.

Now, coming back to the client impact here, clients come to us for various reasons, but one common reason is that they grew up in families that had poor boundaries. And then if we are also having poor boundaries, this reinforces that boundaries aren’t necessary. How are clients supposed to learn from us if we can’t actually heal their history of having poor boundary use?

Boundaries are essential to client growth, and they actually need us to model them as much as we possibly can so that they can apply it to their lives, especially if they didn’t have caregivers growing up that could model that for them. So if you’re taking charge of a client’s experience and healing, they are no longer the empowered one in their journey.

They’re no longer the one that is feeling like they can do it. They actually rely on you more and more, the more that you are over involved or enmeshed. This can lead to improper or even unethical behavior. And once you cross a line, it’s really hard to uncross it. It’s really hard to make a client feel special and entitled to more of your time, energy, and attention, and then take it back. So if we actually want to continue to have effective care for our clients, we need to make sure that we’re supporting them and reaching their goals, not just our own.

Now, again, coming back to what the practitioner might feel here, is that if you’re in meshed with your clients, their wins may feel like your wins, but their losses also feel like yours. This can lead to you really feeling incapable or incompetent in being a caregiver for them when you feel so closely connected to their failures. Now, of course we do have regulatory bodies and colleges in place to protect the clients for a reason. And it’s really important to adhere to those things.

But these are super intimate relationships and it’s natural and normal for humans to want to connect in order to survive. But when you’re crossing these boundaries, it may also lead to you crossing even more. So maybe you want to tell a client about your experience because it’s so similar to what they’re going through and it might just be so helpful. That’s where you really need to step back for a minute and see, am I sharing this because the client would benefit from knowing this information? Or am I sharing it because I want to be held by the client? I want them to know more about me. I want them to understand me, who is actually going to benefit here?

Kayla: That’s a really good point. So, if a listener is listening to this episode and they’re like, uh oh, I think I may have become enmeshed with a client, what can they do to manage or mitigate the enmeshment that has occurred?

Haley: So I think being that we are on Your Clinical Supervisor’s Couch podcast, I think that the first thing to say is seek supervision. Get to your supervisor’s opinion on how you can move forward in a specific situation. I know we’ve given a couple examples of enmeshment and how it can come up, but there’s tons and tons of ways that we can get triggered and enmeshed and entangled with a client, and it can be really meaningful to have a supervisor’s oversight into your process of figuring out what that means to you and what you need to do moving forward.

Now, if you don’t have access to a clinical supervisor right now and you really want to work through this, I do have a couple pieces of advice that might be helpful. So the first is, as a therapist, I believe that all therapists should know what are your triggers? What are the things that set you off, the things that you have as unresolved, the values that are really important to you that keep getting brought up in session, right?

Like, what are the things that are going to set you off your therapist rocker and into client seat, right? So if you know these triggers for yourself, you’re more likely to be able to respond to them in appropriate ways, like seeking out your own therapy. Or doing journaling or whatever your process is, and actually be more aware when they do come up in a client session that you have to be more guarded.

Okay? So you also need to reflect on what you think this client situation means about you as a therapist and as a person. So for example, if a client is going through something difficult that you’ve been through, and you are able to triumph above it, and you want them to know how good you are because you triumphed above it, right?

That’s your own stuff. And if they don’t know it, it’s probably because. That’s your own stuff, and it actually reflects where you are on your healing journey. So maybe it’s actually that you’re not quite healed and you need to prove to other people that you’re healed in this way. And that’s, again, pointing back to your own stuff.

So when you’re able to rebuild your boundaries and understand what an appropriate alliance is between you and your client, you have to actually know what things are really needed to be put in place for you. For example, I won’t answer calls between sessions. I don’t follow any clients on social media.

A clinical supervisor can really support you in creating these rules and boundaries, but these are really, really important. But they’re across the board for every single client because we want to be professional. We want to make sure we’re protecting our clients against our human nature of wanting to connect and share and help and resolve.

So we also want to look at how our own stuff can really impact what clients we choose and what extent we share our own self, our own human self with our clients. So, for example, I’m going to end our sessions moving forward on time because I’m honoring my own time. If this feels abrupt to you, please let me know and we can figure out a good way of transitioning out of our sessions on time together.

If you share your process with your clients, again, that’s you modeling that you also have human failure and you also have things that are hard for you and you’re essentially role playing what it looks like to respect yourself, and that is super, super important for clients to see too. So we talked about this a little bit before, but if we really need to reflect on ourselves, we can also think about the impact it would have if we treated every client the exact same fashion that we are treating this enmeshed client. So like we were talking about earlier, what if I gave everyone this sliding scale? What if I answered everyone’s texts and calls between sessions? What if I extended everyone’s session an extra 10 minutes at no cost? What would that look like? Is that feasible? Is it possible? And if it’s not, that means that my boundaries are too loose and I need to come back and reestablish better boundaries.

I also need to reflect on what kinds of clients and client situations are most likely to put me into a place of enmeshment. Am I actually noticing that there’s patterns and behaviors in clients that make me more likely to step into mama bear mode or to be the protective best friend, or want to help them in a bigger way than I normally would with clients? And again, that allows me to seek out clinical supervision to make sure that I know how to respond better in those kinds of scenarios.

Another big thing that’s really important is taking care of yourself. So at the end of your session, when you realize that you were triggered by a session, you need to take a minute for you and you need to evaluate what is going on for you, what’s coming up for you, but also sit with yourself in that you are able to protect a client. You are able to still value the intimacy and care and empathy that your clients deserve from you without stepping over that boundary.

So when you notice that enmeshment is coming up, it’s really important for you to make sure that you know that enmeshment doesn’t mean you’re a bad therapist, it just means you’re a human. And that boundaries are needed to make sure you don’t cross into that unethical territory.

Kayla: Haley, you offer affordable therapy options in your practice. Can you tell us a little bit about the program and how listeners can either access it themselves or how they can send a referral if they know a client who could benefit from your program?

Haley: Yes, absolutely. So we do have students on our team, they’re doing their master’s level education, and they’re able to offer affordable rates of therapy from September till April of every school year.

So right now we do have two students on our team that are available from now until mid-April of 2026. These students are passionate about being able to serve a wider audience, and our capacity as a team grows so much when we have these P student clinicians available at lower rates that are more accessible to people all across Ontario.

These students are supervised very closely by myself and one of my other clinical supervisors on my team to make sure that they have the knowledge to be able to support exceptional services for clients and have every opportunity for their own growth and learning throughout the process as well.

So our student therapists right now offer support in English, Spanish, and Japanese, and you can learn more about each of them on our website and find their specialties as well as book a free 15-minute video consultation to make sure they’re a good fit.

Kayla: Great. So to sign up or to refer a client to Haley’s Affordable Therapy Program with student therapists, head to therapyuninterrupted.ca/our-team.

Or you can simply scroll down to the show notes and click down the link.

Haley, thank you so much for joining us on the podcast today to discuss the implications of practitioner client enmeshment in therapy.

Haley: Thank you so much for having me, Kayla. I hope this can be helpful to therapists out there struggling with this and feeling unsure what to do next.

Kayla: And thank you everyone for tuning into today’s episode, and I hope you join me again soon on Your Clinical Supervisors Couch podcast.

Until next time, bye for now.