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Sexual Relationships between Patient and Therapist
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by this point in the course I've made a believer out of you regarding this topic's
legitimacy and importance. If so, the next question that may arise in your mind
is "How can sexual abuse of a client by a therapist come about?" With
those clients I've treated who've suffered abuse, I've noticed a certain pattern.
Pattern of Sexual Abuse Victimization
victim, who is seeking help for a disorder or problem, may have some vulnerability
in addition to being in the patient or client role. For example, in Mary's case,
she was going through a divorce. The mystique and authority of the role of the
"therapist" created a situation in which she saw the therapists as having
some sort of special healing powers. Thus she felt she needed to comply with his
directions, advice, and suggestions. Clearly, there is a professional standard to have a commitment to develop the clients ability to help themselves.
Once the treatment began, the therapist came
to have a parent-like importance to her. She described feeling like a young child,
anxious to comply readily with her therapist's advice and suggestions. Admittedly,
we have all had clients that place us in this role and give their power away to
us, thus creating an imbalance.
♦ The Unique Emotional Component - Faith
relationship between mental health professional and client, as you know, is not
just a business relationship. Its unique emotional component helps explain the
faith clients have in us. This faith adds to the emotionally charged factors of
power, superiority, and self-esteem. The therapeutic relationship gives the professional
authority to enter and explore vulnerable aspects of the clients' minds.
as children to embrace the superiority and power of professionals, some of our
clients readily admire their therapists' positions or titles, respect our knowledge,
comply with our directions, and defer to our opinions. Because our clients have
faith in us as professionals, they believe that they will be taken care of, and
make a commitment to us. This added ingredient of "faith" often triggers
clients to comply automatically, and without hesitation, causing a dramatic shift
in power in the therapeutic relationship.
"He was everything to me..."
"Special Status Role" accorded to Mental Health Professionals was evident
when Mary talked to me about her therapist. "He was everything to me
-- sun, moon, stars, mother, father, confessor, everything." She had faith
that the professional was a person of honesty and integrity who had only her best
interests at heart. In the initial sessions with the therapist, I'll call him
Russ, he was able to relieve some of Mary's stress related to her divorce. This
reinforced even further for her that the professional had some special healing
- Stone, M. PhD. Boundary Violations between Therapist and Patient. Psychiatric Annals, 1999, 670-7.
Peer-Reviewed Journal Article References:
Foote, W. E., & Goodman-Delahunty, J. (2021). Understanding sexual harassment: Evidence-based forensic practice (2nd ed.). American Psychological Association.
Goren, E. R. (2017). A call for more talk and less abuse in the consulting room: One psychoanalyst–sex therapist’s perspective. Psychoanalytic Psychology, 34(2), 215–220.
Hakimi, D., Bryant-Davis, T., Ullman, S. E., & Gobin, R. L. (2018). Relationship between negative social reactions to sexual assault disclosure and mental health outcomes of Black and White female survivors. Psychological Trauma: Theory, Research, Practice, and Policy, 10(3), 270–275.
Pizer, B. (2017). “Why can’t we be lovers?” When the price of love is loss of love: Boundary violations in a clinical context. Psychoanalytic Psychology, 34(2), 163–168.
Summers, F. (2017). Sexual relationships between patient and therapist: Boundary violation or collapse of the therapeutic space? Psychoanalytic Psychology, 34(2), 175–181.
Wu, K. S., & Sonne, J. L. (2021). Therapist boundary crossings in the digital age: Psychologists’ practice frequencies and perceptions of ethicality. Professional Psychology: Research and Practice.
What is one key factor that adds to the power imbalance between client
and therapists? To select and enter your answer go to .