Would the world really end if I had sex with my therapist?

Ok theoretical situation.

Let's say the attraction is mutual. (That's an important point. If it's not mutual then I agree all the normal stuff about how to deal with transference applies.)

But say it really is mutual. Say my T and I just grew really close over the years and he got to see the real me, which is adorable and smart and funny and witty and immensely loving and compassionate and cute and sexy and giving and fun to be with. And I found him to be brilliant and sensitive and smart and funny and compassionate and interesting and sexy and vulnerable and kind --basically just another human being like any of us, not idealized and not infallible. And say I was immensely attracted to him in a way I've never been attracted to anyone before because it really was a wholistic attraction: an attraction not just based on physicality but on the person as a whole!

Say we were attracted to the way each other's mind works, say he thought the way my mind worked was really interesting and I found him equally fascinating. Say it's falling in love with a whole person ok?

Then say the very dynamics of the patient-doctor relationship turned us both on, the power dynamics and so-very-forbidden-ness of the situation made us both melt.

[Remember this is totally theoretical and I have no evidence whatsoever my T ever felt this way about me, this is just for the purpose of my question because there is a question here]

So pretend for a minute that all of this is true... and say we talked about it and said you know what, I really, really like you. We are both comfortable with changing the nature of our relationship, we're both adults, why can't we do that? I find a new therapist; he finds a new patient (there are lots!) and we become friends/lovers.

If it's totally mutual, why couldn't I just find a new therapist and change my relationship with my old therapist from "doctor" to "friend" or even "lover"?

I KNOW IT'S VERBOTEN! Please don't just say "because it's against APA regulations" or whatever I want to know WHY IT IS?? I mean have there been studies where it has been demonstrated to totally ruin the patient's or the doctor's lives, independent of the threat of the doctor losing his license? I want to know if there is any evidence at all that in such a situation real psychological harm could be done to either person?

Again, I'm not saying this is my situation. It's not. But if it were... I want to know why it's inherently BAD for two consenting adults to act on their desires in this situation?

I think it depends on the client. I think some clients are so vulnerable that they might think it is mutual and that they are not idealizing the therapist, when they have been manipulated to reach that point. I believe that some of us are fully capable of making the decision that you discuss and that there would be no harm to either party from the relationship. HOWEVER, the licensing boards are not in a position to be making this ad hoc, retrospective analysis in every case of a relationship, and so to prevent harm to the majority, the boards issue this one size fits all rule that obviously is not going to actually fit in every situation.

Ya know what? I was with you all the way, up to where you said it was the power / dynamics of the doctor - patient thing. That kinda creeped me out! Cos that says to me it is NOT a healthy r/s between two adults, mostly that you are not seeing T as a person with needs of his own. I know it sounds counterintuitive, but I often think the rules exist to protect T from us, because WE can be more ruthless because of our lack of insight, yet very very convincing - speaking for myself, of course! But yeah, that kind of playacting - the problem is, a wound has been opened, a psychological bone has been broken - until it's been healed, is a "real" r/s possible?

So have there been studies? idk. I know a patient who married her therapist, I think they're living happily ever after in seattle (they left the midwest, not necessarily a bad thing!). I think most studies and books are about misconduct, not marriage. Who would "wait" 2 years for someone nowadays? Who even "finishes" therapy nowadays? Plus there is SO MUCH to look at what all this means to the client.

I also know someone who married his therapist. They seem really happy together (and have been together more than ten years). I think we know the numerator in the equation (ie the number of complaints about bad T/patient relationships), but not the denominator (the total number of T/patient relationship, which would include the ones that turn out well).

I think you want to get out more. OR FIND A PARTNER

@hankster I think I may have misled with my use of the term "power dynamics". I'm from the BDSM community so we use those terms all the time. I think all relationships have power dynamics in them, and I'm interested (and turned on by) those power dynamics being made "visible" so to speak.

So while I see how they sounded bad to someone not coming at it from that context, in this hypothetical example say both parties are turned on by the "power dynamics" of the doctor/patient relationship (you know the ever-popular "naughty nurse" or "schoolgirl" fantasies --that's another example of people being turned on by "power dynamics"). In this example say it just so happens that both parties like playing "doctor-nurse" or something... so the situation of therapist-client is similar enough to that to be sexually charged for both.

does that make sense?

yeahhhhh... we're gonna need another category! (where do I sign up?!)

The problem with it is in the unbalance. Your therapist is privy to your deepest, most guarded thoughts. You are not privy to his. He knows far more about you than you can ever know about him - no one can know that much unless they're your therapist. It's just how it works. And any of those intensely private things could be used to manipulate the client in a romantic situation.

We often think we know our Ts intimately, but what we know is how they respond to us. We don't know what they think about; we don't know what they're like outside of a therapeutic setting.

I think the lover/spouse of a T would have a very different view of a T. At home, they leave their socks on the bedroom floor, leave the seat up, sit around all day Saturday watching sports, or any of the myriad of things that annoy the snot out of us in our partners.

In therapy, we idealize the T. We imagine that they say everything right all the time. That they put you first all the time. That's just not how the real world works and it would be disillusioning.

I know what you're saying. I can see that. But I can also see a situation in which a client of a therapist can adjust their mindset to accept those things about the T. And the T would adjust their mindset to see the client as an equal partner, not a client/patient anymore. It's not impossible. We do this all the time with other kinds of relationships that change.

I'm not saying this would be very common or likely, just possible. I'm just saying that i am questioning why it has to be ruled out a priori, just on the basis that there is something INHERENTLY wrong with it. I'm imagining the client and the T both would have to be in pretty good headspaces and both have plenty of coping skills (and their own respective therapists probably).

I think the amount of damage this kind of relationship can cause to the client to the client FAR outweighs the benefits - and half the benefits would be going to the T!

And that is why it is INHERENTLY wrong. It is INHERENTLY wrong for a T to risk psyche-altering, mind numbing, life-wrecking problems, in order to GAIN their own personal happiness. The. Client's. Welfare. Always. Comes. First.

In my opinion, I don't see an issue with two consenting adults taking their relationship on a much deeper level.....I have been wanting my ex t for over 2 years now.....

Nothing like backing your T into a corner! If T says he doesn't want to date you, you think it's "just" because of the rule. If T says, no, it's because I'm just not that into you, is that better or worse? When does T even get a chance to see your good side? Pretty much all we do is go in there and complain and show weaknesses and troubles. How attractive is that?? I had a friend at work, I liked telling him my troubles, but I didn't like hearing about his, I thought he was a big whiner! At least I kinda joke about my problems, but him, wah-wah-wah wah-wah. And it was all hopeless, nothing he could or would change. But he was cute... but still! No, I can't go for that! (Hall 'n' Oates) I only see ONE "consenting adult" on these boards - on the rare occasions there have been two, it hasn't been good. That said, I asked - no, TOLD - my T to marry me again today. He didn't even flinch this time, he must be getting used to my therapeutic process

kspope.com/sexiss/sexencyc.php

Sex between client and therapist, an article which discusses research into how patients are affected by a sexual relationship with their therapist.

Sorry it's not a link don't have enough posts to use one yet.

http://kspope.com/sexiss/sexencyc.php

Here's the link. Very interesting article.

See, right there, you've answer your own question I think. The relationship would have to change from the therapeutic one to something else entirely. As long as the therapist is privvy to you and your deepest thoughts and fears, there can be a strong element of coercion there. The therapist has leverage that, IMO, precludes true consent. In the absence of the change that you mention, it's abuse.

See, I would also contend that if the client had good headspace, they wouldn't be in therapy. What you are describing is the end of therapy, not concurrent with it. Attraction exists in the therapy room all the time. By your own admission, if there is action regarding that attraction, then both parties have to leave the therapy room both literally and figuratively.

Also, it's not ruled out. BUT it has to be after a certain amount of time to ensure that the therapy relationship has changed.

A quote from that page. Research is always better than just opinions.

Would the world end, no, would you end up being hurt YES. The study quoted by InTherapy is great at showing that.

If you are attracted to your therapist, then you can assume that many of his other patients are also attracted to him. Now if he would break the rules for you then he is the type of person who would break them again down the road for someone else.

Now if you are talking about just a "fling" nothing serious or long term, still isn't a good idea, if you really care about him would you put his career and reputation in jeopardy just for a fling?

I think it would be so much pressure to always have to keep it hidden if it were to happen. To always have to lie to others about who you've been spending time with, to meet up in a sneaky way, to never be able to go out to dinner or a party together for fear of being outed...I think it would be extremely stressful after a while (this is assuming a relationship were to develop and not a one-timer). Believe me, I've dreamed and fantasized about this very thing for months. I am married and T is single and has a home office. We've talked about it at length and I've finally shifted out of the fantasy and acknowledging my deep love for the man, and him for me. We have developed such safety and trust, and that is so powerful to me as a female who experienced childhood SA, working with a male T. Carrying around secrets and the guilt and shame would just not be worth it in my opinion. Wouldn't it be more emotionally healthy to have a wonderful loving and yes hot relationship with someone who can be in our whole life and not just little hookups here and there?

When I was in high school, the youth minister at my church was providing counseling to me. I was in a really bad situation at home, and while I couldn't tell him all of the details, he was someone I could talk to, and I was in desperate need of help. I saw him a couple of times a week in his office. During my senior year, he had sex with me and then ended the therapy relationship, and told me that no one could ever know what happened. I kept it a secret for many years...I didn't even realize at the time what a profound impact it had on me. I had already been sexually abused, and didn't have a view of myself as someone who was worth being treated ethically, respectfully, or with care.

These things from the article rang really true for me:
-Exploited patients may learn from the therapist that the most important thing is to keep the sexual relationship secret so as not to harm the therapist's career.
-People who have been sexually involved with a therapist may experience a subsequent sense of emptiness, as if their sense of self had been hollowed out, permanently taken away from them. The sense of emptiness is often accompanied by a sense of isolation, as if they were no longer members of society, cut off forever from feeling a social bond with other people.
-People who become sexually involved with a therapist may become flooded with persistent, irrational guilt.
-Women victims in both instances experience considerable guilt, risk loss of love and self-esteem, and often feel that they may have done something to "cause" the seduction.
- the effects on the patients' ability to trust can be profound and lasting.
-Therapists who sexually exploit their patients tend to violate both roles and boundaries in therapy. The focus of sessions shifts from the clinical needs of the patient to the personal desires of the therapist.
-Many patients who have been sexually abused by a therapist are justifiably angry, but it may be difficult for them to experience the anger directly...anger directed inward may lead to self-loathing, self-punishment, and self-destructive behaviors including suicide.

In many ways, the worst thing was the loss of trust. This minster was the first and only person that I had even *hinted* to about what went on in my house. He felt safe and caring. After we had sex, it took me almost 20 years before I even considered talking to a therapist again...20 years when I could have been healing, but instead lived with dissociation, PTSD, and all of the other aftereffects of my childhood.

And I still feel guilty about it, even now, even knowing that he was an adult and I was a minor, and that he was a counselor and I was a client. I hate that guilt. And the shame that seems to come hand in hand with it.

It's still hard for me to think about and to talk about .... I still feel like even writing it here, anonymously, I'm telling a big, dangerous secret and I shouldn't tell. Every time I mention it on the boards, or in therapy, I feel a wave of fear.

So, no, the world didn't end. But it kept me from healing for almost 2 decades, and that makes me sad. I wonder what my life would have been like if I didn't have my trust shattered so badly that I couldn't go and get the help that I so so so needed.

Not sure I am the best to reply - I live with and share a life with my former T.........it is wonderful.........it is not easy to make the transition and the % it works is low.........for me, it is a beautiful life.

wow, see? it can happen! lol...

@nightsky I'm so sorry to hear of your situation. very different from the one I described, but yeah, dang, hard stuff you write about.

@kirbydog why would it have to be hidden? if you waited an appropriate amount of time after ending the counseling relationship... it just would be awkward answering the "so, where did you meet?" question

@Mike_J I'm not talking about acting on a fling. I'm just saying I don't think it's INHERENTLY harmful

and regarding that study, it says the patients were "harmed" but what does that mean? Who defined "harm"? Does that mean the patients regretted it? And did the study take into account mutually consenting relationships? It sounds like those were situations closer to the one that Nightsky suffered, in which case, yeah I can see how that harms people.

Anyway, it's just a theoretical situation. I have no evidence my former T actually felt anything like this for me, just wishful thinking. I can see situations in which it can work out and it looks like @openmind0722 has just such a situation.

It can happen and be wonderful - but jumping into it blind is not advised. It took alot to separate that formal T relationship and say hey, we are now in a personal relationship and you are NOT my T anymore - it's work but easier as time goes by.

I am a believer that as adults we should be able to choose what we want - I absolutely do not condone those who prey upon patients and this is their MO.

My situation was quite unique, heartbreaking for a good year but then, very wonderful in coming together and making a life. It is not for the faint of heart but can be done - honesty in everything is so key.

I hope some of this advice helps........

I guess it varies with the Therapy, people could be having really emotionally powered therapy where a developing relationship beyound doctor patient will be very harmful, because its supposed to be a safe space where they feel they can be completely true and not trying to impress there doctor. but I think theres some cases, where it wouldnt be harmful, one of my old T's dealt with a phobia of mine, although she did help with other aspects the phobia was the main goal, so a relationship developing there would not have been harmful in the slightest, although I would have needed to see a different therapist because the trust will become safety around my phobia, which we wouldnt have wanted it to become. BUT! therapists no matter what type they do are held under the exact same ethics, so although it would not be damaging to me, there career would be, everything they have worked for would be damaged,

I think we always forget during our crushes is the T's feelings, we focus alot on how we feel and that WE wouldnt be effected, which fair enough 90% of the time thats actually probably true, but its 100% true that THERE career will be effected, and if you like someone that much, you should respect that. if its real, then there is a time span of 2 years where after that although the relationship will still be frowned upon, it wont be career ruining.

I think if you are truly in love with your T, you will consider their feelings as much as you consider your own. After all, isn't love caring deeply for another person and not wanting them to be hurt? To protect them as well as yourself?