Sexualisation and Emotional Abuse in Therapy (TRIGGER WARNING)

I see a lot of people on here wishing their Pdoc/T was more, wanting a romantic or sexual relationship with them, and I wanted to share this story with you all regarding how bad things can be when you have an unethical Pdoc/T who takes advantage of you. I didn't experience erotic or romantic transference with the Pdoc who abused my trust in him, but what happened still did a lot of emotional damage. I can only imagine how much worse it would be for someone who was struggling with those sorts of feelings.

Be careful what you wish for, and be thankful if you have a good and ethically minded Pdoc/T who would never go there. Believe me, they are the ones that have your best interests at heart.



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A Wolf in Sheep's Clothing: Encountering the Predatory Therapist.

In 1998 I fell victim to a predatory therapist, who spent an inordinate amount of time grooming, and manipulating his female patients for the eventual purpose of having sexual relations with them. I've decided to write about my experience with Dr A. in the hope that it will help others to identify when a therapeutic relationship may be turning toxic, and what signs to look out for.

Dr A. specialised in the treatment of drug addiction with a vast majority of his patients also having experienced some form of trauma, either in childhood or as adults. Dr A. isn't his real initial. I chose that particular letter of the alphabet because, well, think A for arsehole, B for bastard, C for…you get the general idea. I saw Dr A. as an outpatient for close to 12 months, being treated for Heroin addiction. I was prescribed Naltrexone, having already undergone a (dangerous) modified home version of Naltrexone rapid detox, along with regular therapy sessions to get to the root cause of why I'd ended up an addict in the first place.

Looking back now I can pinpoint three distinct, yet overlapping stages of the grooming process utilised by Dr A. - Presentation, Manipulation and Sexualisation. I'm going to break these down into their separate components to try and give a better understanding of what I mean by each one.

Presentation:

The Idealised Parental Figure

For those of us, and there were many, who had been victims of childhood abuse, Dr A. presented himself as the ideal image of a father figure. Kind, gentle, almost to the point of doting, with just enough of an authoritarian streak to know there would be boundaries to keep you safe. It was all too easy for what amounted to a group of very vulnerable people to fall for his charade. If you'd asked any of us to point out our idea of what an ideal parent should be, I believe most of us would have pointed to Dr A.

The Guru

Dr A. had been at the cutting edge of drug addiction treatment since the 1960's. Dr A. had written peer reviewed papers, had been part of several major research programs, got invited on lecture tours, taught at a senior University level, had a higher treatment success rate than any other Psychiatrists combined. I'm sure if he could have claimed he invented the entire field of Psychiatry he would have. He dazzled patients with his vast amounts of knowledge and experience. None of which, as we later found out, could actually be verified.

The Maverick

Almost from the start we all heard the rumours about Dr A. having sex with some of his female patients, or getting caught indecently assaulting female patients whilst they were under conscious sedation. But you see that was all lies, because there were people out there who wanted to bring Dr A. down. Dr A's treatment was so 'successful' that drug dealers were trying to infiltrate his program to spread propaganda and mistruth's; the medical board was working to bring him down, because they were jealous of his great successes and were too stuck in their ways to admit just how wonderful and right he was; the Pharmaceutical companies rejected his method because they wanted to continue pushing Methadone as the treatment du jour for heroin addiction - and so on, and so forth. Most drug addicts do tend to have at least a bit of an anti-establishment streak about them, so for us it became more than just attending treatment to kick our habits. We were going to get clean, and go on a mission to save other addicts, all this whilst sticking it to 'the man'. Power to the people, right on!

Manipulation:

The Inner Circle

The inner circle were Dr A.'s most trusted patients. They were the ones who had most fallen under his spell. Most of them worked in his so called 'inpatient' treatment centre. Here they were responsible for monitoring other patients, who were under conscious sedation, as they went through rapid detox when Dr A. was unable to be in attendance himself. At this juncture let me just point out that these were recovering addicts, and patients in their own right, who had absolutely zero medical or even basic first aid training. Talking to members of the inner circle was like talking to someone in the midst of a religious fervour. So passionate were they about the treatment program that it was all too easy to get swept along in a tide of enthusiasm. And Dr A. made sure of that.

Divide and Conquer

The inner circle were also Dr A.'s eyes and ears behind the scenes. Most days, before and after sessions, patients would gather on the clinic's veranda to smoke and chat. Invariably someone from the inner circle would be there, quietly listening in and reporting back to Dr A. Who was having doubts, what possible alliances against him were being formed, who was starting to actually believe the rumours. All of this information, along with what was revealed to him by patients during their own therapy sessions, was used to split apart certain friendships, or groups, and realign them to something more suitable to his purposes. Basically he was breaking patient confidentiality on a major scale in order to move us around like chess pieces on a board. All he needed was one piece of information that he could weave into therapy, and make it seem like a so called friend had been talking behind your back, revealing stuff you didn't want revealed. Queue the fall out, and the inner circle suddenly sweeping in to keep the warring parties apart and help them form new bonds.

You'll Never Get Better Without Me

Although it was never stated outright, this was always an undercurrent when dealing with Dr A. Almost every session we heard tales of woe regarding other patients who had dropped out of the program. If only they had stayed they wouldn't now be in jail, dead, back on the streets, hopelessly addicted, etc etc. We heard the same from the inner circle members as well, and the underlying message was clear - leave Dr A.'s treatment program and you're doomed for life.

Sexualisation:

The sexualisation of therapy happened very gradually. As we later found out Dr A.'s modus operandi was to spend anywhere from 12 months to two years ever so slowly breaking down a patient's resistance, before commencing a sexual relationship with them. It was the proverbial frog in hot water scenario. Had he just started feeling us up the moment we walked into his room, more than likely the majority of us would have run like hell.

In my own case it started with a simple hug. Nothing much to it, I remember we'd had a particularly productive session where I had made a number of breakthroughs, and the hug felt like a reward. It was a regular Doctor's hug, you know the sort of hugs that only Doctors can give. It doesn't feel like you're being hugged by a friend, or a family member, or (heaven's forbid) a lover, it just feels like you're being hugged by a Doctor. And that's good; that feels safe, and appropriate. I sometimes like to imagine Doctors spend an entire elective solely devoted to learning how to administer hugs to their patients in the correct manner.

Had it remained that way I wouldn't be writing this article. But the subsequent hugs gradually became longer, more full body contact was initiated, he would bury his face against the side of my neck. Apart from the escalation in hugging, there was other contact that initially started off innocently enough and gradually took on more and more of a sexual over tone. He would start by placing a gently guiding hand in the middle of my back as he walked me out; later it would be an arm loosely draped around my shoulders, and then an arm slung low around my waist, with fingers surreptitiously caressing my hip. Sometimes at the end of a session, while I was still seated, he would come up behind me and place a hand on my shoulder as if to say 'good session, well done'. That eventually escalated to both hands on either shoulder, slowly sliding down onto my upper chest. He always stopped just short of anything too 'intimate', by that I mean there was never any breast or genital contact made, but I have no doubt that had I not left when I did he would have eventually begun to cross those final lines as well.

Then there were the sexually charged comments and innuendos. Again it started innocently enough, an appropriately delivered compliment here and there - "you like nice today", "your face has come to life, great to see", and so on. Even the initial comments on my figure I wouldn't have deemed inappropriate. My current Psychiatrist has paid me a compliment on my body at a certain weight level, and the way in which that was delivered certainly didn't raise any alarm bells. To me an appropriately delivered compliment is one which is given matter of fact, in a neutral yet empathic tone of voice, with no undercurrents or leering facial expressions. That's how it was with Dr A., at first, but of course that's not the way it stayed. Eventually 'You look nice today" morphed into "You should wear that top more often, it really shows off your breasts", or "You should watch yourself wearing a dress like that, you're making me think bad thoughts. If only I was 30 years younger*nudge nudge wink wink*…."

The Aftermath - Realisation and Subsequent Emotional Effects:

My body responded to the escalating inappropriate touching, before my mind did. In my mind I was making up all manner of excuses for what was happening - Dr A. was just old school, he'd been trained in a different era, Psychiatrists must have practiced differently back then, he hadn't really done anything too bad - my physical reactions were saying something else entirely. Every time I walked into that room my skin would begin to crawl, my stomach churned, I would find myself going on hyper alert almost instinctively, if he got up out of his chair I needed to know exactly where he was in the room in relation to me. Inside I was physically recoiling every time he came anywhere near me.

The breakthrough came when I had irrefutable proof that Dr A. was breaking patient confidentiality. I had managed to compare notes with some close friends who were new to the program, and that's when the first layer of realisation set in. Despite this development I still felt as if I needed to keep seeing Dr A., after all his (at that time) 'cutting edge' treatment was going to be what eventually saved me from a life of addiction, or worse. I figured I could just stop the therapy sessions, but still pick up my Naltrexone scripts and continue on the program with the minimal amount of contact possible. But this didn't last long, because I was also gradually coming to realise that the treatment just wasn't working. By this stage even many of the so called 'inner circle' had left, many of them completely disillusioned and mistrustful of any future treatment or therapy. I know there were a few patients who attempted suicide in the aftermath, one or two may have succeeded based on the talk that was going around at the time.

For my own part the entire experience left me with a deep mistrust of the Psychiatric profession in general and male Psychiatrists in particular. I did eventually find my way into another treatment program that worked for me - Methadone in conjunction with CBT based therapy to learn how to deal with things like triggers, and learning to live life without heroin. Naturally I made sure I got a female therapist. And that is pretty much the way it was up until the last couple of years. No matter how bad things got with my other mental health issues, I steadfastly refused to see a male Psychiatrist. At a push, if I got desperate enough, I would agree to a male counsellor of psychologist, but even that I found difficult. My current Doctor is the first male Psychiatrist I have agreed to see in 15 years, and even after that length of time there was still a drawn out process of learning to trust that I had to go through.

Apart from mistrust, for years afterwards I was also left with a truckload of guilt, embarrassment and shame. I'd been told what was happening right from the start, and refused to believe it. I felt guilty that I didn't just quit right then and there and try to take as many other patients with me as possible, thus saving them from their own potential abuse. I was embarrassed, because I wasn't stupid, and I should have known better. I was reasonably intelligent, and streetwise, and yet this still happened. And I was ashamed because deep down I knew what was happening was wrong and I still did nothing to stop it. But that's the thing about predators, they are masters of manipulation. They get inside your head and distort your mind until you don't know which way is up or down. And that type of manipulation, especially when it's done by a professional, can stay with you for a long time. As can the notion that not being able to speak up and say 'no' to what was happening, somehow implied consent on your part. Even if you had wanted the behaviour to happen (I certainly didn't, but I know other patients who did) it still wouldn't have been consensual. Because of the power imbalance between patient and therapist, it is simply not possible for a patient to ever consent to any form of sexual contact with their therapist.

Dr A. was deregistered some time ago. I believe the reasons given were something along the lines of 'conduct unbecoming, running an inpatient clinic without proper authority or license, and patient endangerment'. Since my own experience with Dr A. I did eventually learned where to place the blame, squarely on his shoulders. That and there are male Psychiatrist's out there who are trustworthy, even if it did take me 15 years and a further undisclosed amount of time to work that out for myself.

Thank you for sharing your story. It is helpful.

Your story rings true to me as well- especially the manipulation part. Manipulation in my case was very subtle. Gradually enlarging boundaries . Maybe walking a little closer to me on the way out of the office, and once asking me if I wanted a hug. I didn't.

But i think there was also testing to see if I was attracted to her. After we were living together, I told her that I liked her green sweater. Answer - I know. Did you wonder why I wore it so often? She told me later about some things she did - walking to the white board and stretching to make sure I saw her body, wearing a skirt to show off her legs. At the time she told me those things I was still flattered and intoxicated by her interest in me , but i still remember having to push my brain past a boundary. Take a leap of faith.

One thing I've learned - anytime I am making a decision based on someone else's behavior or story, and I feel a need to push to believe or accept what they are doing or saying - i need to listen to that " stop" and find out what is really going on.
No more leaps into space because I think I can trust someone completely.

Thank you for sharing - even though very different from mine, it is also very similar.

I often wonder what would happened if I had really been warned, as you are doing here for others? I think I was so far into transference that I might have still taken the leap, because I thought that she would always be there, warm, accepting everything I did unconditionally, wanting to provide me with love, things and the loving home I had never had.

Imagine this - I did confide in one therapist friend , who started to warn me - but
to her " What can it hurt to see what will happen? I'm the one with the power over her, because I can report her." OMG how wrong I was. Giving me the illusion that I had power and control in the relationship was part of the process.

I know in my case I didn't know as much about boundaries in therapy (apart from the major ones like 'don't have sex with patients' and 'don't violate Doctor/Patient confidentiality) back then, because I was under the (false) belief that the Doctor would take care of all that. I didn't think I needed to worry so much about boundaries (didn't even know that was a term), because well that was what the Doctor did. He was the one that was supposed to keep me safe, and I trusted him to do so. He betrayed that trust, and I very quickly learnt about the concept of boundaries in therapy the hard way. I can't even imagine the damage that must be done to people for whom those boundaries are violated beyond what I experienced - by that I mean those who have the misfortune to have a, I hesitate to even use the words 'therapist', or 'psychiatrist/doctor' who does cross that final taboo and actually initiates a sexual relationship with a patient. Just going through what I went through totally screwed with my head, and I consider myself one of the lucky ones that I did manage to get out when I did.

I'm so sorry you had to experience this sort of blatant exploitation, manipulation and abuse of both power and trust.

Wow-thanks for sharing!! I think you will help many here on pc.

Luckily, both my male T's are very ethical. My feelings are the ones out in left field. I wouldn't want a sexual relationship with either of them, but my feelings can be hard to manage.

I do hope it will help, even in some small way.

This is powerful, thank you for sharing this. It will be very helpful, I think to those that are willing to accept it.

Thank you for having the courage to share your story! I very much relate and you describe it eloquently. Sometimes it is hard for me to summarize, pick out the over-ridding themes amidst the chaos. You presented it so well and clearly. Thank you.

Presentation: Your words are also my experience, tthough different circumstances. At times, I still feel so amazed how similar our perpetrators are. When I start thinking "maybe he wasn't so bad" - I read such similar experiences that give me the self validation that this type of abuse deserves.The Idealised Parental Figure. Absolutely
The Guru Absolutely
The Maverick Absolutely

Manipulation: Slow and consistent. Drawing me in to relationships with others under his spell, isolating me, inviting me into his inner circle. Spinning situations with others and with me. Presented as if not only that he knew the problem, but also that he held all of the answers. Absolutely "yes" to all of the below:
The Inner Circle
Divide and Conquer
You'll Never Get Better Without Me

Sexualisation:
I ended it before it got there, but I do know that he was grooming me, and I feel as if I was being prepped to be his second or next wife. Wife priming. He was super careful with the sexual stuff, but it started to creep out towards the end. While I rationalized away most of it, my body also felt very uncomfortable with it.

The Aftermath - Realisation and Subsequent Emotional Effects:
When I started to talk to others about what had been going on (no longer keeping his secrets, breaking out of his emotional blackmail) I felt blind sided. Side swept by how manipulated I had been, how abused, how perpetrated. Obviously, no one wants to blindly find themselves in those shoes. And I also felt so much loss and grief. The aftermath is something that thankfully evolves over time, but it is no easy path. I would say that life is better now that my soul is tied more to me.

I'm so sorry you've been through this as well. It leaves deeper scars on our psyche than I think a lot of people realise.

my sister has ptsd and has been seeing a therapist for over a year in her home because she has agoraphobia (fear of leaving the home) She just told me - she might be pregnant with therapist baby.....told me not to tell a soul.. he would lose everything.. what do I do? this is not right? my sis is in her upper 40s...what do I do????

Jen: he needs to be reported. I suggest you contact the TELL people; they can be very helpful. She needs to understand that if he did this to her, he probably has or WILL violate his ethics. This is a crime in some states.

file a complaint with ur states board of psychology online. i had a sexual relationship with a T. it damaged me pretty badly. be careful what u wish for is right. i reported him to the board and he lost his license and got a divorce. i regret spending 7 years as his patient, even when he were having sex in his office after therapy. boundaries are there for a reason. to keep u safe. there is a power differential in a therapeutc relationship. its not meant to be.

Oh Jen, what a tough position for you to be in. In some states, what he did is actually against the law, and criminal charges coukd be brought against him. There are a bunch of links at the top of the page for those abused by therapists. Contact TELL by emailing- they can help you look at the options.

It sounds as if you understand that your sister has no blame in this. She has been manipulated, and her need to keep his secret is part of that. Kind of like a sex abuser who tells a child his mother will die if he tells - she is afraid she will lose him if you tell.

Here is the link to TELL. You won't feel so alone. TELL: Therapy Exploitation Link Line