Sex with the therapist

I'm mainly trying to stir up a bit of discussion after reading some of the other threads....let's say you've been to therapy for a while, and perhaps have made some improvements to yourself from it. Now you consider the possibility of stopping therapy, and starting a relationship with the therapist.

Why do the people against an affair with the therapist often appeal to the illegality of it in several states? After all, gay marriage is also illegal in several states, and I would imagine several of us would not be against the idea of gay people getting married in a different state just because it is illegal in our particular state.

Second, so what if there is a power differential? That's the case in many relationships. Our partners often use our weaknesses against us in arguments in heated moments. We probably do the same at times. When I got together with my partner, I imagined that I would tell him everything about my internal mental life. And for the most part I have been able to. At times I didn't feel accepted, but I didn't hesitate to state what i am like inside. Very similar to how my T knows me, but maybe even better since there are things which seem too inconsequential to bring up in therapy and there is also a limit on the time. My partner definitely has a more dominating personality than me. I sometimes cannot stand up to him or its hard for me to discern my true feelings because I am so swayed by his. That's the way it is, how is it so different from whatever power the therapist might have over me.

Good question! It's somehow on par with violating minors, prisoners or the cognitively impaired...by virtue of fairly recent laws. The public doesn't feel antipathy towards dual relationships, like they do about adults initiating intimacy with minors. If you had a relationship with your T, it might be viewed by your peers as odd, but not transgressive or abusive. But the psych profession and state laws sees things differently. They created this current paradigm. It's like the new and final frontier of transgression, replacing what used to be unique stigma of LGBT relationships. If you're interested, there is empirical research into negative effects of sexual intimacy between T and C. It's a hard topic to survey because of nonresponse bias, but the data suggest strongly this is a different kind of power differential than what you have outside therapy with a dominant partner. It causes real damage in most affected clients.

I find this to be a ridiculous and slightly offensive comparison. It completely minimizes the struggle for glbt people to make a far-fetched point. Discuss all you like why you want to have an affair with your therapist and why or why that should be legal or not— but can we not minimize or conflate the historic struggles of an entire community to make that point, please?

Um.... I appreciate the rest what you're trying to say but again, just I don't think the comparison is appropriate. I person born gay, is not the same as someone who enters a profession as an adult and with the understanding of those rules in place before they get there. The Gay-marriage thing just fails as a metaphor, I think.

The main difference between a partner and a therapists strikes me as rather obvious. A partner isn't paid to listen to you and set their own lives aside as a starting point. A partner doesn't have professional training to be a partner with a license or, theoretically, I assume, have several other 'partners' whom he/she is paid to be patient and advise.

As to why it is illegal, I would think all one has to do is re-read the numerous threads here by people who have been abused and manipulated by their therapists. How are we to protect the fragile ethic that is already challenged by so many bad therapists already?

There are also plenty of articles out there written by therapists as to why patient/Therapist relationships are damaging and unethical.

No offense but honestly, as you describe it here, this sounds like an unhealthy dynamic and not one to model as an example of desired ideal.

I would hope that if someone often feels like they need to suppress their own feelings and/or "stand up" to their therapist or their partner, that the productive value either relationship would be examined. Again, sorry if I offended.

I have always thought that this rule was an example of the condescending, paternal/maternal attitude that the mental health profession has toward clients. None of us are healthy enough, strong enough, emotionally intelligent enough, etc. to make our own decision about whether we wish to have a relationship another person. The rule is a one size fits all solution in a complicated world.

I did not intend to offend with the gay marriage example. Its just another law that I personally don't believe in or understand the need for.

Anyway, let's replace it with the illegality of marijuana in several states. And I'm only using examples because I confuse myself if I am too abstract.

The point I was trying to make is that perhaps we should examine our appeal to the illegality of patient-client relationships. To me, that argument doesn't hold water. To convince me, you must give some arguments about why that illegality is different from the illegality of possessing marijuana.

Just a note that I've certainly been in ordinary relationships which really messed with my head - I felt suicidal when they ended, the person manipulated me or took advantage of me etc. To be concrete, I once dated a guy who I was very emotionally invested in and only realized after he broke up with me that he wanted to use me to practice having sex with. He was getting married through an arranged marriage with a person from his country and wanted to be more sexually experienced. To me that's not any better than a dr. taking advantage of you because you are enthralled with them. And it could be the case that a relationship with a therapist is much healthier.

Some Ts want only sex not relationships in real life, maybe they are unhappy in their personal life and miss love.
I saw one pdoc who told me he slept with some of his clients, I don't know if it's true but he told me about this thought I wasn't interested, he told me that it's illusion that Ts don't **** their clients but nobody ever knows about it. So I can understand those who say- run away.

I think that relationships with T is just like relationships with any other people, man loves you, then man leaves you, you are broken but if he is your T you can report him, it's like revenge. Many clients are dying how they want their T, then they get what they want and lose it. It's unfair to say that only T is guilty, he is not superman.

I think many Ts wouldn't leave their partners and children to be with their clients, maybe they think that love is fading thing and it's not worth to destroy their career because of it. Maybe they feel like losers if they are with their clients, I don't know.

If it's true love than no rules will stop you (and I'm not talking about abuse, I talk about real love). But... in every relationships there are possibility that you will be left and broken no matter who is your partner- your T or your classmate or your boss.

I liked what you said about gays, so true.

Ok I can approach this argument with this metaphor.

I'm sorry about how your partner used you and misled you. That's awful and you deserve better.

I also agree that marijuana laws in this country are bunk. MJ is no worse than alcohol, IMO. It can be used responsibility and it can be abused. There is also, as often the case in systems where any kind of 'taboo' is oppressed and shamed, a LOT of misinformation out there about it. What is the difference between a dealer and a seller? The Law, how it's enforced and whom it's more likely to be enforced against. The laws that forbid it are enforced in a way that benefits a racially biased class system.... and well don't ... get me started... about how wrong much of that is... anyway...

Using this metaphor, I see a therapist as a seller of a certain kind of product. The user decides why and how they want to use it. There are a lot of sellers who are believers in medical properties of Marijuana as well as the right of people to have the freedom to use it for whatever personal reason they like. There are also unethical sellers who are out to make a buck, who don't care to know about the product and don't care about the user and their own addictions, or potential problems with the product.

So using this metaphor. What about a seller who is paid to have knowledge of varieties of hemp. I'm told some varieties make you feel calm, others make you fell hyper, silly, etc. What if a seller sells a customer a variety knowing that they'd like to to go home with that customer and get high together? At what point does the seller start to change his/her recommendations based on his/her own desires rather than the client's?

And this may not be the best metaphor because we're talking altered states of mind, but in the end if we're talking marijuana or vacuum cleaners, a Seller is responsible for their presenting an honest deal to the end user... and the seller's desire, or romantic involvement with the buyer of those goods challenges the question of integrity of the one who has more knowledge of the product the user/client/patient/etc came has a need for.

This is a good point, actually. and hypothetically it would be ideal to remove the patriarchal B.S. altogether.

The idea that a client is someone powerless to make their own decisions is not okay.
However, many people, it could be argued the majority of people, go into therapy for issues that involve confused identity, relationship problems, severe distress often involved issues of abuse and sexuality. How do we protect the majority from abuse if we let go of those rules?

In the legal world, we are not allowed to have sex with clients unless the romantic relationship predates the legal one. However, should you wish to begin a relationship with a client, you find them new legal counsel and can begin a relationship if the client wishes to do so. We assume our clients are our equals. However if the client later shows the attorney used his or her position as an attorney to the disadvantage of the client, that is unprofessional conduct and the attorney can be subject to sanctions.

Also, it is not illegal in all states for a therapist to have a relationship with a client. It is unethical in all states, but not illegal. In my state, it is a violation of a State regulation, but not a State law. So many therapists think it is illegal, but it is not.

Also we know the numerator on the fraction of therapist/client relationships that are bad. We do not, however; know the denominator. Personally I know of at least two people in very successful relationships with their former therapist.

I don't think it's about being powerless to make your own decisons. After all , in the US romantic relationships are allowable after an acceptable Time has elapsed since therapy. If the relationship has real potential as opposed to just transference feelings or power issues then waiting a few years won't change that. If the client is still in therapy I view the problem as that once in a romantic relationship both parties completely lose objectivity about the client's course of treatment. That is the ethical conflict. The therapist is no longer working in the client's best interest but in their own. Choices become fraught with emotion. This is why doctors do not generally treat serious illness in their own family members.

Sorry for any offense I may have caused by repeating the OP's original reference to gay marriage. By way of explanation, I've been reading authors who write about sexual expression as a transgressive act in different historical periods, and really it's striking how tolerant Western democracies have become with regards to sexual orientation.

Even so, one author said there is always some quarter in any society where sexual expression is forbidden...and alluring. That forbidden quarter today relates to consent and equality. That makes sense for Western democracies. A minor, an incarcerated person, a person impaired by disability, drugs/alcohol cannot give consent. So says human subjects boards that review research protocols.

Apparently also true for the therapeutic client. So says state law, or regulation.

I'm not advocating for or against anything. Just trying to look at social context for sexual attraction and expression.

I see the value of this law in the case of T-patient relationships. I see the power differential as a big deal. And yes, other power differentials can exist in any relationship.

But it was my understanding that a relationship CAN happen 2 years after a patient stops seeing a T?

I think it's because at the heart of erotic transference is (supposedly) some maternal/ paternal feelings such that unconsciously you confuse your T with mommy and daddy on some level so when they hurt you it's like mommy / daddy hurting you.

I dunno though, I would **** my therapist if he would be down with it. I'm already suffering recurrent major depression so in my mind what could possibly happen to make things worse?

Yeah I'm not exactly clear what the law is. Anyway, my point was only that it seems a bit illogical when people say - your therapist came on to you, how terrible, its against the law! (There are many stupid laws, we don't lecture people if they make a decision to break some of them, e.g. smoking pot.)

Yes, that's why in my OP I said - you decide to stop therapy and then pursue a relationship.

I think that it has to with the kind of relationship you are in with your T. In therapy you are not responsible for supporting your T emotionally in any kind of way. You do not have deal with or watch out for any of her baggage. Because of this you are able to be uniquely vulnerable in therapy, when you say things about how you feel you don't have to worry as much that you will offend your T, or say something that will hurt her. She is responsible for dealing with whatever reactions she has to what you say else where. This allows you to depend on her in a very specific and highly intimate way, which is someways mirrors the parent child relationship. This kind of dependence or need for your T is a critical part of the therapy relationship (and I don't mean some kind of unhealthy dependence where the client can't separate themselves from the T, but where the client understands and appreciates the depth with which they need their T, and feels comfortable enough to develop an attachment). This healthy attachment allows the client to internalize a caring and loving figure who will help them to develop the kind of strong self that is required for living in the world. The development of this internal figure would be impede if you entered a relationship with your T, because you would no longer have a figure to internalize, instead, you would have a partner who you were expected to relate with (which would cause a very different kind of internalization--not the kind you need in therapy). This would leave the center where that loving figure was supposed to sit blank (or allow it to continue to be filled by the negative introjects that most likely sent you to therapy), or it would lead to a feeling of betrayal and confusion if you had begun the internalization process.

But the OP's question wasn't about what would happen during therapy, but after. So here's the thing. Even if the therapist and the client wait for a while after therapy to start a romantic relationship, and even if they both have good intentions, if the therapy was successful the client should be carrying with them an internalized positive version of the therapist. This internalized version of the therapist is likely a guiding light for the client and it is important that that light continue to guide the client for the rest of their lives. Entrance into a romantic relationship could dim this light or alter it, or shut if off all together. Perhaps there are some cases where the relationship may not interfere with this light every once in a blue moon (some people do marry their T), but on the whole this is a huge gamble. A romantic relationship, even with the best intentions may undo all the work of therapy. So the thing is that the risk of harm is so great that it warrants legal protection. And while in some states T's may engage with clients after several years, all professional codes state that a T may not enter a social relationship with a client after therapy has elapsed if that T believes for any reason that such a relationship may harm the client. So the T is always, always, always, responsible for the client's health and well being.

All of this being said I would really encourage anyone reading this forum who is having transference or strong feelings about their T to tell them. I told my T a while ago that I loved her, and she told me that she couldn't say "I love you," back, because this was a boundary for her, but when pressed she said if there was a way for her to say unambiguously that she loved me as a therapist she would say that, and when I told her that I thought she loved me (even though she wouldn't say so), she simply said, "how do you know?" Since this appointment, she has found ways to really show and tell me how much she cares. And the relationship is really developing into a strong and loving bond. I think that for some people erotic feeling in therapy might just be the beginning of developing a healthy attachment with a T. It is worth it to explore these feelings, and I think it helped me a lot to know that even though my sexual desire for my T would not be met, the needs that that desired represented would be met either in the therapy relationship, or by the things that I learned in therapy.

AMAZING POST, Depletion. Thank you.

Depletion,

Thank you for this well thought out, clear, amazing, heartfelt post.

I agree. Depletion. Great post !! Thank you very much!!!

Yeah, I liked very much what Depletion said about T being a guiding light.

It's not going to happen. He's happily married and his wife's a doctor so I have no way of fitting into his world

There is a part of me that completely understands why there are laws about this kind of thing, but the rest of me mostly thinks it's dumb if the client wanted it to happen or participated willingly. I have a relationship with my former therapist and while I know it's wrong, it seems so right. Torn over the topic. I'd never tell on him ever! I know I'm not normal. Just very confused on this topic myself.

I understand, in theory -- and for many of those who have dealt with real situations -- why it's wrong.

But why MUST it always be wrong?

I came to my T completely hollowed out and destroyed already. I was stripped of my pride, my hope, my will. I felt that I was already dead in most of the ways that mattered.

There is nothing a relationship between us could do to hurt me any more. I would never do anything to hurt her professionally or personally. We are two consenting adults and kindred souls.

I don't accept that it must always be wrong or hurtful.

I am happy for you that something that seemed right to you became right in reality.