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The following statement on the issue of whether a psychotherapist’s sexual relationship with a patient can be deemed to be consensual was given in testimony in Massachusetts in the 1990 in conjunction with House Bill H5697, an act relative to criminal penalties for sexual misconduct by mental health professionals and health professionals. Although this bill died in committee, we continue to believe that this statement makes clear why such relationships are neither consensual nor “affairs.” “I come here as a therapist and in association with TELL, The Therapy Exploitation Link Line. TELL now serves as a networking base for more than 150 women who have been sexually abused by therapists and other health care professionals. For most TELL members, this was a trauma from which they may never fully recover. "We know that many of you have been led to believe that victims of sexual abuse are a group of sex starved individuals who welcomed and consented to the therapists' advances or, in more extreme cases, actively seduced an unsophisticated, unsuspecting psychotherapist. Our purpose in testifying is to make clear just how far from the truth such assumptions are. "Consent is meaningless unless it is also possible to say no. Coerced consent is a direct contradiction of terms. Yet, this is precisely what is involved in the abuse of a patient by a health care professional. "The nature of the doctor–patient relationship is based on complete trust and openness. From the outset, a patient in a therapy relationship is assured that it is completely safe to be more open with the therapist and more trusting than he or she has ever dared to be before. Indeed, patients are told that the absence of complete and absolute trust will undermine the therapist's ability to help. As the therapy progresses, the relationship grows, and the patient becomes ever more dependent on its continuation. "In short, the investment in the therapy relationship becomes huge, both in dollars and emotional commitment. For many victims, the course of the therapy has also included a systematic isolation from family, friends, and sources of intimacy outside of the therapy setting, an isolation actively fostered by the victimizing therapist. When the therapist either explicitly or implicitly suggests—and this is what often happens in therapist abuse—that having sex with him (or her) is a necessary step in the therapy process, the victim's choice is to yield or risk the loss of that investment. "The threat of being cut off from the critical support that the therapy relationship has provided makes it all but impossible to refuse. The coercion could hardly be greater if it took the form of a gun to the head. This may sound melodramatic, but it is precisely this vulnerability that therapists are trained to recognize, and the bad ones have learned to use. "We believe that the vast majority of therapists are wholly reliable and would never become sexually involved with their patients. However, the ten to 15 percent of therapists that competent researchers say abuse patients must be punished or deterred. "These are health care professionals who, in the guise of healing, are willing to injure their most vulnerable patients in order to satisfy their own base needs. They rely on the vulnerability of their patients not only in coercing the sexual relationship but also in avoiding its disclosure. Many even tell their victims that they don't fear disclosure because no one would believe the patient's word over the doctor's. "Over the years, most of these abusing therapists have been proven correct. Very few victims have been willing to go public. But, as with rape and incest, the time is past when we can continue to blame the victim while allowing the perpetrator to go unchecked.” TELL Founders To return to the list of Essays, click here. |
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