If it shocked you to read, in today’s story about a psychologist accused of sexual misconduct, that 9 percent to 12 percent of mental health professionals admitted in surveys they’d had sexual contact with a patient, consider this: Those percentages could be an underestimate.
The numbers reflect only those therapists who responded to the surveys and who acknowledged the conduct.
Jan Wohlberg, a founder of the Therapy Exploitation Link Line or TELL, an online network for survivors of exploitation by health care providers, said that her website gets 40,000 to 45,000 visits a year — a sign that therapist abuse remains a common concern.
Why would a therapist do such a thing? Andrea Celenza, a psychoanalyst who studies therapist-patient sexual misconduct, said that some are predators with a need to dominate and control, but about 60 percent merely fall prey to their own weaknesses.
Wohlberg takes a harsher view, saying that many are “psychopaths or almost psychopaths,” who act compulsively.
Even if you believe that a therapist guilty of sexual misconduct can be rehabilitated, Wohlberg said, would you send a family member to a person who had committed such an offense?
Can’t a psychologist fall in love with a patient? A psychologist may start to feel that way. But all are taught to confront and manage those feelings in consultation with other professionals, and always to refrain from acting on them. If they can’t control their feelings, they have an ethical obligation to terminate the therapy and refer the patient to someone else.
Even if the patient welcomes or encourages such feelings — even if the patient actively tries to seduce the therapist — it’s the therapist’s responsibility to maintain healthy boundaries.
How does sexual misconduct affect patients? No matter the therapist’s motivations, the patient is almost always grievously harmed by the betrayal of trust inherent in sexual misconduct. For therapy to work, patients need to bare their soul and put trust in the therapist, which gives the therapist tremendous power. To exploit that trust for personal gain is considered such a severe offense that it’s not only unethical, it’s illegal. In half the states -- although not Massachusetts -- therapist-patient sexual contact is a crime.
“It is the only mortal sin we have in our profession,” said Eric Harris, a retired lawyer and psychologist who worked as a risk-management consultant. “It’s the worst thing you can do to someone.”
How can you tell if a therapist is crossing the line? Inevitably strong emotions will arise in therapy, including love. But the therapist should know the boundaries.
“Psychotherapy is a talking cure. There really isn’t touch involved for the most part,” said Gary Schoener, a Minneapolis psychologist well-known for his expertise in therapist sexual misconduct. “Touch, long hugs, are always suspect. Self-disclosure by a practitioner should be fairly limited to things that are connected to the client’s case.”
If the therapist is talking too much about his or her personal life, that’s a warning sign, Schoener said.
This article on the TELL website provides a checklist of red flags in therapist-patient relationships.
Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer