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Way Too Personal


WebMD Feature

Secrets, dreams, fears, fantasies -- all are shared with the professionals we hire to guide us toward optimal mental health. It's no surprise that patients often become attracted to their therapists.

But woe to the shrink who allows this attraction to develop into a sexual relationship. In its Code of Conduct, the American Psychological Association (APA) forbids sexual relationships during therapy and for two years after therapy ends. Violating this code can bring expulsion from the APA, a revoked license, and a nasty lawsuit.

Every year, about 17 therapists are expelled or asked to resign from the APA due to sexual misconduct, according to the organization, which began keeping track of the numbers in 1993.

Now, the APA is considering changing its Code of Conduct to forbid post-therapy sexual relationships forever. This means that if a woman runs into her former therapist 10 years later, for example, and the two begin a sexual relationship, the therapist could risk his entire career.

Once Vulnerable, Always Vulnerable

Why such a hard-line attitude? "Because of the possibility of the patient being harmed," says Rhea Farberman, spokeswoman for the APA. People often arrive at therapy with many concerns, sometimes focusing on sexuality issues and distress about how they were parented, says Farberman. ''These vulnerabilities can remain for a lifetime, and a sexual relationship with a therapist could compound their problems," she adds.

When Is Close Too Close?
Despite the current controversy, reputable therapists may offer hugs and other physical comforting, and as long as the relationship stays professional, that's fine.

"The perception of the person being hugged is more important than the hug itself," says the APA's Farberman. If you're not comfortable with the touch or the words, they are inappropriate.

First, tell the therapist how you feel. "If it moves to a clearer sexual advance, stop seeing him or her immediately," says Farberman. "If you want to, file a complaint with the state licensing board and/or the APA Ethics Board in Washington, D.C." For more information, go to www.apa.org.

Furthermore, says San Francisco psychotherapist Dorothea Lack, Ph.D., the process called transference almost always occurs during intensive therapy. This happens when the patient transfers onto the therapist the feelings he or she had for an earlier authority figure, typically a parent. "Transference lingers for life," she says, which is why a sexual relationship can never be equal, even years after therapy has ended. (Transference is not common, however, in short-term counseling, such as the two to six visits typically provided by managed-care programs.)

A Hug-Free Zone?

Since it's part of an in-depth review of the Code of Conduct, the APA's code on sexual relationships won't change for two to three years, if at all. Members are expected to comment on the proposed change by the end of this year. The final decision will be made by the APA Council of Representatives, which includes its board of directors and state and regional representatives.

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