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The following is excerpted from the booklet Professional Therapy Never Includes Sex published by the California Department of Consumer Affairs.

Warning Signs
In most sexual abuse or exploitation cases, other inappropriate behavior comes first. While it may be subtle or confusing, it usually feels uncomfortable to the patient. Some clues or warning signs are:

  • Telling sexual jokes or stories.
  • “Making eyes at” or giving seductive looks to the patient.
  • Discussing the therapist’s sex life or relationships excessively.
  • Sitting too close, initiating hugging, holding the patient or lying next to the patient.

Another warning sign is “special” treatment by a therapist, such as:

  • Inviting a patient to lunch, dinner or other social activities.
  • Dating.
  • Changing any of the office’s business practices (for example, scheduling late appointments so no one is around, having sessions away from the office, etc.).
  • Confiding in a patient (for example, about the therapist’s love life, work problems, etc.).
  • Telling a patient that he or she is special, or that the therapist loves him or her.
  • Relying on a patient for personal and emotional support.
  • Giving or receiving significant gifts.
  • Providing or using alcohol (or drugs) during sessions.

Signs of inappropriate behavior and misuse of power include:

  • Hiring a patient to do work for the therapist, or bartering goods or services to pay for therapy.
  • Suggesting or supporting the patient’s isolation from social support systems, increasing dependency on the therapist.
  • Any violation of the patient’s rights as a consumer (see “Patient Bill of Rights”).

Therapy is meant to be a guided learning experience, during which therapists help patients to find their own answers and feel better about themselves and their lives. A patient should never feel intimidated or threatened by a therapist’s behavior.

If you are experiencing any of these warning signs, trust your own feelings. Check on the therapist’s behavior with a different therapist, or with any of the agencies in “Where To Start” (below). Depending on what you find out, you may want to find another therapist.

What If It’s Me?
If you have been sexually abused or exploited by your therapist, you may be feeling confused. You may feel:

  • Guilty and responsible — even though it’s the therapist’s responsibility to keep sexual behavior out of therapy.
  • Mixed feelings about the therapist — protectiveness, anger, love, betrayal.
  • Isolated and empty.
  • Distrustful of others or your own feelings.
  • Fearful that no one will believe you or understand what happened, or that someone will find out.
  • Confused about dependency, control and power.

You may even have nightmares, obsessive thoughts, depression, or suicidal or homicidal thoughts. You may feel overwhelmed as you try to decide what to do or whom to tell.

It’s essential that you face what happened. This may be painful, but it is the first major step in healing and recovering from the experience. You may have positive and negative feelings at the same time, such as starting to feel personal control, being afraid of what may happen in the future, remembering the experience, and feeling relieved that the sexual relationship is over.

The second step in the healing process is to decide what YOU want to do next. Try to be open-minded about your options.

Remember: It doesn’t matter if you, the patient, started or wanted the sexual involvement with the therapist. Therapists are responsible for keeping sexual intimacy out of the therapy relationship and are trained to know how to handle a patient’s sexual attractions and desires.

Where To Start
You may need to (1) talk to someone who will understand what you’re going through, (2) get information on whether the therapist’s behavior was illegal and/or unethical, and (3) find out what you can do about it. Three places to get help are:

  • Licensing Boards — In the Department of Consumer Affairs, three different boards license therapists. They can give general information on appropriate behavior for therapists and your rights for reporting what happened, as well as how to file a complaint.
  • Sexual Assault/Crisis Centers — These centers have staff trained in all types of sexual abuse and exploitation. They can provide general information on appropriate behavior for therapists, crisis services, your rights for reporting what happened, and names of therapists and support groups that may be helpful. Look in your telephone book under “sexual assault center” or “crisis intervention service.”
  • Professional Associations — Each licensed therapy profession has at least one professional association. Associations can provide general information on appropriate behavior for therapists, your rights for reporting what happened, and how to file a complaint. They can provide names of therapists who may be helpful.

What You Can Do
You can deal with your situation in several different ways. Take time to explore all of your rights and options. It may help to decide what your goals are:

Reporting the Therapist — Perhaps you want to prevent the therapist from hurting other patients. You may want to make it known that sexual exploitation is always wrong. If this is your decision, you have several reporting options. It is important to note that reporting misconduct is time-sensitive. What can be done in response to the report of misconduct usually depends on:
— who the misconduct is reported to, and
— the length of time between the misconduct and when the report was filed.
Such a time limit is called a “statute of limitations.” As you consider your options, be aware of these time limits.

Your Recovery — You may also want to explore and process what happened between you and the therapist. If you decide to do this, you can look into therapy or support groups.

Moving On — You may wish simply to move on past this experience as quickly as possible and get on with your life. Remember — you have the right to decide what is best for you.

Your Reporting Options
If you decide to report a therapist’s behavior that you believe is unethical and illegal, there are four different ways to do so. All of these reporting options are affected by time limits, so you should consider reporting misconduct at the earliest appropriate opportunity. You may choose one or more of the options listed below.

  • Administrative Action — File a complaint with the therapist’s licensing board.
  • Professional Association Action — File a complaint with the ethics committee of the therapist’s professional association.
  • Civil Action — File a civil lawsuit.
  • Criminal Action — File a complaint with local law enforcement.

From Professional Therapy Never Includes Sex Copyright 2004, California Department of Consumer Affairs.

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127 Comments

  1. Hi, I see my therapist weekly & somehow he has arranged that I don’t have to pay a co-pay which saves me $40 per month. I have been seeing him for two years. We are close in age & we both are married. My marriage is not good, but i have been a faithful wife even tho’ my husband & I have not had sex in over 12 years in a 19 year relationship.
    My past is filled with sexual, physical & emotional abuse that I have been trying to treat on & off for 35 years with quite a few of those years being suicidal.
    I had never before seen a male therapist that was this close in age with me. We started off slow, but as I began to trust him I opened up to him in ways I had never before with any other therapist. He began to tell me about his life. He began to call me sweetheart, honey, sweetie. He would sometimes hold me if I was crying especially hard & he hugs me after every session. He also calls me once or twice during the wek just to talk. He says we are friends & he promised he will never leave me, I am sure he made this promise because of my separation anxiety, not to be cruel.
    Now I have found myself to be in love with him, of course, his feelings are not reciprocated. He tells me that he will be leaving me to return to his hometown. I am devastated. I am so scared & confused. I feel very suicidal right now.
    My family tells me to give therapy another chance – this was my another chance – I can’t do this again, trust someone, create a new relationship. I’m so tired, I don’t know what to do.

    • Sue, I’m so sorry to hear about this and for what you’re going through. Your therapist really violated the boundaries of the relationship, intentionally or not, and now you are paying the price for it. I understand being exhausted, scared, confused, and wanting the pain and suffering to be over with — and you’ve got to hang on. He is not worth your life. Your life is precious and it is YOURS.

      Please call a crisis support hotline. There are some listed on the right side of the website if you scroll down.
      And I know it’s tough, but if you can get a referral for a new, FEMALE therapist with a good reputation (maybe check Yelp for reviews?? or try an online directory like PsychologyToday.com) it would be really good to process this with a boundaried therapist who can help you understand what happened and heal. If you can’t do that, perhaps a religious or spiritual advisor?

      This guy really messed up. If he has any clue what he’s done, HE should give you a referral for someone new because holding the boundaries for a SAFE therapeutic relationship is absolutely his responsibility.

      Keep reading the posts and comments on this website — it may help you feel less alone. You can also visit TELL at http://www.therapyabuse.org for things to read.

      If you continue to feel desperate, PLEASE CALL CRISIS SUPPORT or 911. They’re there to help.

      Love to you!
      Kristi

  2. Hi Kristi,

    I started seeing my new therapist (he’s a psychologist) since December. I was seeing seeing another therapist but then decided to end it because I got tired of talking about how I feel for so many years. I just got fed up and told myself I’m better now I don’t need therapy anymore. (I have social anxiety, depression, bipolar disorder and borderline personality disorder). In December I began having panic attacks again and my depression got worse after an incident with someone on facebook. I deleted my account but I was still hurt and started cutting myself which I did a lot when I was a teen. I’ve been feeling suicidal also. I was diagnosed with having borderline when I was 18 but I never discussed it with any therapist because of how some therapists feel about people who have it. There seems to be a stigma with borderline and people think if you have it you’re a difficult patient and or violent. I’ve never been violent with anyone. If I’m angry I usually cut myself but never assaulted anyone. So I kept it to myself all these years. I never told my friends I have borderline either. I felt ashamed to have it, but they know about my other disorders. My mom knows but not anyone else in my family. I was sexually abused by my dad when I was a kid so I always had a hard time being intimate with men, extremely uncomfortable with sex to the point of denying that I have any sexual feelings. I felt it was wrong to feel that way. Again, no one I dated knew how I felt because I kept it hidden which was very frustrating. So then I decided I needed to talk to someone again and be honest about having borderline. I found another therapist who is a man. The one I was seeing before was a woman but I’ve had a few male therapists in the past so I wasn’t uncomfortable about it.

    When I called him, it was difficult but I had to be honest from the beginning. I was so relieved when he said he has experience with borderline patients and that his approach is different. He’s very friendly and more open to doing other things than what most therapists do because he wants patients to be very comfortable and trust him. The first session I was anxious but after a while he made me feel more and more relaxed. He has a great sense of humor which also helped. He doesn’t mind texting which I never did with my other therapists and when I need to, he often texts back the same day. He likes to take walks and explained to me that some patients feel more open to talk while walking instead of always having to talk inside the office. Also, at the same time, getting exercise because that’s part of therapy. He told me exercise helps patients feel better mentally. I felt, wow, this is different and I really like that. He also wants me to join a group because of my social anxiety but right now, he’s only introducing me to some people so I can be comfortable with them before I join. I often talk to one person in the waiting room every Tuesday after my session is over at 11 am. The group starts at that time and the sessions are two hours. While everyone is in his office, I’m usually talking to one of the members for two hours in the waiting room. At first I thought it was a great idea but this has been going on since January and I don’t understand why he feels I’m still not ready to actually talk with those I’ve met inside the office since I feel comfortable with them now and it’s only a small group. I’m thinking, why I have to keep talking to the same people in the waiting area? I can understand if it’s someone different he wants me to meet. Maybe it’s nothing but for some reason I’m confused about it.

    Other things have happened recently like one session he wanted me to drink water that will also help me feel better mentally and physically. When I drink something, I usually sip it unless I’m very thirsty and then I’ll drink a lot. He wondered why I was sipping it and showed me how he drinks water which is gulping it down. I felt, well, I’m not really thirsty and also that’s the way I drink. Is there a rule I have to drink it the way he does? I never discussed it with him because I’m not comfortable expressing how I feel about something that irritated me. I know I have a hard time being assertive and get so angry at myself when I just sit there and don’t say anything. Sometimes I still have difficulty with eye contact so he brings it up a lot. I told him the reason is because I have social anxiety and if I’m uncomfortable about something that’s difficult to say, I can’t look at him and find myself focusing on something else in the office. Again, I got irritated because he’ll keep saying it’s one of my weaknesses but doesn’t give any suggestions on how I can improve it. I feel I make eye contact better than I have in the past but he insists I still have poor eye contact. Yes, he actually said poor. I felt he was being too critical and he knows I don’t feel good about myself because of my mom who was very critical of me so I always felt I needed to be perfect. I know he wants me to get better but maybe he should have said it differently? Maybe I’m reacting this way because I’m very sensitive? Again, I don’t know.

    At first I felt really comfortable with him but now he seems different. He can be very controlling and sometimes I feel like he treats me like a child. Once, while waiting for my session to start he came out of his office and said come in young lady. Young lady? I’m in my 40’s and he’s in his 60’s. Why is he treating me like I’m his daughter? He wasn’t joking either. He said it very serious like a stern father. Then I thought maybe it had to do with me finally being assertive and confronted him about something he said in another session. It seemed like when he said come in young lady (which he never said before) I sensed that he may have been upset that I spoke up about how I felt. But isn’t that what you do in therapy? To discuss what you’re feeling? Even if you’re angry about something? Should a therapist take it personally? He also talks about himself a lot during some of my sessions. I don’t mind if a therapist disclose something about him or herself if it helps me feel better and more relaxed. I can open up more because they’re not so rigid. But many times I’ll say something and I notice the conversation goes back to him. Like lately he talked about going to the pool and he’s a member there. He loves to swim and it makes him feel better mentally. I was curious about it and told him I have a water phobia ever since I was 15 when a guy I knew threw me in the water at the beach despite me telling him I can’t swim. My therapist asked me if I want to see the pool and since he’s a member he can take me there as a guest. He also said he can help me get over my fear of water and teach me how to swim, but again, he added it’s good exercise and it’s part of therapy so I’ll need to buy a swim suit. He asked me if I would be comfortable with him seeing me in a swim suit and seeing him without his robe when he gets in the water. I said yeah, but now I’m feeling is this right? He said it will be my therapy session but should we be that close because there would have to be physical contact while he’s teaching me. Then he also said I was pretty and I have a nice body a few weeks ago because he knows I have a hard time accepting compliments from people and when someone looks at me, I’m always thinking I look weird. So I guess he wants me to feel better about myself but then last week he said I was beautiful and I have nice skin. I’m thinking, wait, at first I felt good about him complimenting me because he wants me to think more positive about the way I look and I thanked him. But after he said I’m beautiful, should he say that to a female patient? Is he really flirting and wanting me to think it’s part of therapy to help me feel better? I’m very confused and what’s worse, because he’s saying all these things, I’m starting to have strong feelings for him. I find myself very attracted to him and having sexual fantasies about him constantly. I feel so ashamed to be feeling this way. I try so hard to deny any sexual feelings but now I’m afraid of losing control and I’ve been obsessing about if he’s attracted to me. Maybe he’s not but why does he say things or want me to do things like going to the pool? Is what he’s doing wrong or is it just me feeling paranoid especially since I’m borderline? I don’t know what to do. I’m just so confused right now. Kristi, what do you think because I don’t know anyone else I can talk to about this.

    • Hi Vonnie,
      I agree with J. This sounds so much like my own grooming process — and that of so many other victims of abusive therapists. He is testing the boundaries, then pushing them to see how far he can get, while totally normalizing the process and making it seem as though all this is the most natural thing in the world. It’s not. This man has horrible boundaries and he will keep pushing yours. Your therapy has become about HIS needs, not yours. There’s nothing YOU can do to bring this back into balance. It’s not your fault, it’s not your responsibility. Follow your gut and instincts on this — they’re telling you that this is not right. I strongly encourage you to stop seeing this therapist and find someone new. He will want you to keep coming to see him and won’t want you to leave — that, too, is the mark of poor boundaries, because a good therapist would respect your need for something different. So yes, you will probably need to make some effort to leave. Call on whatever support you need. Perhaps you can start looking for a new therapist who can support you in getting away from this guy?

      Stay strong and true to yourself!
      Kristi

  3. I know you were asking Kristi specifically, so I don’t mean to butt in, but I felt so unsettled reading what you wrote that I had to say something….. I know this road you seem to be on. I’ve been there, and it doesnt lead anywhere good. I dont know how exactly being a borderline would change the way you feel about a normal situation, but this doesnt sound normal, so dont let him or anyone else blame your discomfort on your being a borderline, or on you being sensitive, or on anything else. You’re feeling uncomfortable because what he’s doing is wrong. He’s testing the waters. He’s trying to see how far he can push the line before you freak out, and if I had to guess, I’d say that whenever you do freak out, he’ll probably just blame it on your disorder and claim that he meant no harm or that you’re over reacting. Guys like that are all the same. They seem to have a script they adhere to when they’re behaving unethically. I’ve read countless stories that sounded almost exactly like my own in some ways. It’s as if guys are offered some class on how to take advantage of female patients properly, so now they’re all doing the same things, in the same order, etc… They each put their own personal spin on it eventually, but the beginning of the path seems to always be the beginning of the path. I can’t say I’ve ever heard anyone say that they were on this path, but it led nowhere. Know what I mean?

    As far as your feelings for him, you have nothing to be ashamed of. Really, I’d bet that that is also his doing. He knows exactly what to say and what to do to spark those feelings in you, and it sounds like that is just what he has done. . .and even if your feelings are really your own, that’s ok too. There is no reason why you should have to be ashamed of that. Youre entitled to have any feelings that may come up. You should also be entitled to share those feelings in therapy without it pushing the relationship to a more inappropriate place. Therapy should be safe. It should never leave you with a need to seek out websites such as this one.

    I wouldn’t normally tell someone what to do when I dont know them or the whole story, so please forgive the presumptuousness, but in this case Ive heard enough to feel comfortable saying this – get yourself away from him. It’s not going to get better. He sounds like the kind of person who will keep pushing the line further and further as long as he can. If you wait too long to get out, you will find yourself in a lose-lose situation. Letting him get away with everything will feel intolerable, but the reporting process is equally intolerable. Im in the middle of it now, and It’s completely violating… Please get out before you end up having to choose between two equally horrible paths. Find someone who has good, traditional boundaries. You’re not paranoid. You’re smart enough to see through what he probably thinks is a good smokescreen.. Trust your gut and move on to someone else. I wish you the very best

  4. Vonnie
    J is right. Get yourself away from him as fast as you can! I am speaking from personal experience. I was married to a psychologist and it is my understanding that this is the same pattern that he used with people. He was forced to resign from one job due to sexual harassment and then lost his license to practice after having inappropriate relationships with several patients, one (or more) of whom he impregnated. He made them feel comfortable then guided them into a “relationship” with him. I believe he also used psychological testing perhaps to see who was susceptible to his advances. Whenever I questioned him about something I observed, he would say I imagined it and even told our own therapist that I was crazy because I was always “imagining” things and that it must be out of jealousy. Needless to say, the things I “imagined” were indeed real and it manifested after his patient turned up pregnant. From what I understand, he would provide marriage counseling and use his skills to basically alienate the wife from the husband while using what the wife complained about to make the husband look unreasonable and wrong and make himself seem like the better pick. To my knowledge, he destroyed several marriages this way. He would also woo children of single mothers with gifts and use that to form a “relationship” with the mother. I know of at least 7 “victims” so who knows how many there really are. Not one of his female patients have reported him or acknowledged that he crossed boundaries with them. He had a habit of bullying and manipulating people into keeping quiet or doing other things. Once I saw the magnitude of his illness, I divorced him. He is now married to one of the patients he impregnated. I also found out after we divorced, that he had propositioned or been inappropriate with, several friends and family members ( a couple of whom were teenagers at the time). Trust me when I say you would do well to cut all ties with your therapist!

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