I am a therapist. One of my opposite-sex clients and I have grown very fond of each other, and we've talked about a physical relationship. Client-therapist sex is considered ethically taboo, of course, but I don't see anything wrong with it in this case. We both want it, so it's not exploitation.
We are both intelligent adults who can make our own decisions. I used to believe in the taboo, but this situation makes me realize that the taboo goes too far in not allowing for exceptions. The taboo denies the individual autonomy of both therapist and client. As long as both parties are mature and the decision is mutual, adults should be allowed to make up their own minds on this.
Don't you agree?
No, we do not. And despite your conclusion, you must have had some nagging doubt yourself, or you wouldn't have asked . . . and we're sorry to have to tell you that your doubt is correct. Don't do it!
Sexual relations between therapists and their clients are categorically wrong, not because of "ethics", but because of the nature of the relationship, which precludes true autonomy on the part of the client. Furthermore, it is entirely the responsibility of the therapist to prevent sexual relations from happening.
That's the bottom line. but why is it so?
A therapeutic relationship is inherently authoritarian to some extent, no matter how much you may try to avoid it. In this it is like client/student/disciple relationships with doctors, lawyers, teachers, clergy, gurus and inner-growth facilitators. There is an imbalance of knowledge. expertise, power and often
resources in the relationship. The client wants, needs, something the practitioner can provide, and may be frightened that it might be withheld. This fear adds to the client's vulnerability and therefore may not be acknowledged. All this creates a powerful incentive to please the practitioner, so clients may mask negative feelings about the relationship even from themselves.
In this situation, an element of intimidation is inherent in any overtures made or accepted by the practitioner. There is no way to eradicate this, for it derives not from any action or attitude but from the structure of the relationship itself. Similarly, an unconscious element of prostitution may be present in any overtures made by the client if he or she senses that such overtures might be welcomed by the practitioner. Trading sex for favors from those in power is not a new idea - even chimpanzees do it. And where intimidation and prostitution may motivate the sexual solicitation, how can it be accepted without exploitation?
Implications of Regression
The harm goes deeper - much deeper. The dependency, power and authority imbalances in the client-therapist relationship resonate with the dynamics of the parent-child relationship in both client and therapist. Again, this is true also for doctors, lawyers, teachers and clergy, but in therapy (and often other forms of inner guidance) it is carried a step further. Because therapy so often deals \k,th a client's childhood issues, the parent-child dynamic within the therapeutic relationship is reinforced. In fact, this "transference" may be therapeutically utilized as an aid to the client's regression. This is very beneficial, since regression enables the client to process feelings and issues at the psychological age at which they originated.
This means that the client is to some extent, at least, functioning in the therapeutic relationship from the psychological age of a child rather than an adult, and is relating to the therapist in part, at least - as a child relating to a parent. This means that any sexual relations between the client and therapist will have, to some degree at least, the meaning and impact for the client of a parent-child incestuous rape having occurred at the age to which the client is regressed.
You may object that sexual relations with a client can avoid this catastrophe as long as the client is not in a regressed state at the time. But this won't work, for four reasons:
For example, as part of the oedipal stage, many children have desires and fantasies of having "relations" with the opposite-sex parent, although the sexual details of this may not be understood. This is normal and common. But under the influence of transference in the therapeutic setting, it may manifest as feelings of affection and sexual attraction for the therapist. These may be expressed in a completely adult way, and this can be very flattering as well as arousing to the therapist.
Also, sexually "coming on" to the therapist may be a way for the child to test that Mommy or Daddy is "safe" - and for the adult client to test that the therapist is safe.
A client's masking of regression and transference, along with your own countertransference, may create a massive blind spot in this area that you cannot assess. The only safe response is to assume that regression, transference and countertransference are always operative. And if they are, any sexual relations with a client may have the psychological impact of parent-child rape.
- It demands of the client a 100% capacity to separate in his or her mind the client-therapist relationship during the regression from the client-therapist relationship during the adult state. This is impossible, since in fact it is the same two people.
- You can't tell if regression is totally absent at a particular time. Few people operate entirely from an adult state. Most operate somewhat from the dynamic of unresolved parent-child issues, and this is itself a chronic partial regression that is masked and presented as part of the adult state. In any case, even if no regression is manifest in the communication, you cannot be sure what associations are in the client's mind.
- Even if the client is in a fully adult state while discussing this, and when making the decision, they are likely to slip into a regressed state during the sex itself or to recall the sex during a regressed state In therapy, so that the adult sex with the therapist is mingled with the child-parent relationship at a regressed (child) age in the client's mind.
- As you know, the client's projection of a parental image onto his or her therapist --transference -- is often matched by the therapist's projection of a child image onto the client - countertransference. It may be impossible for you to assess your countertransference objectively. This, in turn, sets you up to is interpret your client's feelings of affection as well as your own.
The Therapist's Responsibility
The client has an intrinsic right to test and express in sexual ways, and the therapist has an intrinsic responsibility to understand this and be able to handle it - which means finding his or her own sexual gratification elsewhere. If necessary, you can insist that your client not express beyond a certain limit, for you have a right to your own boundaries. It is far better to assert your own boundaries than to transgress those of the client.
As a therapist, your job is to lead your client towards a healthy mind and a healthy life. How can you lead them to a place where you are not? And part of a healthy life is getting your sexual needs met in some way that you find satisfactory. Thus, if you are a therapist, you ought not to need additional sexual fulfillment from your client, and in accepting such you are inflicting your own deficiency on them. How can this not divert the therapy from its most healthy course? And how can inflicting such damage on your client for the sake of your own deficiency not be an exploitation and betrayal?
Some therapist-client "couples" have tried to dodge all these problems by ending the therapy and waiting several months - perhaps not seeing each other in the interim - then getting together and developing a new relationship sans therapy. A clever idea - but can it really work?
Your client has come to you for therapy. In terminating therapy - even for "love" - you would be abandoning them as a client. This compromises their therapy, unless your therapy with them is terminated naturally. But even the idea that you could do this may create a pressure in you to terminate the therapy at a time when the client needs you to be there for them as a therapist instead.
And after the moratorium, what then? Unless your former client now has another therapist they still cannot be free of their client role with you. Even having a new therapist may not prevent that. And the pattern you initiated may have set them up for doing this with other therapists, thus further subverting their therapy. It just doesn't work.
Even thinking about it doesn't work. Of course, sexual desire as well as countertransference may always get stirred up in you, and part of your job is to recognize and deal with these internally. But the moment that you allow even in principle the possibility that you could actually act out such desires with a client, this idea will infect your mind like a virus, drawing your mind away from the detached caring attention the client needs and is paying for and this infection will spread to contaminate your relationship not only with this client but with every client you may find attractive.
Furthermore, because the subconscious mind acts as a servomechanism (goal-seeking device), holding an image of sexual relations in your mind will cause you to act in subtle ways that tend to bring this about. And then, when your client makes the first overt move, you will say, "Of course! I could see it coming," never realizing how you steered things to create the situation.
The only solution is to take a deep breath, sigh, and let go forever of the possibility . . . then turn your attention 100% to the client's needs.
There are other fish in the sea - for both you and your clients. Part of your job is to help guide your clients into expressing their healthy feelings of affection and sexuality in relationships with well-chosen peers. A client and practitioner are not peers - not because one is superior as a human being, but because of their roles.
And so . . . no sex with a client. Being a therapist has many rewards, and rewards always have a price. The discipline of sexual restraint is part of the price of being a therapist.