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Psychotherapy is an intimate, private and deeply personal experience. Both therapist and patient/client co-construct, in the common professional parlance of the day, a relationship where unknown or unexpressed desires, conflicts, questions and dreams are explored. For this unveiling process to occur the therapist must reveal some “humanness”, kindness, and compassion no matter how neutral he or she is with regard to technique. There can be and often are intense, deeply experienced emotions expressed by the client/patient. The range of their feelings is broad including anger, fear, despair and love.

If the therapist is able to continue to engage and not be frightened off by such an emotional outpouring, the therapy can progress as misunderstandings are addressed, ruptures repaired and emotions integrated. The therapist is often a trusted, calm ally present for the client/patient’s self scrutiny and questioning. This is if all goes well, and as with any human enterprise such is not always the case. Often, love expressed in therapy, for example, can be confusing, frightening and fraught with potential risk for both patient and therapist.

Despite whatever emotional reactions the therapist might have, he or she has the responsibility to prevent this “love” from becoming sexual in the consultation room. Again, sadly this is not always the case. The therapist, perhaps feeling lonely or depressed, seeks to get respite from these feelings by becoming sexually involved. Other therapists may believe they deserve sexual favors due to their inflated sense of their own attractiveness and charisma. There are many reasons for such boundary violations and none of them are good. The therapist has abrogated his moral responsibility by taking advantage of the patient’s vulnerability to meet his needs. The therapist is not loved in the true sense of the word, but, as Freud reminds us, rather he is loved for what he represents (yes, it’s still called transference).

There are warning signs for clients to notice which may reflect the therapist’s intent to sexualize the relationship.

1. Routinely extending the session beyond the agreed upon duration.
2. Touching the client after the session, e.g. a hand on the shoulder, a rub on the back or most confusingly, asking the patient if she feels like she “needs a hug.”
3. Suggesting changing appointment times to the last hour of the day without a clear rational offered.
4. Spontaneously talking to the client about his feelings for her, e.g. how special she is, how she seems to understand him and his work, how no one really seems to appreciate her beauty, etc.
5. Being too solicitous, making calls to the client when they have not been requested.

These are but a few “seductive maneuvers”. If you as a patient experience any of them, caution is in order. Frequently a simple question about the conduct will be enough to prevent further intrusions. If, however, the therapist becomes defensive, accusatory or attempts to shame or humiliate then it is time to leave. If the patient/client is made to feel it necessary to take care of his or her therapist, therapy has also ceased. Sex, as a behavior to be acted on, has no place in any respectable therapy.