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No profession involving intimate contacts with clients, patients, or students is immune to sexual temptation. Masters and Johnson report evidence of such relations occurring in “physicians of every established discipline treating sexually inadequate men or women, behaviorists (the major disciplines), theologians (the major religions), and legal advisors.”’ To this list we must add teachers, counselors, and paraprofessional help-givers. This paper will describe some psychodynamic aspects of the seduction of patients in psychotherapy.
Reliable estimates of the frequency of such occurrences are understandably very difficult to arrive at in view of their sensitive and covert nature. In 1973, Kardener and his associates2 published the results of an anonymous questionnaire survey of 460 physician respondents from a county medical society, 25 percent of whom were psychiatrists. Five percent of these psychiatrist respondents admitted to having had sexual intercourse with their patients, while an additional 5 percent said they had indulged in erotic practices short of intercourse. An equally disturbing figure was that 20 percent of the psychiatrists were of the opinion that such contacts might be rarely or occasionally beneficial to the patient! It is of scant comfort to know that the percentage figures from other physician respondents were all somewhat higher than those for psychiatry. Figures such as these, however small, cannot and should not be ignored because the potential for harm of such behavior is very great, not only to individual patients, but to our discipline as a whole.
There has been much written in the psychoanalytic and psychiatric literature about the erotic transference that often takes place between female patients and their therapists — about its meaning as a resistance phenomenon or as an unconscious effort to sabotage the therapy. A good deal has also been written about the seductive female patient and her psychodynamics — the oral dependency masqueradin