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I have now been a therapist for over twenty years, and I never cease to wonder at the extraordinary nature of our work and at how much I have learnt about people, their way of coping with life's stresses and pain, their weaknesses and bravery. I am also amazed at how much I still learn about how the human mind works. It is, in fact, an extraordinary privilege to be allowed to get so close to individuals and to learn so much about them and their lives in such intimate detail. However, not only is it a huge privilege, it is also a huge responsibility.
I am very involved in the study of human violence. In my book on the subject, I devoted some space to the subject of the perversion of the professional caring relationship (Zulueta, 2006a). While other powerful individuals such as judges, military leaders, or police officers can all be involved in the perpetration of violence through the misuse of their power, it is misuse of power by those involved in the direct care of sick or disturbed individuals that is causing me increasing concern.
The professional-patient relationship lends itself to the re-enactment of childhood abuse as the relationship is very similar to the parent-child relationship. The doctor or therapist is entrusted with the care of his or her patient, whereas the patient is invited to regress to more dependent forms of behaviour because of the nature of the treatment. A surgical patient has to trust her doctor even when unconscious under the anaesthetic; a psychiatric patient needs to feel safe in the bewildering and painful confusion of a psychotic breakdown; a psychotherapy patient relinquishes old defences at the risk of feeling very vulnerable and helpless.
When any of these human interactions involves the re-enactment of an earlier abusive experience, the outcome can be devastating for the patient as a result of the unequal power relations that exist between therapists and their patients. Doctors used to address this particular danger when they swore t