Comments and Criticisms

To the Editors:

In his unemotional paper on a highly emotionally loaded subject for which he deserves greatest praise, C. C. Dahlberg mentions the infantile grandiosity that is blatant in the therapist who ventures to cure the patient through sexual intimacy ["Sexual Contact between Patient and Therapist, " This Journal, Vol. 6, No. 2 (Spring 1970)]. However, Dahlberg fails to see this grandiosity in McCartney, whom he quotes but treats with too much protectiveness. In the article referred to by Dahlberg, McCartney claims to "have conducted over fifteen hundred psychoanalyses … with an average of 89 hours" over forty years. Assuming that he worked 365 days per year, this represents ten patient-sessions per day, which McCartney claims "represents 26 per cent of all the psychiatric patients seen." He thus must have seen an additional thirty patients per day 365 days per year!

This raises the question of how many patients McCartney, who was sixty-seven or sixty-eight years old when he wrote this article, treated daily in accordance with their sexual needs. It also raises the question as to what he did with male patients who might need therapeutic sexual intervention. It thus seems clear that all justifications of sexual contact between patient and therapist must be put into their proper place as rationalizations and denial.

I am wondering whether psychopathic tendencies do not play a part in therapists' sexual acting out. A former patient of mine in her twenties had first been seduced by her former therapist, who was married and had a child. Then the therapist found another female patient of his to informally adopt his mistress and support her through college. Of course, the adoptive mother knew nothing, and was to know nothing, of the affair between her therapist and her adoptive daughter. Furthermore, the therapist employed his mistress (after discontinuing her treatment) as secretary, in which capacity she was typing up material concerning other patients. He