Psychoanalysis and #MeToo: Where are We in this Movement?

Abstract

This paper discusses the impact of the #MeToo Movement on the field of psychoanalysis and the problem of sexual boundary violations in particular. A careful delineation of the past 4 decades within psychoanalysis is presented and aims to highlight how this vexing problem has been and continues to be addressed. I use the metaphor of the complex nature of light—constituted by both particles and waves—in order to envision a close, detailed examination of sexual boundary violations at the individual, psychoanalytic level and at a macro, group level. I contend that we have already had our #MeToo Movement, occurring in the late 1980s and 1990s, constituting a first wave of addressing this problem. I then describe a second and third wave through the examination of the various particles that make up each new wave. Case illustrations are used to exemplify typical cases that characterize the third (current) wave. The concern is raised that important insights on prevention and modes of redress are threatened to be lost if the history of what we have already accomplished, at both particle (individual) and wave (group) levels, is overlooked or forgotten.

Introduction

As psychoanalysts, we are as dedicated to finding truth as we are to cure. Sometimes these two, truth and cure, are set up in opposition: Do we relieve distress or help our patients understand themselves? This is a false dichotomy—truth is foundational in the process of growth and cure. We are also best suited to do both, given the excellence of our training, our ability to discriminate well-designed studies from those that are methodologically flawed, and especially our ability to think deeply, make subtle distinctions and fine discriminations. This is relevant for the #MeToo movement. We always denounce the exploitation of others, but with careful examination at the individual level (a different register

of meaning construction from the group level), we can see that not every exploitation is predation, nor every flirtation an assault.

The #MeToo movement is usually spoken of in universals—sometimes stereotypes, even—male vs. female, us vs. them, female victimology, toxic masculinity. These ways of categorizing phenomena reside at the group level, in the sociocultural register and level of discourse. It would be a category error to adopt this level of discourse and apply psychoanalytic principles to the group, especially in the absence of knowledge of or exposure to individual meanings and unconscious psychic construction. At the same time, the sociocultural register is not divorced from the individual level of discourse or study; they stand in dialectical tension and there are ways ‘one becomes the other’ in the sense that we internalize social reality, societal principles becoming part of our social unconscious. But again, this is done in very particular ways. We have to reckon with our sociocultural context, which in turn influences the way we phenomenally and unconsciously experience our lives. In turn, the sociocultural register impacts the way we unconsciously translate and constitute our unconscious. This is not a one-to-one correspondence, the individual is implicated in the way this sociocultural surround is translated, especially unconsciously, and these translations will vary.

What is happening outside our field, coinciding with and in some cases instigating the #MeToo movement, from my perspective as someone who has been addressing these concerns from within our field, harkens back to a time long past for us. The list of predators is long (at least in America) in Hollywood, corporate America, and the political arena. All of these are examples of abuses of institutionalized power—an imbalance that confers greater agency to the (usually) male figure over a disempowered woman. There is sometimes physical force involved, and possibly accomplices. In April, 2017, a list of accused ‘powerful’ people was compiled with a variety of allegations, some involving force, others including simply harassment.1 Here is a partial list of the accused:

Bill Cosby, Harvey Weinstein, Matt Lauer, Kevin Spacey, Bill O'Reilly, Tom Brokaw, Tom Ashbrook, Brett Kavanaugh, Clarence Thomas, Avitall Ronell (a female professor of Comparative Literature at NYU),

Al Franken, Louis C.K., Mario Batali, Cristiano Ronaldo, Bill Clinton, and Donald Trump. As can be seen, the accused span the range on the political spectrum. Some have received a due process investigation and hearing, some have been found guilty, others have had accusations recanted, all have had their reputations marred if not ruined.

Within our field,2 physical force is rarely involved. But we have had our list of predators. These include psychopathically organized practitioners who perversely exploit their patients premeditatively, sometimes multiple times with multiple women. Bizarre sexual practices are often involved and the harm these perpetrators impart is horrific, perhaps most importantly because of the ways in which it closes the door to support and treatment for the patient/victims. Further, I believe (based on my clinical experience but absent systematic, empirical evidence), that the prevalence of psychopathic predation within our field has markedly declined. This is a direct result of our zero tolerance for this kind of behavior and the fact that we are no longer naïve to it.

Derived from this, and honing in on each individual's relation to the so-ciocultural surround, is the psychoanalytic project: to expose and reconstruct, après coup, unconscious re-constituters, that is to re-elaborate and foster the evolution of an individual's unconscious and transferential propensities. Mechanisms will emerge in the here and now and be reconstituted, transformed and will retranscribe the ways the past is understood and held anew, in the present as well as encompassing a gaze toward the future. All of this occurs at a very particular, individualized level.

Here we can use a metaphor of the dual nature of light—both particle and wave. As the theory explicates, when light is refracted through a triangular prism, there is a dispersion of distinct wave frequencies associated with a diversity of colors, a rainbow, as it were. Using the nature of light and its properties as a metaphor, I suggest that we must be attuned to the particles as well as the waves and be curious about the dispersion

of frequencies in both. We must not be carried away with the wave itself, in its non-particularized form. Such is the challenge and complexity of the #MeToo movement in multiple registers. I will be noting the impact of the wave while focusing in on the particles and vice versa.

In my view, a psychoanalytic perspective articulates and differentiates the particles, thereby deepening the perception and experience of the waves. I intend to demonstrate the ways in which the #MeToo movement, through a psychoanalytic lens, may help to shed light on these very complicated problems if we hone our perceptual abilities and commit ourselves to grapple with the complexity of the moment in multiple registers. I also intend to demonstrate how we have had our own #MeToo movement beginning decades ago—in my view, this moment in time represents our third wave and I am concerned that the first wave in other industries (Hollywood, corporate America, the political arena—from where the so-called #MeToo Movement derives) is threatening to sweep us backwards. I further suggest that we, as psychoanalysts, are in a more complicated era that presents more difficult challenges, requires finer discriminations, and sometimes brings forth uncomfortable nuance. Finally, I will be suggesting that our second and third wave carry with them particles that have at times unsettled us and threaten to do so again. We must not shy away from examining these particulars with their cautionary themes. We must avoid simple reversals that are, in themselves, mere repetitions and do not advance our field.

Psychoanalysis and the #MeToo Movement: The First Wave

I would have thought that there would not be anything in the arena of sexual boundary violations that might garner pride. The prevalence statistics are unacceptably high—12% of all mental health caregivers3 is a conservative estimate. We have had to learn some hard truths—that this is a problem that is not going away and likely never will.

Yet, we do have some aspects to be proud of, and that is that we, at least in America and within psychoanalysis, have addressed the problem of sexual boundary violations within our industry, that is psychoanalysis, better than this problem has been addressed elsewhere. Though the

problem in general will never be fully eradicated (and I will speak of why this is likely to be the case), I contend that we are now in our third wave and have virtually eliminated psychopathic predation within our institutes, one type of sexual boundary violation and the most egregious of the profiles. This is no minor fact and comes from the gradual awareness of the nature of the profiles of sexual boundary violators in their particularities. The history of this growing awareness bears this out.

The #MeToo movement for us—our first wave—began in the early 80s, when the occurrence of sexual boundary violations surfaced as a problem we could no longer ignore (Schoener, et al., 1989). Many courageous women came forward and we will be forever grateful to them. This was an era characterized by victims and perpetrators, the latter mostly psychopathic predators. At this time, our focus went first to the patient/victims. We examined the particular post-traumatic stress syndrome that is associated with sexual boundary violations and found among the cluster of PTSD symptoms an additional symptom—mistrust of mental health caregivers and, consequently, a great difficulty seeking help in subsequent treatments. Though this makes exquisite psychological sense given that their abusers were mental health caregivers, it closes the door, sometimes permanently, to receiving much needed help and reparation. This is a tragic feature that is particular to our industry in the aftermath of this kind of abuse.

Another feature of this first wave is the unavoidable, indeed starkly obvious, finding that the victims/survivors/patients of sexual boundary violations are predominantly women—somewhere in the area of 80%. (Schoener, et al., 1989). This finding became obvious in press releases about sexual boundary violations but has also been well researched in prevalence studies.4 The violators in these cases are the so-called ‘multiple offenders’ who premeditatively exploit numerous women (similar to Harvey Weinstein and Matt Lauer). Given the high number of women who are exploited by transgressors in this category, it appears, from the transgressor's perspective, that the women are psychologically interchangeable and objectified, i.e., they do not carry particularized psychological meanings (tied to their perceived attributes) besides being a

female object of exploitation.5 (This is despite that they often profess being ‘in love’ with one or many of their victims.) Though these predators exploit multiple women and account for a large number of the victims, we have also learned that they actually represent a minority of sexual boundary violators, at least in our profession.

What can be said about the victims of sexual boundary violations outside of the transgressor's perspective, especially in relation to the question of whether there is a characteristic profile or cluster of qualities that are typically found? There is one characteristic (actually a positive and healthy quality) that most, if not all, victims possess and that is the tendency to care for others, to empathically perceive the other's point of view and to provide the care they sense is needed. Sadly, this can play a part in reversing roles. As for other characteristics that may play a meaningful role in the dyadic enactment, these are particularized and do not fall into neat groupings.

I have stated that the particularities of these women are not consequential in the understanding of psychopathic predation, i.e., in the selection by the transgressor of any one woman at any one time. As noted, the women are characteristically diverse, and appear to be objectified and interchangeable in the transgressor's mind, i.e., there is little recognition by the transgressor of the other as a separate subject. This is not to suggest that the psychopathic predator or ‘multiple offender’ (a behavioral description) does not have an intrapsychic personality organization that might be identified and described. However, we simply do not know (from a first-hand evaluative position) what the personality organization tends to look like in terms of internal motivating conscious and unconscious dynamics. These offenders usually refuse to be evaluated, they lie about their involvement with the victims, blame the victims and, because they typically lose their license and are expelled from professional communities, are lost to follow up. For these reasons, we remain unfamiliar with their underlying personality organization at a dynamic level.

Some speculation is unavoidable, however it is derived from behavioral observations and should be held lightly since it is not based on careful,

comprehensive and in-depth evaluations aided by first-person accounts or information derived from in-depth treatments. (This is in direct contrast to the incisive knowledge we have derived from the intensive evaluations and in-depth treatments of the one-time offenders, summarized below.) As noted with regard to psychopathic predators, the behavior manifested in their relationships with the victims reflects the experience of the other as de-particularized and objectified. We can presume that this refers to a primitive level of intrapsychic organization, i.e., relating to others as part-objects, absent of subjectivity and used for (sexual) sensation rather than a more meaningful intersubjective involvement. Given the absence of, or hope for, some kind of unconscious repair, these relationships lead to a seemingly endless repetition of similar engagements. Hence the tendency toward multiple victims.

In some cases, it can be discerned that the exploitation is driven primarily by the predator's desire to degrade the industry/profession. As I have noted elsewhere (Celenza, 2021),

“Other sexual boundary transgressions, especially the most notorious, predatory type, can make use of a displacement object, [the dynamics of which] are more accurately formulated as a displaced perverse scenario. In these cases of sexual boundary transgressions, the effort to degrade is often not primarily directed at the [victim] but is directed at the profession, the body or figure that, in fantasy, oversees the dyad. Hence the frequent use of the symbol of the couch, the icon of psychoanalysis, as a place to enact this scenario.”6

In this sense, the couch can be viewed as a third7 symbolically representative of psychoanalysis. The patient is a displacement object, a stand-in,

so to speak, for an aspect of the setting or context. In displaced perverse scenarios, the primary motivation is the erasure or degradation of the third.8

But we must resist the temptation, again a category error, of importing what we know at a group level and apply it to the particular individual. This may be especially tempting in the case of multiple offenders because of the number of victims involved and due to the absence of particularized information at the individual level. Such importation can occur from other industries where group-based stereotypes abound. For example, cases of exploitation in Hollywood, academia, and politics lead us to ‘toxic masculinity,’ a damning sociocultural stereotype, however prevalence studies have (again) consistently shown (and this is still at the group level) that though the great majority of sexual boundary violations are male/therapist-female/patient pairs, psychopathic predation does not satisfactorily describe the majority of the cases in our industry nor do justice to the dynamic scenarios at the level of particulars required in psychoanalytic discourse. Also, female/therapist-female/patient dyads account for the next most prevalent dyad and there are finer discriminations to be made within these dyads as well. It was the examination of different types of dyads, specifically one-time offenses by both male and female transgressors, that eventuated in the development of our second wave.

From another vertex, the sparseness in the literature on psychopathic predators may reflect a more clinically meaningful phenomenon. It is possible that this ‘negative space’ is a dynamically meaningful absence, that is, a present absence reflecting unrepresented, nonverbal areas in the psyche of these persons. On the surface, as has been noted, the psychopathic predators refuse to be evaluated, tend to staunchly deny responsibility for their actions and worse, blame the patient for the violations. While these behaviors are disturbing externalizations, they also indicate defensive processes likely borne from trauma and reflective of deficits in the capacity to mentalize and internalize conflicts manifested in their acting-out. Perhaps we can look beyond these behavioral observations and speculate, not that they refuse to be evaluated but that

they cannot be evaluated or feel/take responsibility due to the inability to self-reflect, mentalize and thereby be known at a meaningful level. Again, speculatively, we could wonder whether the externalizing and projective defenses are those more familiarly associated with deficits at a structural level, i.e., the turbulence of the unstructured unconscious, rather than conflicts representative of structured, albeit repressed fantasies and wishes.

Psychoanalysis and #MeToo: The Second Wave

In the early 90s, and in what I contend constitutes our second wave, the violators themselves began to be examined at the individual level. I became interested in this particle during this time, in part because I was the Director of Training for Psychology at a Harvard-affiliated teaching hospital and was interested in the gaps in our training for mental health practitioners. By then, I had seen more than a few therapists from a variety of disciplines (no psychoanalysts yet) who had engaged in sexual boundary violations with a patient, and I was intrigued by the similarities among these therapists at the psychodynamic level. I collected data on these individuals at a deep level, data deriving from psychoanalytic treatments or detailed multi-dimensional evaluation processes I was conducting. My focus started at the particle and my findings, which dovetailed with the findings of Gary Schoener et al. (1989) and Glen Gabbard (1991; 1994; Gabbard and Lester, 1995—the only other researchers in this area), played a part in forming the next, our second wave. (Recently, a colleague noted that our focus has predominantly been on the practitioners and violators, while not enough on the victims of sexual boundary violations—she was apparently noticing the features of the second wave and was unaware of the first, when the victims were, in fact, and rightly so, our first order of business.)

I suggest that the second wave was formed when we learned that most male therapist/transgressors are not psychopathic predators. In the mental health field, and I suggest especially among psychoanalytic therapists and psychoanalysts, research consistently shows that the great majority of sexual boundary violators are one-time offenders who exploit one patient, usually over a period of time where the phenomenal, that is conscious experience is one of a mutual rescue fantasy and an idealized, romantic love. Though the truth is more complicated and revealed over

time (perhaps only with subsequent treatment), the idealized love affair is inarguably exploitative and thereby unhealthy from the beginning. Still, it is most often phenomenally experienced as a ‘true’ love affair by both victim and transgressor.

Though the patients may ultimately feel objectified and used (as in psychopathic predation), the tragic truth is that these victim/patients usually do represent an unconsciously meaningful other to the therapist/analyst in very particularized ways. By and large, the relationship, from the therapist/analyst's point of view, engages a grandiose attempt to provide a cure through the purity of their (incestuous) love. I insert the word incestuous here because of the power imbalance, inevitably conjuring the mother-child generational difference and also evoking, for these transgressors, a transferential opportunity to reinstate an unresolved, fantasied omnipotent position of the son (now therapist/analyst) in relation to a depressed and unreachable maternal figure. Not coincidentally, the paternal figure or third is nowhere to be found in this psychic scenario. These women are not objectified and interchangeable (as they are with psychopathic predation) but are very specific transference objects to the therapist, harkening back to unresolved childhood internalized imagoes.9

My work has primarily focused on this group of transgressors. The variety of individuals in this profile span the range of disciplines and are associated with no one modality of therapeutic intervention. Among analysts, there is no difference in prevalence among theoretical orientations. In examining this aspect, it has become clear to me that our theories fail us differently. Our theories, and derivations of technique from theoretical stance, all fail us, but in different ways, so there actually may be some differentiations to be made in type of sexual boundary transgression and profile (correlated with theoretical orientation), but not in quantity or frequency of occurrence (see Celenza [in press] for more detail on this subject).

Another part of the second wave involved the examination of female transgressors and the dynamic underpinnings of this therapist-patient

dyad. For female transgressions, the great majority of victim/patients are female (roughly two thirds). Interestingly, these therapists are not necessarily previously self-identified as gay. The typical dynamic scenario in these cases is also not characterized by psychopathic predation (where the other is interchangeable object) but rather comprises a very particularized reenactment than is unconsciously meaningful to both individuals. The exploitation is again a mutual rescue fantasy, however from the point of view of the female therapist/transgressor, it is an over-identification with the patient in a highly idealized fashion. One female therapist said to me, “She was the child I was. I couldn't stand the pain she was in. I had to help her out of this pain.” This experience reflects the subjective, phenomenal experience and unconscious psychic meaning that the relationship typically has for the therapist. The relationship is also characterized by a stark disregard for differences between the therapist and patient, including an almost total neglect of the patient's aggression.

I have not found any differences between therapists and analysts with regard to the characteristics discussed above. This has been surprising, given the amount of training and the depths of treatment(s) analysts presumably have undergone. I would have imagined greater insulation among analysts against masochistic surrender as well as less vulnerability on the whole to engaging in sexual boundary violations. Barring both of these, I expected at least a greater understanding of their dynamics and intrapsychic (perhaps even unconscious) vulnerabilities to certain kinds of enactments, dependent on their personal histories. This is sadly not the case. On the contrary, I have been surprised at the lack of insight into their involvement with the victim and their ‘love’ for her. Instead, what I have discovered is a specific kind of unidimensional understanding of the transgression, even somewhat concretized and unsymbolized. Only upon subsequent treatment and in-depth reflection do these transgressions become explicated. Many analyst-transgressors have noted deficits in their prior analysis (sometimes analyses) while others have regarded the transgression as inevitable given life circumstances and the like.

Given that the analyst embodies multiple self-states in relation to the patient, we know that the multiplicity of roles can collapse under the pressure of undue desire or need. The perplexity we often feel when a previously competent, even revered analyst comes to describe his role in relation to his patient in an oversimplified, justifying manner is stunning

both in its distortion of the process, but especially for its unidimensionality. The retreat from role or disciplined commitment involves the truncating of self-states, the erasure of other potential modes of being and a psychic shift from analyst-as-multiple to (solely) lover. Here, the boundaries have become impermeable and define a unidimensional mode of relating that is constricted by the retreat from (walling off or erasure of) other potentialities.

One fallibility of such boundary collapse is the emphasis of one particular relational modality to the exclusion of others, as if this mode of relating is discontinuous with other self-experiences. For example, to speak to the baby while discounting, ignoring or otherwise neglecting the adult can be regressive and humiliating. This is a good description of the pressured ways in which transgressing analysts refer to their former analysand/now lover as if the lover mode is the real (and only) mode of relating conceivable (Celenza, 2016, 2021, in press).

This is the primary reason I have come to believe that the vulnerability to sexual boundary violations is a universal vulnerability. Along with this, I will state unequivocally that there is absolutely no responsibility to be borne by the victims of sexual boundary violations. The responsibility to maintain an asymmetrical stance rests solely on the shoulders of the therapist/analyst. Indeed, many of the characteristics of the victims identified as playing a part in the unconscious enactment culminating in sexual boundary violations form the basis of the reason the victim came to treatment in the first place. This only serves to emphasize the responsibility of the therapist/analyst to maintain the frame.

These are the findings that represent the particles of the second wave and characterize the therapists and analysts who engage in sexual boundary violations as they are immersed in various dyads. I group them together along the dimensions of their commonalities, but these findings are not sociocultural, they are psychodynamic, that is, derived from the individual, unconscious meanings of each person and can vary still further upon finer examination of each particular case.10

One salutary finding, in my clinical experience and that of others,11 is that as awareness of these characteristics has spread, there has been a marked diminution of psychopathic predation in our field. I do not mean to suggest that the multiple offenders, i.e., the psychopathic predators, are totally eradicated from our midst, but the occurrence of these types of cases has clearly decreased, at least within American psychoanalytic institutes, to the point where it is rare. I believe our sensitivity and attention to the persistent problem of sexual boundary violations has resulted in this decline due to our zero tolerance for this behavior. But this is only within our field – in the domains of Hollywood, corporate America, academia, and politics, these industries are just getting started and would do well to follow our lead. As I have been noting, I believe these industries are in their first wave and just beginning to address the problem of exploitation of power.

Psychoanalysis and #MeToo: The Third Wave

I believe we are now at the cusp of a third wave. Our attention is turning to the psychodynamics at the level of group and institutional motivating factors and effects—both in terms of fallout (so-called collateral damage) as well as institutional phenomena and cultural factors that may play a part in the instigation of sexual boundary violations. Institutional group-related contributions from various areas of institutional life and its culture can unwittingly encourage enactments of sexual boundary violations. Institutional life involves group effects and political dynamics (corruption, systemic abuses of power, cover-ups, harsh training experiences, etc.) that can affect individuals and play a part in the motivational configuration eventuating in sexual boundary violations. For example, the clergy person cited above (who sexually abused a parishioner on the altar in order to “fuck the church”) had a longstanding, unresolved hostility toward his bishop (along with underlying unresolved childhood resentments with abusive paternal figures). These intersected with ways in which the diocese had been known to exploit their priests along with culturally sanctioned ethics endorsing certain kinds of self-deprivation among its priests. These appeared to have culminated in an unconscious enactment that was aimed to degrade the church. In this way, the sociocultural surround and group membership can represent various types of

thirds that become incorporated into an individual's psyche and motivate unconscious fantasies of revenge.

This implicates the sociocultural milieu of the setting, especially its cultural life. One example in the psychoanalytic ethos is its tendency toward overwork and the neglect of self-care (Celenza, 2010), a feature of our grandiosity that is facilitated at the cultural level but (always) instantiated differently at the individual level. This cultural trend sorely needs to be examined and addressed. Many colleagues have written or are writing about phenomena at this level: Glen Gabbard (2016), Adrienne Harris (2008), Muriel Dimen (2021), Avgi Saketopoulou (2017; 2021), Katie Gentile (2021), Julie Leavitt (2017), Jane Burka (2014), and multiple colleagues at the Psychoanalytic Institute of Northern California (Burka et al., 2019). Perhaps it is fitting that the beginning of a third wave is characterized by our attention to the sociocultural surround in our field—the functional third of the setting, as it were.

These authors have identified circulating particles in our sociocultural surround, especially in psychoanalytic institutes, that serve to contribute to, if not instigate, sexual boundary violations among its members. In my view, these problematic particles include the pathologization of erotic countertransference (Celenza, 2014, in press; Saketopoulou, 2017), intergenerational transmission of unrepresented, uncontained sexuality (Leavitt, 2017), the persistent desexualization of psychoanalytic theorizing (Celenza, 2014), the resistance to recognizing sexual boundary violations as a universal fallibility (Celenza, 2007), the tendency to polarize, vilify, and ultimately expel the universal vulnerability to sexual boundary violations (Celenza and Gabbard, 2003; Celenza, 2007; Gabbard, 2016), and the lack of containment of such vulnerabilities extant in the psychoanalytic institutional milieu (Gabbard et al., 2001; Celenza, 2007; Gabbard, 2016). Indeed, Leavitt (2017) sees the sociocultural surround of our psychoanalytic institutes as already collaterally damaged and thereby unable to provide a holding function.

There are also recent findings comprising the third wave with which we must reckon and these may further unsettle. Still, they must be grasped because they are part of the truth. The unsettling findings to which I refer are twofold: the first is an apparent rise in female transgression. This should not be surprising given the feminization of our field in general.

The second finding that may unsettle is the rise in false complaints.

Illustrative Cases of the Third Wave

In the following, I will mention a few cases that represent typical dynamics and scenarios that are emerging in recent years. These are all recent cases in which I have consulted in one form or another and which I believe constitute our third wave.

First, there is a continuation of the one-time transgression for both male and female therapists and analysts. In America, the typical scenario, as noted above, are cases that involve an idealized, incestuous love affair in a grandiose attempt to love the patient back to health. Interestingly, these cases often involve active suicidality in the patient (Celenza and Gabbard, 2003; Celenza, 2007; Gabbard, 2016) and the seduction occurs at a moment when the therapist believes the treatment is at an impasse—the seduction is used to move the patient away from her suicidality and threat of self-harm. These are the types of cases that involve deep-seated unconscious transferential repetitions on the part of the therapist. Glen Gabbard12 and I believe these types of cases will always be with us, since we are always, at some level, opaque to ourselves and capable of self-deception. Self-care and support through our analytic communities are key to maintaining our balance, especially as we age and face illness, the waning years of our careers, and the challenges of mortality in general.

These scenarios are increasingly engaged in by female therapists and analysts. I mention these cases because they exemplify the kinds of cases that are emerging in recent times in America and not solely within psychoanalysis. I do not mean to imply that the one-time transgressor scenario with a male therapist and female patient has disappeared—this is not true and not likely to ever happen. But as our industry becomes increasingly populated by female therapists and analysts, it makes sense that the prevalence of sexual boundary violations among this population will rise.

Case #1: Female/Female Dyad

A 23-year-old college graduate entered therapy for anxiety and depression revolving around her difficulty finding a job after graduation. After

a few months of treatment where the patient did not seem to be making progress, the therapist suggested she become a control case for her training to become a psychoanalyst. The patient readily agreed, feeling honored and eager to have more contact with the therapist. Soon they recognized a special bond between them and increasingly looked forward to the sessions. There was a striking similarity in their histories (e.g., both had been sexually molested by a neighbor growing up). The slide down the slippery slope was comprised of the therapist's self-disclosures whenever she found an uncanny similarity between the two of them. The therapist also was in the midst of a divorce and found comfort in the solidarity of ‘two women trying to make it on their own.’ The patient welcomed the therapist's disclosures and began to request, even demand them if the therapist was notably silent on a particular day.

The analysis slid irreparably down the slope when the patient requested to put her head on her analyst's lap. This led to fondling and kissing. They had sexual relations soon thereafter. The treatment was terminated but they continued to see each other during the patient's usual hours, each feeling they had finally found their soulmate.

Case #2: False Allegation13

A group of women knew of a male counselor who had recently passed away by suicide. They decided to compose a false complaint against his estate alleging sexual misconduct with one of them, in the hopes of procuring a financial award. Since he was deceased, they knew he would not be able to defend himself and thought this was a way to easily win the case. Unbeknownst to them, a third person overheard their plot and informed the licensing board. (The case was dismissed.)

Case #3: False Allegation

Another case involves an elaborate scheme to vilify a psychiatrist in retribution for his refusal to continue treatment with a bipolar patient after she had refused to comply with her medication regimen. (The termination was part of an explicit contract between him and his patient, agreed upon after multiple hospitalizations, each precipitated by medication noncompliance.) When the patient was informed of the termination,

the patient accused her psychiatrist of sexual misconduct. He was found not guilty of the alleged sexual misconduct but was put on a multi-year probation for inadequate record-keeping. His reputation was badly tarnished given that the complaint was posted on-line.

It is disconcerting but also makes psychological sense that as sexual boundary violations are increasingly adjudicated in the public arena, there will be a rise in false complaints. Unfortunately, as sexual misconduct (and sexual harassment) receive more press (and here is where the #MeToo Movement plays a central role as other industries take up the challenge of exploitation of power), there will be cases where false allegations are used vindictively or as a means to acquire monetary awards. It is now well known that therapists in particular are vulnerable to lawsuits of this kind, but any professional relationship where there is an institutionalized imbalance of power and where the mode of service delivery is essentially or wholly private is subject to this kind of abuse of process.

Case #4: Predatory Psychiatrist Practicing Outside the U.S.

I was contacted by a female psychoanalyst in another country who was trying to find support, reparation and some measure of justice for an egregious sexual molestation that occurred within her training analysis. She was understandably distressed, confused, and was being treated for intense anxiety, depression and episodes of psychotic dissociation. When speaking with me, she repeated herself often, her thoughts were circuitous and she was obviously frightened. At times, I worried that she was mildly thought disordered and worried about her credibility, however her story never wavered despite her obvious difficulty in putting her thoughts together. In addition to helping her find a local therapist, I met with her via skype over a period of two years, playing the role of consultant to her case as I helped her file a complaint and obtain justice for the many ways in which her analyst had violated her: there was sexual exploitation, but he also manipulated her, using her to procure medications for himself (he would write the prescriptions) and coerced her into sadomasochistic rituals in their sexual practice. (This is an example of how some movements may begin, much like the 80s in the psychoanalytic institutes in America and the #MeToo movement around the world. The process usually begins by adjudicating the most egregious and horrific cases.)

A salutary effect of this journey for the woman in the above case was revealed to me by the way in which she grew over time, especially evident at the end, when her analyst was expelled from their institute and had his license revoked. Where she was frightened, confused and prone to psychotic dissociation initially, she is now cognitively clear, her depression has lifted and there is little sign of distress. This case is a good illustration of how seeking truth is healing and depicts how an internal process is strengthened with public acknowledgment and social justice. This is the core of the #MeToo movement and highlights the necessary process of seeking support, reparation and justice.

Conclusion

As psychoanalysts, we should vigorously eschew political correctness and groupthink. At the same time, we are not averse to the subversion of cultural convention. This is a time in our cultural history when we can use our power to influence and create change. We can seize this moment as an opportunity, as exploitations in other industries come under scrutiny. We, as psychoanalysts and psychoanalytic practitioners, have the tools to understand this crisis more deeply and take leadership in accord with these understandings. In this effort, it is important that we not lose our ability to think. We should avoid the temptation to let politics determine our differentiations. We should remain steadfast in the commitment to finding truth by asking more questions and not shy away from complexity. The truth may be uncomfortable and we can bear that as well.

If anecdotal accounts are to be believed, the #MeToo Movement has affected the ways in which men and women converse, do or do not find comfort with each other, and the ease with which they negotiate sexual relations. I have heard that some companies are reacting to the threat of lawsuits associated with alleged sexual harassment by hiring fewer women, a change that is attributed to the #MeToo Movement. Of course, I do not want to be misunderstood as implying that the #MeToo Movement is harmful or bad – my point is to stress that we, in the psychoanalytic industry, should not lose the ground we have worked so hard to cover and progress beyond.

The idea of a universal vulnerability toward sexual boundary violations (especially in later stages of one's career), is derived from the fact that our

work revolves around the experience of love and understanding, indeed that sexual boundary violations are an occupational hazard. This was a hard-won realization subsequent to the examination of the particulars of sexual boundary violations at an individual level. This acceptance came only with the careful examination of the different forms of sexual boundary violations, the elucidation of particular dynamics (from which none of us are immune) and with the sad realization that our work requires a sustained commitment to the asymmetric distribution of attention and gratification (in the sense of understanding) in the analytic relationship. This asymmetry can feel self-depriving under stressful circumstances and especially later in life, becoming more difficult to sustain. Further, it is only with this level of understanding that we can make sense of the disappointing and seemingly continuous reality of the downfall of some of the best or at least most revered analysts among us.

Licensing boards in the United States, in the absence of deeper understanding, remain sometimes harsh and erratic. Psychoanalysts rarely (if ever) have their voices heard in these adjudicatory processes. The #MeToo Movement has exacerbated this problem and, unfortunately, made the allowance for rehabilitation programs far less available. This is a major step backward, but our institutes do not have to follow in their footsteps.

What does this have to do with our everyday practice of psychoanalysis? Sexuality is implicated in everything we do, every moment we experience the world and others. It is the way in which we gaze into the world, grasp it and the way the world receives us. It structures our unconscious (Green, 1995; Laplanche, 1989, 1997). We must not be afraid to let our bodies experience the analytic process, to be present to our patients in our totality, including allowing sexual desire to be present in our countertransference. If we accept the universal vulnerability to sexual boundary violations, we might be tempted to retreat, thereby constraining our analytic stance. But this would mean a retreat from our patients who often need to speak frankly about their sexuality and to re-experience this aspect of their being with us, as the object that cannot be had. If we constrain ourselves, desexualize our being in relation to our patients and desexualize our theorizing as well, our patients will have nowhere else to go. Our work is threatening and difficult, precisely because the psychoanalytic setting is one where the analyst, as the forbidden incestuous

object, is at once titillated and overstimulated while also constantly frustrated through our abiding disciplined stance. This is a set-up for us as well as our patients that requires the utmost ethical responsivity.

Aggression is a force, a form of potency. In this way, unbinding, a form of destruction, is necessary for every creative act. We need to have the full range of potent affectivity at our disposal.

To hold in mind the ubiquity of the erotic in our psychoanalytic project, indeed within the erotic field, is to remind us of the magnitude of our ethical stance and required discipline. This asymmetry is not a given but is comprised of moment-to-moment choices that require constant monitoring against a background of self-care (Celenza, 2016, 2017, in press). There is a universal vulnerability to sexual boundary violations—of this I am convinced—and therefore, we must not pathologize erotic countertransference or view the absence of erotic feeling as a relief or an easy route to neutrality and abstinence. Rather, the absence of erotic arousal in our countertransference should be viewed as a present absence and in this way, problematized. The project of psychoanalysis is to strengthen subjectivity, heal divisions and splits, and construct subjectivities. This is a creative journey that requires both sexuality and aggression.

The analyst is desire that cannot be had, but could be had. The analyst is the object that holds open the space for desire and containment, in the context of full potentialities. We, as analysts are the object that doesn't give itself, and in that, we fertilize the ground in which desire is nurtured. The oedipal defeat is life-giving—the parent that maintains the incest taboo gives the child her life.

Power is an individual challenge, as well as one that may be institutionally or hierarchically conferred. It does not translate into the ‘powers that be’ or ‘received wisdom’ but rather true power that has many registers. There is subjective power, that is the power that one owns and authorizes as a feature of one's personality. This is an aspect of one's subjectivity that we can (usually) phenomenally experience. Then there is another register in which power resides—this is the power that is structuralized. It is a kind of institutional power that is conferred (by both parties) by virtue of one's role in a particular context.

The difference between subjective power and structuralized power is an

important one because practitioners of all mental health disciplines are often confused by the so-called power imbalance inherent in the therapeutic setting. An analyst or therapist does not necessarily experience, on conscious, phenomenal levels, structuralized power. In fact, in the midst of the perfect storm conditions of sexual boundary violations, the therapist/analyst often feels, on a phenomenal, i.e., conscious level, that they have no power. This is a typical example of the experience of structuralized power, inherent in the fabric of the role of being a therapist or analyst, and existing whether or not the therapist/analyst can feel it.

Though the great majority of the accused are men abusing women, there are women represented among the alleged perpetrators and there are instances of same-gendered dyads as well. In the case of men accused by women, we have the dynamic of sociologically conferred power coinciding with institutionalized or structuralized power as well.

Thus, the #MeToo Movement is not for women only. We all need to find our voice, our backbone, and speak truth to power. We could say this is where subjective power challenges institutionalized power. This is the challenge of the #MeToo movement in whatever wave we choose to examine.

Researchers in this area (Gabbard, Schoener, and myself) have exerted enormous efforts toward making the understanding of this problem more sensible and more humane. Our efforts have been as dedicated to helping the victim/patients and therapist/violators as they have been toward enhancing the understanding of this problem for all of us. There are also efforts at prevention by addressing institutionalized problems and those at the level of individual self-care. Let's not forget all we have learned—let's not mistake particulars for the waves.