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When michael tansey originally organized this series of papers for a panel at the April 1993 Division 39 meeting, he invited me to serve as a discussant. Because I was already overscheduled to speak elsewhere, I declined the invitation, although with considerable distress that I would miss a rather unique opportunity. I was particularly pleased, then, when given a second chance (the return of the distressed) to comment on these three groundbreaking contributions in the pages of Psychoanalytic Dialogues.
Two of the authors (Tansey and Davies) appropriately invoke the affect of dread in their titles. Erotic countertransference has been the last taboo in psychoanalytic circles. Tansey's historical references amply testify to the sordid array of sexual transgressions in the early years of our field. He is, of course, only skimming the surface by mentioning well-known published cases from the past. Virtually every institute and society harbors “family secrets” involving analysts who have married former patients and others who have referred patients on to other colleagues after engaging in sexual relationships and ending the treatment. The closets of our institutional houses are full of skeletons.
In the same way that awareness of incest has surfaced in recent years, so has the problem of sexual enactments between therapists and patients—professional incest, if you will (Gabbard, 1989a). Because of the difficulties the mental health professions have encountered in attempting to address the problem, 12 states have already criminalized therapist-patient sex, while several others are seriously considering it.
The reasons for our reluctance to grapple with a serious professional