Sexual Abuse in the Therapeutic Setting: What Do Victims Really Want?

Current research and reflection are bringing new understanding of the meaning and impact of patient-therapist sexual relations. To some degree, this comes from recognizing the similarities this phenomenon bears to childhood sexual abuse and rape. All are life-changing, traumatic, and damaging events that occur in significantly power-imbalanced relationships. While there is finally recognition that it is neither productive nor appropriate to blame the victim, we have not yet established a culture in which victims are freed from self-blame and allowed to believe that patient-therapist sex is always the responsibility of the therapist.

As a victim of sexual abuse by a psychotherapist and as one who has, over the past 8 years, come into contact with several hundred other victims, I present a victim's perspective of what happens, why it happens, and what we in the victim community believe the professional and lay communities can do, on both the micro and macro levels, to continue to change the existing culture. Because I am not a therapist, this article is descriptive rather than interpretive.

An analysis of the phenomenon of patient-therapist sex must ultimately focus on process, impact, and healing, rather than on patient pathology or behavior. Although questions about identifiable and shared characteristics of those most likely to become victims seem to be of understandable concern to those struggling to comprehend the phenomenon, the answers cannot be used to explain the problem